Senate Seeks To Use Budget Gimmick In Budget Reconciliation
The Senate has been forced to approach budget reconciliation the way President Donald Trump and the House Republicans want it – one “big beautiful bill” — to address taxes, spending cuts, and the debt limit. But because the Senate fears major spending cuts, it is entertaining a bit of a budget gimmick related to how the bill should be “scored” – how the Congressional Budget Office (CBO) will add up costs, savings, and the deficit.
Traditionally, CBO scores apply “current law.” Because the 2017 Trump tax cuts expire at the end of the year, extending them costs revenue. Senate budget rules say that, to avoid a filibuster cloture vote and pass the measure with 51 votes, the deficit cannot increase over the applicable budget horizon. Thus, offsetting cuts are needed.
But GOP leaders in the upper chamber are looking at whether the bill should be scored based on “current policy.” Since the tax cuts are already in place, they can be assumed to continue and they would not need cuts to extend them. What’s more, the GOP leaders are arguing that the Senate budget chairman alone can decide this and the Senate parliamentarian does not need to be called upon.
Scoring the bill based on “current policy” would mean less severe budget reductions, especially on healthcare. This wins over moderates in the GOP caucus. But it could alienate more conservative members who do not want to see the true deficit baseline or national debt to increase. Even if the Senate were to agree on lower budget cuts to pass the bill, rightists in the House could object.
So, the roller coaster ride is not over. From my standpoint, you can argue that giving in to “current policy” would shield healthcare from major reductions. However, “current policy” would inflate the deficit in a big way, regardless of what the CBO says. It sets a terrible precedent when we have a huge and growing national debt. It, too, would open the floodgates for future Congresses to pass tax cuts or increase spending without regard to the budget deficit and levels of debt. As a former state budget director who had to abide by a balanced budget each year, I am a bit appalled.
Additional articles: https://thehill.com/homenews/senate/5224322-senate-republicans-budget-resolution/ and https://www.axios.com/2025/04/01/senate-budget-tax-cuts-current-policy-graham
#budgetreconciliation #healthcare #trump #congress #spending
HHS To Explain Reorganization And Layoffs’ Impacts
In light of huge potential fallout from 10,000 more layoffs at major healthcare agencies, Senate HELP Committee Chairman Bill Cassidy, R-LA, is asking Health and Human Services Secretary Robert F. Kennedy Jr. to testify on the major reorganization of the departments. Democrats, health advocates, and even some Republicans are raising issues about whether core public safety and regulatory duties at the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH) can be carried out with the reduction of a total of 20,000 employees (with earlier downsizing), which equates to about 25%.
Additional article: https://www.medpagetoday.com/special-reports/features/114915
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#hhs #cdc #fda #nih #layoffs #rkfjr #congress #healthcare #publichealth
https://insidehealthpolicy.com/daily-news/cassidy-calls-rfk-jr-testify-hhs-reorg-amid-dems-outrage
GLP-1 Costs For Those Without Diabetes Surges
A new study finds that spending on GLP-1 weight-loss medications surged to $5.8 billion in 2022 among those without diabetes. Those using the drugs more than tripled from 2018 to 2022, rising from 0.1% to 0.4% of the U.S. population, or an estimated 854,000 people.
The study says that patients paid around $35 out of pocket per fill despite the $1500 or so monthly cost. But this is entirely misleading. Most of those with access have rich benefits that allow coverage for just obesity. Most Americans who could benefit simply do not have true cost-effective access to the drugs. Again, just 0.4% are being covered at the low cost of $35 per month.
#glp1s #weightlossdrugs #drugpricing #branddrugmakers
https://www.beckershospitalreview.com/glp-1s/glp-1-spending-hits-5-8b-for-adults-without-diabetes
States Experimenting With Healthcare Cost Growth Caps
Interesting article on a number of states that are seeking to control healthcare costs via setting healthcare cost growth targets. While some question whether the policies really curb costs, there is some data pointing in the right direction.
Around a dozen states have implemented or are considering policies that track healthcare spending trends and reduce cost growth. Nine states set targets for cost growth. Massachusetts was the first to establish a benchmark in 2012. Massachusetts’ cost growth fell below the national average in eight years spanning 2012 to 2023.
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#healthcare #spending #regulation
https://www.modernhealthcare.com/providers/cost-growth-targets-massachusetts-oregon
— Marc S. Ryan
