Partial Government Shutdown Will Occur Despite Deal But Should Have Limited Impact
The Senate passed a compromise provision to fund the government for all agencies yet to be funded and two weeks for the Department of Homeland Security. That will give time for parties to negotiate over some constraints on immigration officers. The Senate passed legislation Friday on a strong bipartisan vote.
The government technically shuts down at midnight tonight, but the House will be back on Monday to vote on the amended package. House Speaker Mike Johnson, R-LA, will seek to suspend the rules to take up the bill to get funding moving quickly Monday. That requires a two-thirds vote, requiring about 70 Democrats. In part, Johnson is doing this because he could have defectors among conservatives and he is challenging Democrats to oppose the measure and have a longer shutdown.
If all goes well, the mini-shutdown this weekend will end quickly.
Healthcare provisions in the legislation include:
- Enacting some pharmacy benefits manager (PBM reforms).
- Extending Medicare’s telehealth rules for two years and hospital-at-home rules for five years.
- Funding $4.6 billion for community health centers.
- Delaying Medicaid disproportionate share hospital payment reductions until 2029.
- Extending add-on payments for low-volume and Medicare-dependent hospitals, Medicare geographic payment adjustments for doctors, and ambulance payments through the end of the year.
- Restoring a 3.1% bonus for physicians participating in Medicare alternative payment models.
Additional articles: https://www.modernhealthcare.com/politics-regulation/mh-senate-funding-bill-telehealth-pbms/ and https://thehill.com/homenews/house/5715812-mike-johnson-fast-track-funding-shutdown/
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#governmentshutdown #trump #democrats #healthcare
https://thehill.com/homenews/senate/5715914-senate-government-funding-package
GLP-1s in Medicare Reviewed
As the Trump administration strikes deals with weight-loss drug makers Eli Lilly and Novo Nordisk and readies the new BALANCE weight-loss models for Medicaid and Medicare, healthcare policy group issued a briefer on GLP-1 use in Medicare.
The analysis examined Medicare Part D claims data from 2019 to 2024 to document the increase in the number of beneficiaries being treated with GLP-1 drugs and the growth in Medicare spending and claims for GLP-1s.
- Two million Part D enrollees used Ozempic in 2024, versus fewer than 150,000 in 2019.
- Mounjaro was used by nearly 1 million Part D enrollees in 2024, up from 54,000 in 2022 when it was approved for Type 2 diabetes.
- There was a fivefold increase in Medicare Part D gross spending on GLP-1s.
- Assumed rebates based on MedPAC estimates are about 50%.
- GLP-1 claims between 2019 and 2024 increased fourfold.
Additional article: https://www.beckershospitalreview.com/glp-1s/5-things-to-know-about-glp-1-use-in-medicare-kff/
#glp1s #weightlossdrugs #medicareadvantage #medicaid #partd #drugpricing #balance #mfn #irp
https://www.kff.org/medicare/recent-trends-in-glp-1-use-and-spending-in-medicare/
Healthcare Issues Resonate In New Poll
A healthcare policy group KFF poll finds that Americans are more worried about affording healthcare than any other household necessity. Some key findings from the poll:
- Two-thirds said they felt more anxious about paying for healthcare than for the most basic household essentials.
- More than half of respondents reported a rise in their health insurance rates in the past year and an expectation they will continue rising.
- On affordability, 71% of Democrats, 68% of independents and 57% of Republicans are either somewhat or very worried about affording health insurance as well as out-of-pocket costs.
- Large majorities of Democrats and independents said Congress did the “wrong thing” by not extending the subsidies, while 63 percent of Republicans said lawmakers have done the “right thing.” The majority of Democratic and independent voters said the expiration of the tax credits will have an impact on their vote in the 2026 midterms.
- Two-thirds of Democratic voters and more than 4 in 10 independent voters said healthcare will have a “major impact” on how they decide to vote in November 2026. About half of Republican voters said the costs will impact their vote.
- Democrats have a 13-point advantage over Republicans when it comes to healthcare issues except for prescription drug prices, where President Donald Trump has made significant advances in reducing drug prices. On drugs, 35% of respondents said they trusted Democrats and 30 percent said they trusted Republicans.
Additional article: https://www.kff.org/public-opinion/kff-health-tracking-poll-health-care-costs-expiring-aca-tax-credits-and-the-2026-midterms/
#healthcare #coverage
https://thehill.com/homenews/5715815-rising-healthcare-costs-concern/?tbref=hp
— Marc S. Ryan
