Wakely Wire

September 25, 2025

New Insights

Events & More

Newsworthy Findings

Bonus Article

Just for Fun

New Insights

Whitepapers, briefs, press releases and more

By Karan Rustagi

Navigating the Post-Subsidy Cliff

A Consumer-focused Analysis on Mitigating Premium Increases After the Expiration of Enhanced ACA Subsidies The expiration of enhanced premium subsidies under the Affordable Care Act (ACA) Marketplace on December 31, 2025, will cause a significant increase in health insurance premium contributions for millions of Americans. This white paper analyzes the financial impact of this change ... Continue reading

By Michael Cohen

Week in Washington 09/25/25

Shutdown Washington was focused this week on the potential shutdown. Absent an approved budget, the federal government will shut down at midnight. While essential programs and services will continue, non-essential services will be closed. This often means that even essential services are diminished (i.e., it’s recommended to get to the airport early as getting through ... Continue reading

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Events & More

Join us at HMA’s National Conference, Adapting for Success in a Changing Healthcare Landscape, October 14-16 at the Four Seasons New Orleans.

Federal policy is shifting, and the effects are showing up fast in state markets, health plans, contracting, and care delivery. For those focused on the effects and implementation of federal policy changes, this is an opportunity to engage with leaders shaping the future of healthcare.

Online registration ends on October 10. Use code FLASH25 to activate your limited-time discount of 25% off the cost of registration.

Learn more and register.

Newsworthy Findings

Disparity in Vaccine Access Between States Roils Patients, Providers

Recent changes to federal guidance on COVID-19 vaccinations have providers worried about what’s to come. “We have opened a door to not using science to guide care,” one physician said.

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Editor's Note

Access to COVID-19 vaccines has been sharply curtailed in some states following HHS Secretary Robert F. Kennedy Jr.’s decision to remove the shot from the CDC’s vaccine schedule for healthy children. The move has deepened partisan divides: Democratic-led states have rushed to issue executive orders protecting access, while others have scaled back availability.

States Should be Full Steam Ahead on Medicaid Work Requirements, Experts Say

There’s a lot that states want the CMS to weigh in on. But given the tight rollout timeline for the controversial mandates, they shouldn’t delay.

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Editor's Note

States face a 2027 deadline to implement Medicaid work requirements—but the challenge is more complex than it appears. Overhauling eligibility and data systems, expanding outreach and education, and monitoring compliance will all demand significant resources. State officials are also pressing CMS for clearer guidance on exemptions, particularly around the classification of “medically frail” populations.

CVS’ Omnicare Division Files for Bankruptcy

CVS’ pharmacy services subsidiary was hit with a $949 million judgment in July. The Ch. 11 process could delay the government from recouping the funds.

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Editor's Note

Omnicare, a pharmacy services subsidiary of CVS that provides pharmacy services to long-term and post-acute care facilities, was ordered to pay $948.8 million in penalties and damages. It was determined that the company was illegally getting money from the U.S. government for prescription drugs.

Privia Acquires Evolent’s Value-based Primary Care Unit for $100M

It’s an opportunity for Privia to further increase its shared savings from Medicare’s largest value-based program.

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Editor's Note

Privia Health is one of the biggest physician enablement companies in the U.S., with a footprint in 15 states and Washington, D.C. It is now acquiring a value-based primary care business from Evolent Health as it continues to expand its care delivery network into new geographies.

UnitedHealthcare Launches Direct-to-Consumer Marketplace for Health and Wellness Programs

UnitedHealthcare has unveiled a direct-to-consumer portal for commercial members to buy additional benefits that may not be covered by their employer.

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Editor's Note

Employers have traditionally struggled with member uptake of such programs when they’ve been made available. Hosting a range of options in a single marketplace could give patients an opportunity to self-select into what interests them. But it’s not a replacement for actual insurance, UnitedHealthcare warned.

Bonus Article

‘Hairy’ Deep-Sea Coral Species Newly Discovered is Named After Chewbacca

The coral itself was first recorded in the wild in 2006, but at the time it was not officially described as a distinct species. Only after further research, including genetic analysis, did scientists confirm its uniqueness and formally recognize it as a new species in a peer-reviewed study.

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Just for Fun

Math Joke:

What function is used to model an actuary’s journey to work each day?

Prior Week

Q: What does a statistician name their daughter?

A: Emily (MLE)

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