What if Congress bans spread pricing by Medicaid drug middlemen?
A Medicaid PBM spread-pricing ban compresses CVS/Cigna/UNH pharmacy-benefit profit pools — short the three PBM-integrated payers, a managed-care-specific hit. Rhymes with the late-2023 PBM-reform scare and UNH's 2024-25 MLR-driven drawdowns, contained to healthcare. The generic crypto cascade is irrelevant; no meaningful macro transmission.
Every number ships with its receipt — the odds, the range, the precedents, and a public grade at Reality Check. The statistical machinery that produces it is proprietary.
The butterfly cascade
How this trigger trickles across markets, left → right — the root shock, its first‑order moves, then the ripple effects. Drag any node; tap a market for its real price history.
Resolution timeline — how this probability is moving
Our model's odds (electric blue) over time vs the market's (Polymarket, amber), from the past toward the 1–3 years horizon. Each dot is a real macro event that nudged the probability — green pushed it up, red pushed it down. Tap a dot for the source. Loading the probability audit trail…
What it would mean
If this plays out, it is a mixed shock. Congress enacts the dropped Medicaid spread-pricing ban, extending de-linking to managed-care plans and further compressing CVS/Cigna/UNH pharmacy-benefit profit pools. The trigger decomposes into signed root‑shocks — Risk appetite ▼ — which propagate through our causal graph to the markets below.