October 9, 2025

Oz offered his perspective across the ACA, Medicaid, and Medicare. On the ACA, he voiced support for a clean continuing resolution and suggested delaying decisions on subsidies until CMS subject matter experts return to work. On Medicaid, Oz reaffirmed his support for work requirements and said CMS is partnering with states to develop platforms for tracking compliance. Regarding Medicare, Oz emphasized that CMS remains committed to RADV audits but declined to comment on whether he supports Medicare coverage of GLP-1s.

Providers have long criticized CMS for being slow to address complaints and are urging regulators to strengthen enforcement to ensure insurers pay claims promptly after disputes. A lapse in funding could further delay the review and processing of complaints, creating yet another obstacle for consumers seeking timely resolution.

While falling premiums may appear favorable to beneficiaries, the contraction in plan availability could limit choice and shift risk toward increased cost-sharing or narrower formularies. This underscores the need for scrutiny of benefit changes beyond just the price.

While early metrics like 250,000 referrals and high appointment follow-through suggest strong uptake, sustained success will depend on continued interoperability, provider adoption, and integration with social services.

Although shifting procedures toward lower-cost ASCs could generate significant savings, insurers must still negotiate provider networks carefully and assess trade-offs related to access, capacity, and quality.