Preitauer Perspective: Q1 2025

Reflections on a Whirlwind Week in Washington 

As we step into 2025, CareSource Mission remains steadfast in our commitment to advocating for our members and sharing the benefits of managed care.

We had an opportunity to spend a week in Washington, D.C., engaging with lobbyists, policymakers and political leaders to address the most pressing issues impacting our industry. 

We had meaningful discussions with key leaders, including U.S. Representative Troy Balderson (Ohio), Senator Bernie Moreno (Ohio), U.S. Representative Mike Carey (Ohio), U.S. Representative Mike Turner (Ohio), U.S. Representative Buddy Carter (Georgia), U.S. Representative Debbie Dingell (Michigan) and U.S. Representative Brett Guthrie (Kentucky). We also met with leaders from Senate Finance committee, Energy and Commerce committee, Medicaid and CHIP Payment and Access Commission – MACPAC Executive Director Kate Massey, CMS Deputy Administrator Drew Snyder, Abe Sutton, Director of the Center for Medicare and Medicaid Innovation and Richard Topping, nominated to be Chief Financial Officer, Department of Veterans Affairs. With a few additional staff briefings and some key industry dinners, it was an insightful and productive week.

Here are some key takeaways: 

Medicaid Cuts May Not Be as Severe as Expected 

Congressional leaders were very candid about the current state of proposed Medicaid cuts. Many acknowledged that the proposed cuts will go through numerous rounds of revisions, and they predicted the cuts will be much less severe than initially proposed. 

While reductions remain on the table, and we do expect some level of change, we value the time and attention we received from legislators who are weighing these difficult decisions. I’m confident our proactive advocacy efforts on behalf of our members and the managed care industry were heard and appreciated. This is exactly why our advocacy matters. Thank you for your continued support, which makes it possible to open doors with legislators and have these types of valuable conversations. 

Work Requirements in Focus 

The conversation around Medicaid work requirements is gaining traction, though there’s reason to believe it will move forward through state waivers rather than a sweeping federal mandate. Because we have worked in states with Work Requirements, we have experience in implementation if they happen across multiple states.

Fraud, waste and abuse are also taking center stage as a target, with numbers floating significantly lower than the $880 billion circulating right now. As federal and state leaders explore ways to tighten financial controls, CareSource Mission stands ready to demonstrate the value of CareSource’s mission-driven model to deliver superior health outcomes with integrity and operational excellence. 

While there was no discussion on legitimately making changes to the Federal Medical Assistance Percentage (FMAP), provider taxes and per capita caps were mentioned. We will continue monitoring developments to ensure that CareSource Mission remains at the forefront of these critical conversations.

Building Strong Relationships 

I’m proud to say we’re making meaningful progress in expanding CareSource Mission’s presence in D.C. Both lobby groups we have in place — Guidepost (Military/Veterans) and Alpine (Medicaid & healthcare policy) — have been instrumental in navigating conversations. 

We’ve made strong inroads with leaders from Ohio and Georgia. The meetings  were meaningful and we felt each congressman left with a deeper appreciation of our work in their state. One very interesting conversation was about CareSource’s capabilities and impact in claims payment and employment services. The Chairman of Energy and Commerce Committee was intrigued and sought additional information in both areas. Our meetings with Michigan and North Carolina representatives proved to be strong door-openers for us in those markets.  

We were also pleased to meet with Drew Snyder, former Mississippi Medicaid Director and current Deputy Administrator at CMS. Reconnecting with a familiar face who understands and appreciates CareSource’s mission is yet another example of the importance of building strong relationships at the state and federal levels. 

Final Thoughts

As we wrapped up our week of meetings, I left Washington with optimism. While there is still uncertainty around how budget negotiations and policy shifts will play out, CareSource is well-positioned to manage the likely changes ahead.

As our engagements continue to grow and strengthen throughout 2025, so will our impact on shaping health care policy. 

Thank you for your support of our advocacy work as we navigate this evolving landscape.