Trump Says Drug Tariffs Coming
President Donald Trump announced that he plans to impose tariffs on pharmaceutical products within the next two weeks. In addition, he issued an executive order directing the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA), and other agencies to facilitate domestic pharmaceutical production and to raise fees for inspecting foreign drug plants.
Health plans and pharmacy benefits managers (PBMs) have had a mixed reaction to the imposition of tariffs. CVS Health and Centene see impact that they are studying now, while United Healthcare said it has less concern. Over time, prices will be passed through the supply chain and ultimately to health plans, which will have to pass on costs to employer groups. Government programs would over time recognize cost hikes as well. At the same time, tariffs costs could end up in diminished formularies and higher cost-sharing.
The Pharmaceutical Research and Manufacturers of America (PhRMA) the brand lobby, submitted comments to the tariff investigation, arguing tariffs will backfire.
See my blog on healthcare tariffs: https://www.healthcarelabyrinth.com/tariffs-impact-on-healthcare-costs/ .
Additional articles: https://www.modernhealthcare.com/insurance/drug-tariffs-unitedhealth-cvs-health-centene and https://insidehealthpolicy.com/daily-news/phrma-warns-tariffs-won-t-boost-us-drug-manufacturing-cites-global-trade-benefits
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#tariffs #drugpricing #healthcare #coverage
Major Medicaid Cuts Taken Off Table
House Speaker Mike Johnson, R-LA, took one major Medicaid reduction off the table and said another might be taken off soon. This was because of huge concerns from moderates. While progress is being made to build consensus on a budget reconciliation bill, no final decisions have been made on Medicaid cuts.
Johnson officially removed a reduction of enhanced reimbursement to states for expansion populations. And he said per capita caps would likely be ruled out as well. Fraud, eligibility reforms, and work requirements are likely to be included.
The move by Johnson came after moderate GOP House members sent their sternest warning yet about their unwillingness to support major Medicaid cuts.
The Congressional Budget Office issued estimates of budget savings and enrollment losses for five of the Medicaid options Republicans have floated: eliminating the enhanced federal match for Medicaid expansion states, limiting state taxes on providers, capping federal Medicaid spending for the entire Medicaid population, capping spending for the expansion population only, and repealing a Biden-era Medicaid eligibility rule. Millions could lose coverage although hundreds of millions could be saved over the timeframe.
In other news, a Health Affairs Forefront blog touts the Basic Health Plan (BHP), a Medicaid option created in the Affordable Care Act (ACA). The article touts the BHP as a safe option if enhanced subsidies disappear in the Exchange.
Last, the Centers for Medicare and Medicaid Services (CMS) says it now wants cost-sharing reduction subsidies (CSRs) appropriated again. Trump 45 defunded them, which actually costs more because plan must continue to create cost-sharing subsidy plans and must inflate Silver premiums to do so – dubbed silver-loading. Premium subsidies’ increases exceed what an appropriation for the benefit would be. CMS is asking plans to supply bids for 2026 with and without a CSR subsidy. Some states are also asking Exchange plans to submit bids with and without enhanced subsidies.
Additional articles: https://thehill.com/policy/healthcare/5286567-house-republicans-medicaid-proposal-trump-agenda/?tbref=hp and https://www.healthaffairs.org/content/forefront/basic-health-plans-promising-alternative-amidst-marketplace-subsidy-decreases and https://insidehealthpolicy.com/daily-news/cms-suggests-congress-may-fund-csrs and https://www.fiercehealthcare.com/payers/cms-hints-possible-cost-sharing-reduction-payments-insurers-impacting-aca-enrollment and https://thehill.com/homenews/house/5288952-house-gop-moderates-medicaid-senate/
(Some articles may require a subscription.)
#budgetreconciliation #medicaid #coverage #spending #trump #congress
https://thehill.com/policy/healthcare/5287540-republican-plan-health-insurance-millions/?tbref=hp
Clover And Oscar Report Good Financials
Medicare Advantage (MA) insurtech Clover Health promoted its financial improvement for Q1 2025. It posted quarterly revenue of $462 million, a 33% increase year over year. It had a net loss of just $1 million vs. $19 million in Q1 2024. Membership grew 30%. It did report its medical loss ratio is rising.
Exchange plan Oscar Health’s enrollment grew by 45% year over year, having 2 million members at the end of Q1. The company reported $3 billion in revenue in Q1 2025, up from $2.1 billion in the same period last year.
Additional articles: https://www.beckerspayer.com/payer/clover-healths-medicare-advantage-membership-grows-30-boosts-financial-outlook/ and https://www.beckerspayer.com/payer/oscar-health-reaches-2m-members-275m-profit-5-notes/
#oscarhealth #cloverhealth #exchanges #medicareadvantage
— Marc S. Ryan
