政策变化：聚焦医疗补助、税收、最惠国待遇、覆盖范围；医院-，医疗技术+ -
USA | Medical Supplies & Devices Policy Changes: Medicaid, Tax, MFN, Coveragein Focus; Hospitals-, MedTech+/- We hosted Sam Cappellanti, Principal at Meridian Research, who walkedthrough potential policy changes impacting the HC landscape, includingimplications of President Trump's Big Beautiful Bill (BBB). Key takes: 1)Medicaid cuts to remain largely intact, -ive for Hospital margins; 2) corp tax TWsexpected, +ive for MedTech, Pharma, and Hospitals; 3) Medicare cuts unlikely;MFN (drug pricing) a bit of a black box and could take different forms. BBB Senate Version Likely similar to the House; Senate targeting July 4 for Language; Meridianexpects the bill to pass by August recess.Core framework could mirror the House's version, butthe Senate's draft is likely to be more fiscally expansive, with broader tax relief and fewer deficit-reduction measures, including fewer Medicaid cuts. The Senate could complete its version as soon as this week, setting the stage for July to be focusedon reconciling differences. Our KOL has high conviction that it will be finalized before the Augustrecess (20–30% chance of a modest delay to ~Sept). Medicaid Provisions Likely Softened in Senate Version, Particularly Provider Taxes & SDPs; ButRisk from Admin Changes Remains. Our KOL noted that of the House's proposed ~$800B inMedicaid savings, $600B stems from eligibility restrictions, which Senate Republicans broadlysupport, while the remaining $200B, tied to provider taxes and SDPs, could face pushback.TheKOL's base case is these provisions will be softened or removed in the Senate version, potentiallyreducing total cuts to $500–$600B. In rough math, Meridian believes these changes could hit an avg. hospital's margin by ~1% (Avg.hospital $250MM in revenue, 20% from Medicaid, 5% OM), given a ~3% cut in Medicaid revs(70bps) and higher uncompensated care costs (30bps). CBO has projected a combined 16MMcovered lives lost from ACA and Medicaid changes in the recon bill (50/50) over 10 years. The Bill eliminates drastic changes to the treatment of foreign income that would otherwisecreate a tax HW in '26+.Our KOL believes these have a high probability of remaining in the finalverison and highlighted GILTI, FDII, & BEAT. For reference, BSX (Buy, Taylor) has called out that thesunsetting of such elements (primarily GILTI) would create a 200-300bps HW on '26 tax rates anda 2.5%-4% impact on '26 EPS. Brian Tanquilut * | Equity Analyst(615) 963-8338 | btanquilut@jefferies.com The Bill's proposal of immediate deductibility of short-and long-lived assets benefits domesticcapx, from equipment to production facilities (+ for MedTech, Pharma, Hosp. CAPX).The Bill's100% bonus depreciation remains in full effect for qualified investments from 2025 through 2029.Similar immediate deductibility is extended to domestic R&D, a tax TW.This compares to thecurrent 5yr domestic amortization, and foreign amortization that would remain at 15yrs. Matthew Taylor, CFA * | Equity Analyst1 (212) 778-8721 | matt.taylor@jefferies.com Young Li * | Equity Analyst+1 (212) 778-8671 | young.li@jefferies.com Michael Sarcone, CFA * | Equity Analyst1 (212) 778-8606 | msarcone@jefferies.com Other Items:• Michael Toomey, CFA * | Equity Analyst+1 (212) 708-2630 | mtoomey2@jefferies.com MFNis a black box. There are a number of 232 investigations running, and the administrationis signaling that tariffs in response are forthcoming (possibly by the end of June). Meridianbelieves that by the end of June, 232 tariffs on Pharma could be rolled out, though it's hardto speculate what this could look like. We could see language leading the industry to engagein voluntary cuts, but with penalties/scorched-earth policies if these do not materialize. Thesewould likely start in a more limited CMMI model. Matthew Aspro * | Equity Associate+1 (212) 323-3907 | maspro@jefferies.com Meghan Holtz * | Equity Associate+1 (212) 708-2876 | mholtz1@jefferies.com •MedTech is unlikely to be wrapped up in 232 tariffs and Meridian believes that broader tariffexemptions for MedTech products are possible.•Medicarecuts don't have much momentum (MA cuts unlikely) and site-neutral legislation have< 40% probability & only in modest form (e.g., drug administration). Company Valuation/Risks Boston Scientific Corp Our $122 price target is based on 37x our 2026E EPS. Downside risks include pressure on elective procedures, macro headwinds, product delays,higher taxes and tariffs, TAVR delays or US program shutdown, and share loss due to increasing competition, especially in PFA/EP. Analyst Certification: I, Brian Tanquilut, certify that all of the views expressed in this research report accurately reflect my personal views about the subject security(ies) and subjectcompany(ies). I also certify that no part of my compensation was, is, or will be, directly or indirectly, related to the specific recommendations or views expressedin this research report. I, Matthew Taylor, CFA, certify that all o
