Trump Meets House Leaders On Medicaid Cuts
President Donald Trump met with House GOP leaders to discuss Medicaid reductions. Trump said he opposes Medicaid coverage cuts but would support efforts to rein in fraud, waste, and abuse. But Trump has given little word about what would violate his pledge to protect Medicaid.
Conservatives want deep cuts and have sent a letter to colleagues saying they want “meaningful reforms” in budget reconciliation. They singled out reducing the Medicaid expansion enhanced reimbursement. Moderates are lining up against reductions, with moderate Don Bacon saying he is leaning against reductions in federal matching funds or provider tax changes. Bacon did say he would support up to $500 million in cuts over the ten-year window. He would support work requirements, more frequent eligibility, and bars on the undocumented.
In other news, a poll from healthcare policy group KFF finds that large majorities of Americans, including Republicans, oppose Medicaid cuts.
Last, the Paragon Health Institute continues its publications to influence Medicaid policy. It says there are two proposals to equalize expansion and regular population funding: first, gradually phase down the enhanced expansion match rate and shift nearly half of current Medicaid expansion enrollees into subsidized ACA plans. Second, grandfather current expansion enrollees at the enhanced match rate but apply the state’s match rate for children, pregnant women, seniors, and the disabled for new expansion enrollees.
Additional articles: https://www.modernhealthcare.com/politics-policy/trump-house-gop-medicaid-cuts and https://insidehealthpolicy.com/daily-news/bacon-leaning-no-fmap-provider-cuts and https://thehill.com/policy/healthcare/5275399-gop-medicaid-cut-plan-opposition-kff-survey/ and https://stateline.org/2025/05/01/repub/three-quarters-of-americans-oppose-medicaid-cuts-poll-shows/ and https://www.kff.org/medicaid/poll-finding/kff-health-tracking-poll-april-2025-publics-view-on-major-cuts-to-federal-health-agencies/ and https://www.kff.org/affordable-care-act/press-release/most-of-the-public-oppose-major-federal-cuts-to-health-agencies-and-programs-and-say-they-have-been-made-recklessly/ and https://paragoninstitute.org/newsletter/marking-up-medicaid-reform/
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#medicaid #coverage #spending #budgetreconciliation #trump #congress
CVS Will Exit Obamacare Exchanges Despite Better Financials
CVS Health hiked its 2025 forecast above Wall Street’s expectations after improving Medicare results contributed to a better-than-expected first quarter. The company’s profit soared 60% to $1.78 billion in the year’s first quarter. Total revenue climbed 7% to $94.59 billion.
Yet, CVS Health plans to exit the individual health insurance business also known as Obamacare next year, leaving about 1 million Aetna members in 17 states looking for new coverage in 2026.
CVS’ pharmacy benefit manager Caremark also reached an agreement with Novo Nordisk to give its weight loss drug Wegovy preferred access on its standard formulary.
Additional articles: https://www.forbes.com/sites/brucejapsen/2025/05/01/cvs-plans-to-exit-obamacare-in-2026-impacting-1-million-aetna-members/ and https://www.healthcaredive.com/news/cvs-aetna-exit-aca-novo-nordisk-wegovy-deal/746833/ and
#cvshealth #aetna #medicareadvantage #healthplans #margins #pbms #drugpricing #exchanges #obamacare #aca
https://finance.yahoo.com/news/cvs-health-rides-improving-medicare-125354208.html
DOJ Accuses Medicare Advantage Plans Of Fraud
The U.S. Department of Justice (DOJ) filed suit against three large health insurers accusing them of fraud by paying hundreds of millions of dollars in kickbacks to brokers in exchange for steering patients into the insurers’ Medicare Advantage (MA) plans.
The Biden administration had issued a rule that would have reined in such compensation, but the measure was struck down in court. It is interesting that the Trump administration chose to pursue the case given its friendliness toward MA.
The case is against Aetna, Humana and Elevance Health. Brokers named are eHealth, GoHealth and SelectQuote.
Additional articles: https://www.reuters.com/sustainability/us-files-false-claims-complaint-against-three-health-insurers-2025-05-01/ and https://www.fiercehealthcare.com/payers/doj-hits-aetna-humana-elevance-health-medicare-advantage-kickbacks-complaint and https://www.healthcaredive.com/news/doj-cvs-humana-elevance-medicare-advantage-broker-kickbacks/746933/ and https://www.fiercehealthcare.com/payers/aetna-exit-aca-exchanges-2026 and https://www.modernhealthcare.com/finance/aetna-exchange-market-2026-cvs-health
(Some articles may require a subscription.
#medicareadvantage #marketing #fwa
https://www.modernhealthcare.com/legal/doj-cvs-humana-kickbacks-medicare-advantage
Senate Narrowly Rejects Repeal of Trump Tariffs
The Senate rejected a resolution that sought to stop President Donald Trump’s baseline tariff and additional tariffs on imported goods. The vote on the resolution was tied 49-49 and therefore failed.
#drugpricing #tariffs
— Marc S. Ryan
