Elon Musk Drops Bomb On Budget Reconciliation
Just as Elon Musk exited Washington, the world’s richest man dropped a bomb on Donald Trump’s Big Beautiful Bill by calling it “a disgusting abomination.”
Rightists in the Senate were already agitated by the increase in the deficit and debt as well as what they see as a lack of deep spending cuts, but Musk’s remark has egged the conservatives on. Sens. Rand Paul, R-KY, Ron Johnson, R-WI, Rep. Mike Lee, R-UT, and Rick Scott, R-FL, have all raised issues with the deficits and debt. Lee and Paul backed Musk after his comments went viral.
On the other hand, at least four moderates and pragmatists in the Senate GOP caucus have expressed concern about Medicaid cuts. Normally conservative Josh Hawley has expressed major misgivings with Medicaid cuts and he said that Trump told him Monday that the final bill would not have Medicaid cuts. That upset conservatives in the House, which fought for additional cuts for their support.
House and Senate Republicans are being hit hard in their districts over Medicaid after a concerted effort by Democrats to advertise the issue. Collins and Hawley both have been vocal in the last few days. Hawley says he is concerned about provider tax limitations and cost-sharing.
Trump is busy working senators to vote for the bill. He seems to be making headway with some, including Johnson. But it will be a tough haul.
In other news, the Peterson-KFF Health Tracker looked at early insurance filings in three states and the District of Columbia and concludes that the premium subsidy expiration alone will add 4% to premiums in 2026. Insurers blame smaller enrollment and an increase in risk for the hikes. A major advertising campaign is pushing pressure on Republicans to reconsider a sunset. Some GOP moderates would like an extension, although likely outside of the reconciliation bill.
Additional articles: https://thehill.com/homenews/5331561-elon-musk-trump-budget-bill-gop/ and https://thehill.com/homenews/senate/5331383-trump-bill-senate-gop-criticism-musk/ and https://thehill.com/homenews/senate/5330775-rand-paul-mike-lee-criticize-trump-musk/?tbref=hp and https://thehill.com/homenews/senate/5330251-hawley-trump-medicaid/?tbref=hp and https://thehill.com/homenews/campaign/5331411-medicaid-cuts-republicans-defensive/?tbref=hp and https://www.modernhealthcare.com/politics-policy/trump-senators-tax-bill-medicaid and https://www.healthsystemtracker.org/brief/early-indications-of-the-impact-of-the-enhanced-premium-tax-credit-expiration-on-2026-marketplace-premiums/
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#budgetreconciliation #trump #congress #medicaid #coverage #aca #exchanges #obamacare
Could MFN Cripple Biosimilars and Some Generics?
The biosimilar industry and some generic makers are worried about the impact that the most-favored-nation (MFN) drug pricing proposal could have on their products. While the MFN proposal is targeted just to brand drugs, the biosimilar market in particular says that lower prices for brands could have a ripple effect on strategic planning, investments, and financial assumptions (e.g., returns). Potential tariff impacts add to uncertainty. In summary, MFN could disincentivize biosimilar and some generic investment and creation.
The industry has laid out a number of reforms that could lower the uncertainty and continue to incentivize such investment, including formulary reforms, market access signals, Food and Drug Administration (FDA) streamlining (e.g., easier interchangeability), patent thicket reform, and more. President Trump may soon issue another executive order related to drug pricing that could further the long-term sustainability of the generic and biosimilar drug markets.
I support the MFN proposal on principle. There will be fallouts, and these can be worked through.
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#drugpricing #irp #mfn #generics #biosimilars
— Marc S. Ryan
