Texas Legislature Begins 2025 Legislative Development

December 10, 2024

EGWP marketplace medicaid Medicare

Texas lawmakers have started filing bills in preparation for the upcoming 2025 Legislative Session, even though the session does not begin until mid-January. As of this week, thousands of bills have already been filed, including bills seeking to address artificial intelligence, telehealth, abortion rights, health benefit mandates, immunizations, and drug coverage. Several bills have also been filed to expand Medicaid health insurance coverage in the state, an issue that is considered unlikely to gain traction despite how much federal funding it would unlock.

GOP leadership has been steadfastly opposed to any expansion of Medicaid, which currently covers mostly children, disabled individuals, and older adults. Texas is expected to have plenty of cash to fund any new mandates, education, and existing Medicaid expenses. State Comptroller Glenn Hegar projected that the state would have a $20 billion surplus at the start of 2025.

legislation

CMS Releases Final 2026 MA Policy and Technical Rule; Declines to Finalize Coverage of GLP-1s

On April 4, the Centers for Medicare & Medicaid Services (CMS) finalized the 2026 MA Policy and Technical Changes rule. Of note, CMS is not finalizing certain provisions from the proposed rule, most importantly the proposal requiring coverage of anti-obesity medications (AOMs) in both Medicare and Medicaid. CMS said that it may address these proposals […]
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April 9, 2025

EGWP marketplace medicaid Medicare

legislation

Budget Reconciliation Process Continues with Senate Consideration of Revised House Resolution

On April 5, the Senate voted 51-48 to pass a modified version of the House-passed budget resolution with reduced deficit reduction targets for Senate committees as compared to the House. Specific to health care, the revised Senate resolution instructs the Senate Finance Committee (SFC), which has jurisdiction over Medicaid, to propose changes that will increase […]
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April 9, 2025

medicaid

legislation

2026 Final Rate Announcement for MA and Final Part D Program Instructions

On April 7, CMS released the Calendar Year (CY) 2026 MA and Part D Final Rate Announcement and the Final CY 2026 Medicare Part D Program Instructions. The Administration strongly defended its focus on fraud, waste, and abuse, while protecting beneficiaries. The final rate notice increases average payments to MA plans by 5.06% up from […]
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April 9, 2025

EGWP medicaid Medicare

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