Budget Bill Latest
Congress’ energy continues to be focused on a budget bill. Congress has until the end of the month to pass a budget. One of the largest points of contention is the extent to which an extension of enhanced premium tax credits for the individual market are included. It’s also possible that the budget bill will serve as a vehicle for potential changes such as limiting the upcoming CMMI demonstration around using prior authorization on FFS (the WISeR model)
PI Rule Injunction Ramification
CMS announced that in response to the recent injunction against portions of the Program Integrity rule that issuers with plans now out of compliance, due to AV de minimis issues, would be required to resubmit plans during the September 30/October 1 data window. Unless a stay is approved by September 19th, CMS will not certify plans that did not comply with the injunction ruling.
Economy Updates
New data released this week points to increasing signs of potential stagflation for the US economy. Inflation increased to 2.9%. Jobless claims rose the highest levels since 2021. For healthcare implications, providers/insurers could simultaneously face higher than normal trends while simultaneously dealing with a higher number of uninsured. Stagflationary environments are often more durable than other economic downturn environments.
Prescription Drug Updates
- The Trump Administration announced it would be scrutinizing direct to consumer advertising for pharmaceuticals.
- The Trump Administration is considering restricting medicine from China which could impact both generic drugs and experimental treatments.
