Conservative Rebellion On Budget Bill
Conservative House members on the Budget Committee sent shock waves through the Capitol Friday when they stopped advancement of the budget reconciliation bill over a lack of sufficient spending cuts. In some ways, the meltdown could be predicted, but the fact that the five conservatives defied the wishes of the president and leaders showed just how fragile the GOP’s hold on Congress is.
Speaker Mike Johnson already had a huge issue on his hands when it came to moderates from Blue states asking to increase state and local tax reductions. Now, he has the conservatives off the bill, which could then spur more moderate concern if cuts go deeper.
Principally, the conservatives want work requirements to be imposed much earlier than 2029 and to see tighter eligibility in Medicaid. They complain that cuts are backloaded and spending front-loaded. The bill will be discussed behind the scenes this weekend and another vote could happen.
Then you have the Senate GOP, which has major disagreements with the House bill. And in the upper chamber, there are moderates and pragmatic conservatives concerned about Medicaid and other cuts and conservatives who are budget and deficit hawks. Like the House conservatives, the latter want a deficit-neutral bill.
Healthcare policy group KFF has a good analysis of the Medicaid reduction measures in the bill. Most of the reductions come in three broad categories (about $600B of $625B in total reductions over 10 years):
- Mandating that adults who are eligible for Medicaid through the Affordable Care Act (ACA) expansion meet work and reporting requirements ($300.8 billion); and
- Repealing the Biden Administration’s rule simplifying Medicaid eligibility and renewal processes ($162.7 billion); and
- Eligibility redeterminations for expansion group ($49.0 billion); and
- Establishing a moratorium on new or increased provider taxes ($86.8 billion).
KFF also finds $625 billion over 10 years is about 20% of state financed Medicaid per resident. States have unequal impacts and a lot is dependent on how each state responds to the changes and reductions from a policy and budget perspective. KFF says impacts from 6% to 50% per state.
Additional articles: https://insidehealthpolicy.com/daily-news/hardliners-doom-budget-committee-s-first-crack-reconciliation-another-vote-planned-sunday and https://www.nbcnews.com/politics/congress/senate-republicans-put-house-notice-wont-accept-trump-agenda-bill-chan-rcna206705 and https://thehill.com/homenews/house/5304719-trump-agenda-house-republicans/ and https://thehill.com/homenews/house/5304514-these-republicans-voted-against-advancing-trumps-big-beautiful-bill/ and https://www.kff.org/medicaid/issue-brief/state-level-context-for-federal-medicaid-cuts-of-625-billion-and-enrollment-declines-of-10-3-million/
(Some articles require a subscription.)
#budgetreconciliation #medicaid #coverage #spending #trump #congress
https://www.modernhealthcare.com/politics-policy/gop-tax-bill-blocked-medicaid-cuts
VBC Payments To Rise
More than 6 in 10 survey respondents say they expect higher revenue from value-based care (VBC) arrangements this year than in 2024. About 30% said a quarter of their revenue is tied to VBC contracts, with more than 20% saying at least half of their revenue is fully capitated or downside risk contracts.
Additional article: https://www.modernhealthcare.com/policy/value-based-care-movement-rise-naacos
(Some articles may require a subscription.)
#vbc #healthcare #providers #hospitals #acos
Rite Aid To Sell 1,000 Stores
Bankrupt Rite Aid confirmed Thursday that it had secured a series of deals to sell off more than 1,000 of its stores to multiple pharmacy competitors, including CVS Health and Walgreens.
Our retail pharmacy industry is increasingly consolidated but fragile. Walgreen’s and CVS Health are also feeling major financial pressures.
#pharmacies #healthcare #riteaid
Trump Wants Hospitals To Produce Drugs
The Trump administration wants to encourage the production of more drugs, especially those in short supply, in America. Hospitals could begin manufacturing their own supply via compounding onsite. The proposal brings government agencies, companies (including the Mark Cuban Cost Plus Drug Company) and hospitals and other providers together to make eight drugs.
In other news, the budget reconciliation bill includes some pharmacy benefits reforms in Medicaid and Medicare.
In more news, hospitals are celebrating a federal judge’s initial ruling against pharmaceutical makers on the federal government’s current administration of the 340B program. Drug makers are arguing they can switch to a retroactive rebate vs. upfront discount. The judge has indicated the rebates are unlawful. Whatever the merits of the ruling, the 340B program needs reform as it is not meeting the original mandate and is being abused by many providers.
Last, reports are that pharmacies are stockpiling most common drugs in anticipation of tariffs being put in place. Tariffs could increase prices dramatically and jeopardize many entities in the drug channel, including generic makers and pharmacies.
Additional articles: https://www.fiercehealthcare.com/providers/hospitals-cheer-340b-rebate-ruling-still-await-hhs-final-say and https://kffhealthnews.org/news/article/donald-trump-tariffs-prescription-drugs-generics-supply-chain-biosimilars-biologics/ and https://www.modernhealthcare.com/politics-policy/gop-tax-bill-pbm-restrictions
(Some articles may require a subscription.)
#drugshortages #hospitals #pbms #medicare #medicaid #340b #branddrugmakers #tariffs #pharmacies
https://www.modernhealthcare.com/policy/trump-hospitals-drugs-in-house
Associated Press Does Brand Manufacturers’ Bidding
A ridiculous article from the Associated Press in MedPage Today taking issue with President Trump’s claims that other developed nations pay too little on drugs and America too much. The article quotes experts that argue the systems are different, America’s multi-faceted and others centralized. They argue this gives other nations more firepower to negotiate. In addition, the “experts” argue the whole thing will fall apart because other nations and drug makers will go to a list-rebate-net system to get around Trump’s lowest-price strategy.
Both arguments are wrong. Medicare is bigger in spending than most nations. And we could have had negotiations here for years. But Big Pharma stopped efforts at every pass until the 2022 Medicare drug price negotiation law. Trump is right that Big Pharma’s public policy was to constantly hike prices in America and agree to artificially low prices abroad because the revenue was simply gravy. Big Pharma should not be getting 75% of its profits from America.
#branddrugmakers #drugpricing #ira #nfm #irp
https://www.medpagetoday.com/washington-watch/washington-watch/115617
— Marc S. Ryan
