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Health Care Policy and Legislation

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Regulatory Insights
Making Sense of the Federal Budget Process for Managed Care
02/27/2025
Adam Colborn, JD
The Inflation Reduction Act (IRA) of 2022 was passed as a reconciliation bill. This year, we may have two or more overlapping budget bills. They’re likely to contain some of the most significant legislation of 2025. But how are they...
The Inflation Reduction Act (IRA) of 2022 was passed as a reconciliation bill. This year, we may have two or more overlapping budget bills. They’re likely to contain some of the most significant legislation of 2025. But how are they...
The Inflation Reduction Act...
02/27/2025
First Report Managed Care
Cover Story
What’s Next for Health Care Policy in the US?
11/25/2024
Adam Colborn, JD
With new faces and shifting power dynamics in Washington, concerns about health care policy in 2025 are rising, including potential reform of PBMs, the 340B program, and the IRA, as well as the push for expanded access to innovative therapies...
With new faces and shifting power dynamics in Washington, concerns about health care policy in 2025 are rising, including potential reform of PBMs, the 340B program, and the IRA, as well as the push for expanded access to innovative therapies...
With new faces and shifting...
11/25/2024
First Report Managed Care
Cover Story
Federal Oversight of Managed Care a Priority
03/01/2024
Mary Beth Nierengarten
In 2022, Medicare Advantage plans covered 50% of Medicare enrollees, costing the federal government $403 billion, while 81% of Medicaid enrollees received care through managed care for $254 billion. The Health and Human Services Office of...
In 2022, Medicare Advantage plans covered 50% of Medicare enrollees, costing the federal government $403 billion, while 81% of Medicaid enrollees received care through managed care for $254 billion. The Health and Human Services Office of...
In 2022, Medicare Advantage...
03/01/2024
First Report Managed Care
Cover Story
New Legislation in Washington Focuses on Pharmacy Benefit Managers
11/16/2023
Dean Celia
At least 7 bills targeting PBMs have been introduced this year. Our managed care panel assesses the legislation’s ability to reduce health care costs, as well as prospects for passage.
At least 7 bills targeting PBMs have been introduced this year. Our managed care panel assesses the legislation’s ability to reduce health care costs, as well as prospects for passage.
At least 7 bills targeting PBMs...
11/16/2023
First Report Managed Care
Cover Story
Analyzing the Inflation Reduction Act’s Drug Provisions
12/22/2022
Dean Celia
Pharmaceutical-related measures of the Inflation Reduction Act will be implemented starting in 2023. Will they deliver as promised by the Biden administration and Congressional Democrats? Or will they serve as an impediment to competition,...
Pharmaceutical-related measures of the Inflation Reduction Act will be implemented starting in 2023. Will they deliver as promised by the Biden administration and Congressional Democrats? Or will they serve as an impediment to competition,...
Pharmaceutical-related measures...
12/22/2022
First Report Managed Care
Cover Story
Threat of Gun Violence Goes Beyond Individual Health
08/02/2022
Mary Beth Nierengarten
With the rise of gun violence across the United States, health care professionals and stakeholders across the continuum of care are calling out for recognition of gun violence as a public health issue.
With the rise of gun violence across the United States, health care professionals and stakeholders across the continuum of care are calling out for recognition of gun violence as a public health issue.
With the rise of gun violence...
08/02/2022
First Report Managed Care
Cover Story
ICER's Rare Disease Drug Policy Report Analyzed
05/26/2022
Dean Celia
Experts weigh in on 4 proposed reforms and examine each one's impact on payers, patients, providers, and the pharmaceutical industry.
Experts weigh in on 4 proposed reforms and examine each one's impact on payers, patients, providers, and the pharmaceutical industry.
Experts weigh in on 4 proposed...
05/26/2022
First Report Managed Care

Pipeline Projections

Pipe
Pipeline Projections
Emerging Migraine Treatments Challenge a Mature Market
11/20/2025
Roy Moore
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market...
11/20/2025
First Report Managed Care
Pipeline Projections
Pipeline Projections
Redefining Asthma Management With Emerging Anti-Inflammatories
10/01/2025
Roy Moore
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access...
10/01/2025
First Report Managed Care
Pipeline Projections
The Shift in MS Care as Biologics and BTK Inhibitors Advance
07/25/2025
Roy Moore
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline...
07/25/2025
First Report Managed Care
Pipeline Projections
How Biosimilars Are Shaping RA Treatment and Reimbursement Strategies
04/29/2025
Roy Moore
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline...
04/29/2025
First Report Managed Care
Pipeline Projections
Examining Newly FDA-Approved Anticoagulants and Upcoming Drugs in the Approval Pipeline
02/12/2025
Roy Moore
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate and Editorial Board Member of First Report Managed Care—explores newly approved and existing anticoagulant therapies. He analyzes...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate and Editorial Board Member of First Report Managed Care—explores newly approved and existing anticoagulant therapies. He analyzes...
In this episode of Pipeline...
02/12/2025
First Report Managed Care

Behind the Bill

Behind the Bill
HHS Hits Reset on 340B Rebate Model After Court Setbacks
02/11/2026
Juliet Gallagher
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and...
02/11/2026
First Report Managed Care
Behind the Bill
Funding Package Extends Medicare Telehealth, Enacts PBM Reforms, and Updates Hospital Oversight
02/05/2026
Juliet Gallagher
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President...
02/05/2026
First Report Managed Care
Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care

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