Newsfeed

Oz Confirmed By Senate

Dr. Mehmet Oz, M.D., was approved by the Senate to serve as administrator of the Centers for Medicare and Medicaid Services (CMS). The vote was along party lines, 53-45. Oz walks into an agency reeling from cutbacks by the Trump administration and layoffs.

Meanwhile, a high-profile health influencer in the White House as a temporary employee appeared before a Politico health summit. Calley Means, close to health chief Robert F. Kennedy, Jr., said that the healthcare system has been plagued by inordinate influence from hospitals and drug makers and that CMS has been controlled by the American Medical Association (AMA). Means defended controversial HHS budget cuts and said that National Institutes of Health (NIH) research funding was not slashed.

As well today, Sen. Susan Collins, R-ME, said she was very concerned about the prospects of deep Medicaid cuts given the House healthcare reduction target.

Additional articles: https://www.fiercehealthcare.com/regulatory/dr-oz-cms-administrator-confirmation-senate-vote and https://www.modernhealthcare.com/politics-policy/mehmet-oz-confirmation-senate-vote-cms and https://www.healthcaredive.com/news/dr-oz-confirmed-cms-administrator-medicare-medicaid/744418/ and https://insidehealthpolicy.com/inside-drug-pricing-daily-news/wh-adviser-means-says-cms-controlled-ama-denies-nih-research-cuts

(Some articles may require a subscription.)

#budgetreconciliation #trump #congress #healthcare #spending #medicaid #providers

https://thehill.com/homenews/senate/5230106-medicaid-cuts-susan-collins

Senate Adopts “Current Policy” Scoring Budget Gimmick

The Senate GOP has officially adopted a budget gimmick in its proposed budget reconciliation resolution. Appropriations Chair Sen. Lindsay Graham, R-SC, said he had the authority to adopt the budget scoring method and the Senate parliamentarian said it was appropriate to move forward. The resolution sets lower targets for spending cuts – a minimum of $3 billion. The resolution should be adopted later this week to align in general with the House approach. However, some conservatives in the House are already attacking the gimmick. The House approach sets a $1.5 trillion floor with a goal of $2.0 trillion in cuts over ten years. This could set up a showdown between moderates and conservatives on spending reductions.

The truth is that the current policy approach means much higher deficits to 2034 and after. It is an appalling approach that further inflates our massive debt and burdens future generations.

Additional articles: https://thehill.com/homenews/senate/5226747-republicans-tax-cuts-deficit-senate-parliamentarian/?tbref=hp and https://thehill.com/business/5226495-senate-republicans-eye-budget-resolution-vote-this-week-with-reduced-spending-cuts/?tbref=hp

#budgetreconciliation #congress #trump #spending

https://thehill.com/homenews/senate/5228769-trump-tax-cut-budget-bill-senate

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

https://www.nbcnews.com/politics/congress/senate-republicans-eye-budget-vote-growing-fight-trump-tax-cuts-rcna199186

Enrollment Marketing and Fraud Take Center Stage

The lobby representing marketing agents and brokers is blasting Democrats’ legislation that would slap civil or criminal penalties on agents and brokers who submit fraudulent information regarding Exchange enrollment. It points the finger at the federal government for failing to enforce laws to protect consumers.

At the same time, a report from Senate Finance Committee Ranking Member Ron Wyden says Medicare Advantage (MA) insurers are spending an increasing amount on fees and commissions paid to brokers. The report states that MA plans increasingly rely on third-party marketing organizations and lead generators to drive enrollment. Spending on such fees and commissions increased from $2.4 billion in 2018 to $6.9 billion in 2023.

As well, the Paragon Health Institute is citing the indictment of two men for allegedly running a scheme to glean commissions by enticing people to misstate their expected income to gain subsidized enrollment. Paragon says it highlights lax verification policies and fraudulent activities in the Exchanges. Paragon says the verification process should be tightened and enhanced subsidy enhancements should expire at the end of the year.

Additional articles: https://insidehealthpolicy.com/daily-news/doj-indicts-aca-brokers-1619m-enrollment-fraud-paragon-says-enhanced-aca-credits-should and https://www.beckerspayer.com/policy-updates/senate-report-scrutinizes-medicare-advantage-marketing-spend-broker-practices/

(Some articles may require a subscription.)

#marketing #medicareadvantage #exchanges #fwa #agents #brokers

https://insidehealthpolicy.com/daily-news/agentsbrokers-say-dems-aca-anti-fraud-bill-masks-cms-oversight-failure

Trump Yet To Clarify Tariffs On Healthcare Products

Donald Trump has yet to decide how potential tariffs on pharmaceutical products will be structured. In February, Trump said that tariffs on pharmaceuticals and other essential products would be about 25% and that U.S. companies may get a phase-in period for imported goods, giving them time to shift production onshore.

In a new survey of 200 healthcare industry experts, 82% said they expect tariff-related import expenses to increase hospital and health system costs by 15%. So, most of the tariff costs will be passed through.

Additional article: https://www.beckershospitalreview.com/supply-chain/hospital-finance-supply-leaders-predict-15-increase-in-tariff-related-costs/

(Some articles may require a subscription.)

#drugpricing #branddrugmakers #tariffs

https://insidehealthpolicy.com/inside-drug-pricing-daily-news/trump-undecided-structure-potential-pharma-tariffs-wh-says

HHS And Related Health Agencies Will Downsize By 20,000

The Department of Health and Human Services (HHS) will slash an additional 10,000 full-time jobs after laying off or “buying out” about the same number already. Prior to the moves, the agencies collectively had 82,000, so the workforce will be downsized by about 25%. These cuts are in line with the Department of Government Efficiency (DOGE) commission’s workforce optimization efforts and are slated to save the agencies $1.8 billion per year.

HHS is also reorganizing and will cut the department from 28 divisions to 15 and close five regional offices.

Job reductions include:

• 3,500 at the Food and Drug Administration (FDA).
• 2,400 at the Centers for Disease Control and Prevention (CDC).
• 1,200 at the National Institutes of Health (NIH).
• 300 at the Centers for Medicare and Medicaid Services (CMS).

Additional articles: https://www.fiercehealthcare.com/regulatory/rfk-jr-prepares-10000-job-cuts-across-hhs-new-wave-worker-reductions and https://insidehealthpolicy.com/daily-news/hhs-major-new-reorg-includes-agency-mergers-10k-more-job-cuts and https://www.healthcareitnews.com/news/hhs-reduce-workforce-20k-jobs-major-agency-wide-restructure and https://thehill.com/policy/healthcare/5218547-trump-administration-plans-hhs-cuts/ and https://www.medpagetoday.com/washington-watch/washington-watch/114854 and https://www.modernhealthcare.com/labor/hhs-cuts-rfk-jr

(Some articles may require a subscription.)

#congress #trump #doge #budgetreconciliation #healthcare #hhs #cms #fda #cdc #nih

https://www.healthcaredive.com/news/hhs-job-cuts-reorganization-rfk-trump/743569

Medicare Advantage Deductibles Surged in 2025

A survey by online broker eHealth finds that the average deductible for a Medicare Advantage (MA) plan in 2025 more than doubled to $315. The average deductible for MA plans during the enrollment period was $315, compared to $132 in 2024, or an increase of 139%. Premiums decreased from $9 per month to $5 per month, but MA plans clearly had to save by increasing deductibles and cost-sharing as well as reducing benefits and footprints.

In other news, Becker’s also reports on the fastest-growing non-profit Blue Cross and Blue Shield plans in terms of MA enrollment. Chartis says Blue Cross Blue Shield non-profit plans accounted for around 30% of MA enrollment growth in 2025. That number does not include for-profit Elevance Health, one of the big national plans which is also a Blues licensee.

Big BCBS plan gainers were BCBSMI, Highmark, and Horizon. Chartis also says that 45% of all enrollment growth in 2025 accrued to BCBS non-profits and other non-profits. BCBS plans added 400,000 MA members for 2025.

Check out the Chartis report here – rich in content: https://www.chartis.com/insights/medicare-advantage-market-growth-slows-amid-intensified-headwinds

Additional article: https://www.beckerspayer.com/payer/the-fastest-growing-bcbs-medicare-advantage-plans-2025/

#medicareadvantage #coverage #cms

https://www.beckerspayer.com/payer/medicare-advantage-deductibles-more-than-double-survey/

Hard-Hitting Study Could Drive Medicaid Budget Cuts

A study by the Paragon Health Institute and the Economic Policy Innovation Center could help drive certain cuts adopted by Republicans during the budget reconciliation process. The study focuses in on California and various ways the authors say the Golden State effectively exploits matching rules and launders money to fund its state share at the expense of the federal Medicaid budget. It also indicates that the schemes provide dollars to cover undocumented immigrants, even though federal law bars enrollment in Medicaid.

The GOP in Congress is known to want to stay away from explicit coverage reductions in Medicaid. But it is looking at reining in the amount states are demanding in match as well as eliminating or at least reducing the use of provider taxes for state match.

Study: https://paragoninstitute.org/wp-content/uploads/2025/03/California-Money-Laundering-Scheme_FOR-RELEASE_V3.pdf

#medicaid #healthcare #coverage #budgetreconciliation

https://thefederalist.com/2025/03/24/red-states-are-paying-for-californias-illegal-aliens-health-care

Trump Aligned Think Tank Wants Drug Price Reductions

America First Policy Institute (AFPI), a conservative think tank friendly with Donald Trump, says the administration should bring back Trump 45’s international reference pricing policy for drugs across federal health programs and in the commercial market. So far, the Trump administration has firmly backed the Medicare drug price law.

The think tank says there are many ways the pricing could be implemented, including via the drug law. The push for commercial application is watershed. AFPI also recommends the Trump administration restrict drug makers’ ability to charge lower prices internationally than in America and use its trade negotiation power to press countries to stop using so-called “freeloading” policies.

(Article may require a subscription.)

#drugpricing #trump #ira #branddrugmakers

https://insidehealthpolicy.com/inside-drug-pricing-daily-news/trump-aligned-think-tank-calls-admin-bring-back-mfn-policy

Former Rep. Burgess Leading Contender For CDC Chief

Former Representative Michael Burgess, M.D., R-TX, is a top choice for Centers for Disease Control and Prevention (CDC) director. Former Rep. Dave Weldon’s nomination was pulled over vaccine skepticism.

Burgess, 74, practiced obstetrics and gynecology before going to Congress in 2003. He chose not to seek re-election in 2024. He is known as a major health policy wonk, supported COVID vaccination, and was an advocate for providers. At the same time, he is a conservative and not in favor of major expansion of government programs. He led the House’s Energy and Commerce Subcommittee on Health. He also headed the GOP Doctor’s Caucus.

Another name that has been floated is Florida Surgeon General Joseph Ladapo, M.D., who is an ardent vaccine skeptic and would be extremely controversial.

#cdc #trump #congress #nominations 

https://www.fiercehealthcare.com/regulatory/former-rep-michael-burgess-md-likely-next-cdc-director-nomination-report