Outlook

• The proposed rule sets $32.8409, a 1.68% cut, mainly because 2026's one-year 2.5% increase expires.
• From CY2022 to CY2026 the final conversion factor stayed within 0.06% of the proposed one; the largest gap since 2021 was +0.46%. Matching 2026 would take about +1.7%.
• The final rule has been under OMB review since September 29, 2026; the last five final rules appeared between October 31 and November 2.

Resolves yes if: Yes if the conversion factor for non-qualifying-APM clinicians in the CY2027 PFS final rule (CMS-1848-F), as published, is below $33.4009. Later legislation does not count.

Sources: CMS-1848-P (CY2027 proposed rule) · OIRA rules under review

• Congress raised the conversion factor after the final rule for 2021, 2022, 2023 and 2024 (the 2024 change was signed March 9, 2024). It did not for 2025, and 2026's increase came in a July 2025 law before the rule.
• As of October 21, 2026 no bill restoring the expiring 2.5% has moved. H.R. 9693 (65 cosponsors) would give an update of MEI minus one point but sits in committee.
• The current stopgap funding law runs to December 11, 2026 and has no physician-payment provision; the next funding bill is the likely vehicle, as in past years.
• The forecast weights the four earlier fixes against the two most recent years without one.

Resolves yes if: Yes if a law signed by March 31, 2027 increases the CY2027 PFS conversion factor, or payment for most PFS services, above the final rule's level for any part of 2027.

Sources: H.R. 9693, Patients First Act of 2026 (text) · Pub. L. 119-103 (continuing appropriations to Dec. 11, 2026) · CMS-1848-P (CY2027 proposed rule)

• SB 301 is backed by the Ohio State Medical Association, Ohio ACEP and the Ohio Osteopathic Association and has had committee hearings. The Ohio Chamber of Commerce opposes it and the general ban SB 11.
• Neither bill has passed a chamber, and both die when the General Assembly ends on 2026-12-31. Lame-duck sessions pass many bills, but a bill still in committee in late October has little time left.

Resolves yes if: Yes if, by 2026-12-31, both chambers of Ohio's 136th General Assembly pass a bill that bans or limits non-competes for physicians or a broad class of them, and it becomes law by 2027-01-31.

Sources: Ohio SB 301 (136th General Assembly) · Ohio SB 11 (136th General Assembly)

• Since dropping its nationwide rule in September 2025, the FTC has brought three worker non-compete or no-hire cases in about 13 months: pet cremation, building services and pest control. None was in health care.
• In September 2025 it sent warning letters about clinician non-competes to large health care employers and staffing firms, and its request for information singled out health care. No report on that request had appeared by 2026-10-21.
• Against: the Commission has two sitting members, both Republican. The chair has said the agency lacks the power to ban non-competes nationwide, and the Rollins statement calls for "exacting proof" under a case-by-case test.

Resolves yes if: Yes if, between 2026-10-21 and 2027-06-30, the FTC or the Justice Department publicly files a complaint, announces a proposed or final consent order, or sues over non-competes that a health care employer or staffing firm imposes on physicians or other clinicians. Warning letters, workshops, reports and merger-decree conditions do not count.

Sources: FTC: health care non-compete warning letter · FTC: request for information on non-competes · FTC: Rollins final consent order (2026-06) · Chair Ferguson's prepared remarks, non-compete workshop

• Both parties have passed the same ban. SB 378, covering patient-facing providers, passed both chambers in 2025 and was vetoed over an emergency-room billing provision; the veto message does not mention non-competes. Gov. Lombardo's own SB 495 carried the same ban and passed the Senate 13–8 before the session ended.
• Health care bills that passed one chamber and came back the next session became law in 2 of 3 recent cases (Texas and Oregon in 2025).
• Against: Nevada has now failed twice, in 2023 and 2025, each time because the ban rode in a larger bill that failed for other reasons. None of the 612 bill-draft requests for 2027 named non-competes as of 2026-10-16, though most titles are generic.
• Overriding the SB 378 veto needs 14 of 21 Senate votes and 28 of 42 Assembly votes; the bill got 12 and 27 in 2025, so an override alone is unlikely. The 2027 session runs 2027-02-01 to 2027-05-31, and the 2026-11-03 governor's race decides who signs.

Resolves yes if: Yes if, between 2026-10-21 and 2027-07-31, Nevada enacts a law (including by veto override) that bans or limits non-competes for physicians or for patient-facing health care providers.

Sources: Nevada SB 378 (2025) · Nevada SB 495 (2025) · Governor's veto message on SB 378

• H.4767 would void physician non-competes while letting employers recover documented relocation, training and bonus costs. It passed the House 58–53 on 2026-03-26 and was reported favorably by the Senate Labor, Commerce and Industry Committee on 2026-05-05, but the Senate never voted.
• The bill must be refiled for the session that runs 2027-01-12 to 2027-05-13. Health care bills that passed one chamber and came back the next session became law in 2 of 3 recent cases.
• Against: the House margin was five votes, hospital systems such as McLeod Health testified against it, and 2027 is the first year of a two-year legislature, so the bill can carry into 2028 instead of finishing in 2027.

Resolves yes if: Yes if, between 2026-10-21 and 2027-07-31, South Carolina enacts a law that bans or limits non-competes for physicians.

Sources: S.C. H.4767 (2025–2026) · Live 5 News: lawmakers debate physician non-compete ban (2026-05-05)

• States enacting a physician-reaching limit, by signing date: 5 in 2023, 3 in 2024, 7 in 2025 and 5 in 2026 (Maine, Utah, Virginia, Vermont, with Washington's general ban).
• About 30 jurisdictions still have no physician-specific limit. Among states without one, 7% to 17% enacted one each year from 2023 to 2026, which points to about 4 or 5 states in 2027.
• Every legislature meets in 2027, including Nevada, Texas, Montana and North Dakota, which skip even years. The highest count, 7, came in 2025, the last odd year.
• Against: 2027 starts a new two-year legislature in most states, so 2025–26 bills must be refiled, and the states left include several where hospital associations have stopped bills repeatedly (Missouri, Mississippi, Florida, Wisconsin).

Resolves yes if: Yes if at least three states (DC counts) enact, during calendar year 2027, a law that bans or limits non-competes for physicians generally or a broad class of physicians. Counted by the date a law is signed, becomes law without a signature or is enacted over a veto. A law that tightens an existing physician limit counts. Laws limited to one employer, to staffing firms or to non-physician professions do not count, and neither do laws signed before 2027 that take effect in 2027.

Sources: Becker's ASC: physician non-compete crackdown, a 50-state guide (2026-09-22) · Maine LD 2200 (2026) · Utah HB 270 (2026) · Virginia HB 627 (2026) · 21 V.S.A. § 495q (Vermont)

• Five or more states did this in 2023, 2025 and 2026, and three did in 2024.
• The pool is shrinking: the states that acted in 2023–2026 were mostly ones where medical societies and hospitals reached a deal, and the remaining states include several where hospital opposition has held for years.
• The likeliest 2027 enactments are in states where a bill already passed one chamber: Nevada and South Carolina. Reaching five needs at least three more states with weaker starting positions.

Resolves yes if: Yes if at least five states (DC counts) enact, during calendar year 2027, a law that bans or limits non-competes for physicians generally or a broad class of physicians. Counted by the date a law is signed, becomes law without a signature or is enacted over a veto. A law that tightens an existing physician limit counts. Laws limited to one employer, to staffing firms or to non-physician professions do not count, and neither do laws signed before 2027 that take effect in 2027.

Sources: Becker's ASC: the state-by-state non-compete crackdown, 15 updates (2026-07-21) · Becker's ASC: physician non-compete crackdown, a 50-state guide (2026-09-22)

• Illinois' general non-compete law voids non-competes only for workers earning $75,000 a year or less ($80,000 from 2027), which leaves out nearly all practicing physicians.
• House Labor & Commerce has advanced three bills that would reach physicians (HB 2561, 19–8; HB 4565, 18–9; HB 3213, 16–3), but none has had a floor vote. They stay alive through the fall veto session and January lame-duck days until the new General Assembly convenes on 2027-01-13.
• Physician-reaching bills that got committee action became law 12 of 27 times in 2025–26. These have sat in the Rules Committee for months, and after 2027-01-13 they must be refiled.

Resolves yes if: Yes if, between 2026-10-21 and 2027-12-31, Illinois enacts a law that bans or limits non-competes for physicians generally or for physicians employed by hospitals or health systems.

Sources: Illinois HB 4565 · Illinois HB 2561 · Illinois HB 3213

• The Senate passed a ban covering health professionals at any pay in 2025 (S4641A, 40–22) and 2026 (S9759, 40–21). The Assembly Labor Committee acted on neither.
• Gov. Hochul vetoed a broader ban in 2023, objecting that it had no salary threshold. She is on the 2026-11-03 ballot.
• General bans that passed one chamber became law 3 of 9 times since 2023, and three of the six failures were New York's.

Resolves yes if: Yes if, between 2026-10-21 and 2027-12-31, New York enacts a law that bans or limits non-competes for physicians, whether in a general ban or a health care bill.

Sources: N.Y. S4641A (2025) · N.Y. S9759 (2026)

• A1647 would void physician geographic restrictions, with exceptions. It was referred to the Assembly Health Committee on 2026-01-13 and has had no hearing. It and the general ban A1829/S1407 stay alive until the session ends on 2028-01-11.
• No physician-reaching bill that lacked a hearing or committee vote became law in 2025–26 (0 of 18).
• The previous session's physician bill never got a hearing. A general ban cleared Assembly Labor in December 2025 and expired a month later.

Resolves yes if: Yes if, between 2026-10-21 and 2027-12-31, New Jersey enacts a law that bans or limits non-competes for physicians, whether in a general ban or a physician bill.

Sources: N.J. A1647 (2026) · N.J. S1407 (2026)

• $16,400 is a 2.76% rise. The guidelines move with the change in annual-average CPI-U from 2025 to 2026.
• CPI-U for January–September 2026 averaged 3.35% above the same months of 2025, and September alone was 3.74% higher.
• The one-person figure has differed from the CPI change by up to about a point (2026: +1.98% against 2.63%), which keeps the forecast below 90%.
• IBR protects 150% of the guideline from payments; RAP does not use it.

Resolves yes if: Yes if the 2027 guideline published in the Federal Register for a one-person household in the 48 contiguous states and DC is $16,400 or more (2026: $15,960).

Sources: 2026 HHS poverty guidelines · FRED: CPI-U, not seasonally adjusted (CPIAUCNS)

• By statute the rate is the 10-year Treasury high yield at the last auction before June 1 plus 3.60 points, capped at 9.50%. The 2026–27 rate came from a 4.468% yield on May 12, 2026.
• The 10-year yield was 5.12% on October 20, 2026. Getting back to 8.07% needs it to fall about 0.68 points by the May 2027 auction.
• From mid-October to the May auction, the yield fell that much in 6 of 36 years since 1991 (17%) and 4 of 26 since 2001 (15%). The forecast takes about 18% for a fall large enough, so 82% for a higher rate.

Resolves yes if: Yes if the Department of Education's announced fixed rate for graduate/professional Direct Unsubsidized loans first disbursed July 1, 2027 to June 30, 2028 is above 8.07%.

Sources: 20 U.S.C. 1087e(b)(8) · FSA Electronic Announcement GENERAL-26-33 (2026–27 rates) · U.S. Treasury daily par yield curve rates, 2026

• The cap binds if the 10-year Treasury high yield at the May 2027 auction is 5.90% or more, about 0.75 points above its October 20, 2026 level of 5.12–5.15%.
• A rise of 0.75 points or more from mid-October to the May auction happened in 5 of 36 years since 1991 (14%), 2 of 26 since 2001 (8%) and 2 of 16 since 2011 (13%).

Resolves yes if: Yes if the announced 2027–28 graduate/professional Direct Unsubsidized rate is 9.50%.

Sources: 20 U.S.C. 1087e(b)(8) · U.S. Treasury daily par yield curve rates, 2026

• The government appealed on August 27, 2026 in three cases. No stay of either vacatur appears on the dockets.
• The First Circuit's opening briefs are due November 4 and 16, 2026; briefing would finish around early January 2027 without extensions. That circuit's median from notice of appeal to decision in civil appeals is 13.1 months, which points to late 2027.
• The D.C. Circuit's median is 10.7 months, about mid-July 2027, and it had no briefing schedule as of October 20, 2026.
• The Massachusetts ruling rests on three independent grounds (statutory authority, arbitrary and capricious, First Amendment), so reversal there requires the government to win on all three.

Resolves yes if: Yes if, by June 30, 2027, the First Circuit or the D.C. Circuit reverses either district court's vacatur of the October 31, 2025 PSLF employer rule or stays it, so the rule can take effect.

Sources: 1st Cir. No. 26-1972 docket · 1st Cir. No. 26-1973 docket · D.C. Cir. No. 26-5308 docket · Federal Court Management Statistics, June 2026

• A cut is triggered only if FY2026 general fund revenue growth exceeds inflation (MCL 206.51(1)(c)), determined after the state's FY2026 financial report, around April 2027.
• The May 2026 consensus estimate put FY2026 general fund collections at $14.3 billion, below FY2025's $14.5 billion, so the trigger is unlikely to fire.
• A separate legislative cut would need a new law; none was pending when this was made.

Resolves yes if: Yes if Michigan Treasury determines, or a law sets, a 2027 individual income tax rate below 4.25%.

Sources: Michigan Treasury: 2026 tax year rate determination

• Under §12-6-510(C)(2)(a) the top rate must fall if individual income tax revenue is projected to grow at least 5% in FY2027-28; the forecast in effect on February 15, 2027 decides.
• South Carolina has cut its rate in each recent year, including a retroactive 2026 cut signed March 30, 2026, so a legislative cut is possible even if the trigger fails.
• The revenue forecast that decides the trigger was not yet published when this was made, which keeps the forecast near even.

Resolves yes if: Yes if, by July 31, 2027, South Carolina law or the Department of Revenue sets a top rate below 5.21% for tax year 2027, whether by the statutory trigger or new legislation.

Sources: S.C. H. 4216 (2025–2026) · S.C. Code Title 12, Chapter 6