Top of the Funnel: Macro + Earnings
Medicaid Redeterminations. ELV (+), UNH (+), MOH (+), CNC (+) CMS has identified and ordered states to move to correct a glitch in their redeterminations. Apparently, states were terminating an entire household if only one person failed to provide information on an ex parte basis. The most affected group is children. About 500k will be reinstated.
PFE. On Wednesday, I will be analyzing PFE’s vaccine and Paxlovid ambitions for the 2023-24 flu season. Early signs suggest it will not meet expectations and the base business doesn’t look poised to correct that. I hope you can join our call on Wednesday, September 27th @ 10 am. (Add to your outlook calendar)
CONGRESS
The Primary Care and Workforce Act. AMN (-) This major health legislation cleared the Senate HELP Committee with some controversy over budgetary offsets. For our purposes of the legislation is to expand federal support of the health care workforce. Most of the bill is reauthorizing existing programs and, in some cases increasing the funding.
The intent is to increase funding for graduate medical education and support the training of nurses and physicians, including those in rural areas.
Even Democrats have been critical of offsets, the biggest of which includes taping the Prevention and Public Health Fund which supports things like immunization smoking cessation programs, especially at the CDC.
Other offsets include a few things we need to know more about like telehealth facility fees, anticompetitive insurance contract clauses and pharmacy benefit manager services fees.
These workforce programs are an incremental positive for the health care workforce but the uptake can be frustratingly slow. The effects may not be known for a couple of years.
THE WHITE HOUSE
More Tests. PFE (+) The White House plans to spend $600M to buy more COVID tests and distribute them for free. The impetus is probably the availability of money designated for this purpose.
The move is a net benefit to PFE. Prescriptions for PAXLOVID tend to follow infection trends. The more known infection, the more PAXLOVID. There appear to be a substantial number of doses available so a related benefit is clearing the shelves to make way for either new government orders or full commercialization.
OTHER STUFF
Another Impeachment. Attorney General Ken Paxton was acquitted by the Texas Senate on a host of charges, mostly unrelated to health care. Paxton is a firebrand and no doubt controversial, but he won handily.
Related to health care has been Paxton’s ongoing interest in the pharmaceutical industry. He has launched inquiries into COVID vaccines, drugs used to treat what is referred to as “gender affirming care” in minors and role of pharmacy benefit managers in price increases.
In interviews after the trial, Paxton mentioned his acrimonious relationship with the industry as a possible cause for his recent troubles. It is an accusation that is making the rounds.
Crazy? Maybe.
Have a great weekend.
Emily Evans
Managing Director – Health Policy
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