Reconciliation 3.0 Watch – Congress this week passed a reconciliation bill for funding ICE and related immigration enforcement. With the passage of the 2nd reconciliation bill, eyes turn to the potential of a third reconciliation bill. Several House Republicans hope to pass a bill that would combine military spending with cuts to health programs. Cuts have been discussed for Medicaid, Medicare, and the Marketplaces. If a bill emerges, the most likely timing would be passage at the end of July.
Clover & STARS – CMS granted Clover Health a higher Medicare Advantage score (h/t Modern health $) following its lawsuit win, the company announced this week. The higher score would generate $120 million in bonus revenue. The ramifications of the ruling are unclear as CMS hasn’t publicly announced whether it will appeal the decision as well as it’s unclear how it might affect other lawsuits. A judge has already paused CareFirst’s lawsuit over Star ratings to consider the effects of the Clover ruling.
ACA Enrollment – Additional data published by the Commonwealth Fund finds ACA Marketplace enrollment continues to decline relative to last year. State-based Marketplace data shows fewer people paid their premiums, which in turn is causing the enrollment decline.
Social Security/Medicare Trust Funds – The Office of the Actuary released its update on the state of various trust fund solvencies. Overall, the analysis estimated that the Social Security Trust found would no longer be able to pay 100% of scheduled benefits in the fourth quarter of 2032 and the Medicare hospital insurance trust fund would no longer be able to fully fund its obligations in 2033 Both dates were moved earlier primarily because of changes made in last year’s reconciliation bill (OBBBA).
Inflation and Wages – New data showed that inflation surged in May to over 4.2%, the highest level in three years. Higher inflation could have health care impacts and could increase unit costs but also depress utilization as real wages have declined as a result of higher inflation.
