November 24, 2025
Attached please find a new one-pager from Medicaid Matters NY discussing the likely impacts of the implementation of HR1 – the OBBBA, on New Yorkers with Medicaid insurance. The document is attached in English and also in Spanish.
Breaking News from Politico – 11/24 The White House expects to soon unveil a health policy framework that includes a two-year extension of Obamacare subsidies due to expire at the end of next month and new limits on eligibility, Politico reports.
Punchbowl News: Inside the GOP talks on Obamacare, 11/21
Republican senators have been privately lobbying President Donald Trump to support a limited short-term extension of Obamacare subsidies, arguing it would save the GOP from a 2026 drubbing, and buy time for Congress to pass a longer-term health care plan that mirrors the president’s preferences.
Sen. Katie Britt (R-Ala.) has spoken with the president several times this week to pitch the idea, according to multiple sources familiar with the matter.
Britt and other GOP senators, some with different views on the subject, were scheduled to meet with Trump on Thursday, but we’re told the meeting was canceled for unrelated reasons.
The pitch comes as senators are staring down a mid-December deadline to have a bill ready for floor action — a commitment Senate Majority Leader John Thune made as part of negotiations to end the government shutdown.
Trump’s involvement is critical to secure enough GOP support in both chambers for any health care bill, especially one that renews an Obamacare policy. The effort to sway Trump on a two-step process also highlights the urgency many Republicans feel about finding a solution to address the year-end cliff, rather than turning the floor votes into doomed-to-fail messaging exercises. “I see the political shop on the Democratic side just churning up all the very sympathetic stories that are gonna result if we don’t come up with a reasonable plan,” Sen. Thom Tillis (R-N.C.) warned.
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HR 1 (OBBBA) Consequences
OPIOID SETTLEMENT FUNDS
Some state lawmakers said they’ll consider using opioid settlement dollars to backfill federal cuts to recovery programs in next year’s budget, while others plan to fight hard for other solutions to avoid tapping into the fund, State of Politics reports.
ANTICIPATED COVERAGE LOSSES
H.R. 1 requires states to impose greater administrative burdens on people eligible for Medicaid expansion coverage. CCF’s tracker shows that many states are already struggling to keep up with eligibility and renewal demands. Warning signs – including long call center wait times, low rates of “ex parte” (automated) renewals, and long processing times for new applications – point to risks of widespread, avoidable coverage losses. States underperforming on several of these eligibility and enrollment performance measures will face additional system and administrative challenges when implementing policy changes mandated by H.R. 1. Read CCF’s report and check out the tracker to learn more. (CCF, 11/24)
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MEDICAID MANAGED CARE & INSURANCE COMPANIES
Threatened by looming cuts from President Donald Trump’s tax law and persistently rising costs, some health insurance companies are reconsidering their Medicaid managed care positions. Last week, Medicaid market share leader Centene announced that it lost a $5 billion Medicaid contract in Florida and decided not to bother appealing. By opting to give up on a large Medicaid market, Centene may be the canary in the coal mine for the sector, said Darren Michael, director of research and analytics at Forte Analytics, a healthcare insights firm. UnitedHealth Group subsidiary UnitedHealthcare and Elevance Health have also threatened to abandon certain states over what they deem insufficient payments. Through the first three quarters of 2025, Medicaid insurers are collectively reporting the highest medical loss ratios in at least five years. The share of premiums spent on Medicaid claims has reached 92% this year, according to an analysis by the investment bank TD Cowen. Just 42% of Medicaid managed care contractors reported gains on operations last year, the lowest in at least 12 years, TD Cowen reported. “We think it will get worse before it gets better,” said Michael Ha, a senior research analyst at the financial services firm Baird. UnitedHealthcare and Elevance Health anticipate Medicaid profitability will bottom out in 2026 then rebound in 2027. Molina Healthcare identified the worsening environment as an opportunity to acquire smaller, struggling insurers. As during the post-pandemic “unwinding,” the vast majority of those losing Medicaid this year are caught up in so-called procedural disenrollments. More than seven in 10 are off the program not because states determined they weren’t eligible but because of missing records or other red tape issues, according to an analysis from the Georgetown University Center for Children and Families.(Tepper, 11/19)
Here’s a gift link to the full article from Modern Healthcare, 11/24:https://www.modernhealthcare.com/insurance/mh-unitedhealth-group-centene-elevance-medicaid/?utm_id=gfta-ur-251124&share-code=H6ITTX3C7FAKVG3MXFUQMMPSOA&user_id=5621336&customer_secondary_source=aac_articleGifting
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NYC MAYORAL TRANSITION
CITY & STATE, 11/24
GOVERNING BY COMMITTEE: Mamdani plans to unveil 17 committees staffed by more than 400 appointees as part of his transition effort today. (While that sounds like a lot of people, it’s roughly half the size of Adams’ 2021 transition.)
“A love for hard-work, a deep belief in the promise of New York City, and a commitment to the affordability agenda that New Yorkers are demanding unite the more than 300 experts we have appointed to our Transition Committees today,” Mamdani said in a statement. “By helping us recruit top talent and develop smart policy, these Committees will be instrumental to ensuring we hit the ground running on January 1st — and that our results align with the promises we’ve made.”
The democratic socialist will have committees covering housing, transportation, community safety, economic development, government operations, immigrant justice and technology, among others. Appointees will advise on potential hires and policy.
Two committees, one on worker justice and another on community organizing, have not been part of previous mayoral transitions, Mamdani’s team noted. — Joe Anuta