Health Plan Weekly

One week after announcing sweeping tariffs on nearly every country, President Donald Trump enacted a 90-day pause, sending whiplash through the health care sector as analysts and others struggle to guess how providers and insurers will be affected. 

The pause applies to all countries but China, which saw a 125% hike in tariffs. It also will not apply to pharmaceutical tariffs, which Trump announced are “coming soon.” 

“We’re going to tariff our pharmaceuticals, and once we do that, they come rushing back into our country, because we’re the big market,” Trump told the Republican National Congressional Committee dinner on April 8. 

Reflecting the addition of more recent fee-for-service (FFS) Medicare cost data in its estimates, CMS on April 7 projected that Medicare Advantage plans can expect to see upwards of 5% greater pay next year. After nearly a week of stock market mayhem due to concerns about U.S.-imposed tariffs, major insurers’ stocks soared on the news that an estimated $25 billion in extra MA funds may be available next year. To industry insiders, however, this isn’t necessarily a “rescue” (as Barron’s put it) or a confirmation that the Trump administration is all in on MA.  

The news was released as part of CMS’s Announcement of Calendar Year (CY) 2026 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, an annual notice that must be published by the first Monday in April. The preliminary version of that notice, the 2026 Advance Notice, was released on Jan. 10 by CMS under President Joe Biden. The Biden administration estimated an average change in revenue of 2.23%, or an all-in estimate of 4.33% when accounting for an average risk score increase of 2.10%.  

In 2024, the health care sector reported 14 data breaches that involved more than 1 million patient records, representing almost 70% of the U.S. population, according to an AIS Health analysis of data from the HHS Office for Civil Rights (OCR).

In total, there were 734 health care data breaches that were large enough to report to OCR in 2024, a slight decrease compared to 747 breaches in 2023. However, 2024 was the worst-ever year in terms of the number of patients affected, as a data breach targeting UnitedHealth Group subsidiary Change Healthcare affected an estimated 190 million individuals.

Analysts and investors reacted favorably to CVS Health Corp.’s April 8 announcement that the company had hired a new chief financial officer and expected to “meet or exceed” the 2025 financial guidance it had outlined in February. CVS also hired a new chief medical officer, continuing its executive turnover that began last year and included the ousting of CEO Karen Lynch and Brian Kane, president of the Aetna health insurance subsidiary.  

CVS hired Brian Newman as CFO, replacing Thomas Cowhey, who had been in that role since January 2024 after being the interim CFO for three months when Shawn Guertin took a leave of absence. Cowhey will serve as a strategic adviser to CVS CEO David Joyner, effective May 12. 

Finding a vendor that shares an insurer’s organizational values while enhancing member experience is crucial to getting good return on investment (ROI) from digital health solutions, according to panelists on a recent webinar sponsored by Medicaid Health Plans of America.  

“One of the things that I would say we value is partners who are equally value-based,” said Rebecca Geist, national director of government programs business development for Kaiser Permanente. 

It’s also a matter of ensuring a vendor is “a reflection of our mission and values” and ensuring members retain care and coverage, Geist added.