Government Shutdown Looms
Congress has returned to Washington and the GOP has no plan to keep the government running at the end of the month. Democrats are pushing the GOP to have a four-leaders meeting to discuss a consensus, but the House and Senate majorities are pushing other agendas right now. Democratic votes would be needed to keep the government going unless budget reconciliation was used again. That is a tall order if not impossible. The Senate GOP has floated a short-term spending patch to give more time to discuss FFY 2026 funding. But some conservatives in the House and Senate want a full-year extension at FFY 2025 spending levels with additional spending cuts.
There is some bipartisan interest in negotiating a healthcare package before the end of the year. Senators are already discussing this. On the docket is the possibility of extending the Exchange premium subsidy enhancements, but conservatives are likely to oppose that.
#ffy2026 #budget #spending #congress
New Drug Approval Reforms Finalized
The Department of Health and Human Services (HHS) announced that proposed prescription drug reforms will take effect Oct. 1. The changes, issued in July, would give patients and physicians real-time access to prescription drug costs, insurance coverage details, and prior authorization requirements. The rule requires providers to use certified health IT systems to electronically submit prior authorization (PA) requests, check on drug prices during appointments, and share prescription information with pharmacies and insurers.
In addition, the Trump administration struck a deal with health plans for other significant PA reforms.
Additional article: https://www.hhs.gov/press-room/hhs-prescription-drug-price-transparency-rule.html
#drugpricing #priorauthorization #hhs #cms
https://www.beckershospitalreview.com/pharmacy/hhs-issues-rule-to-boost-drug-pricing-transparency
Judges Declare Most Tariffs Illegal
President Donald Trump’s imposed tariffs on foreign nations have been ruled illegal by the U.S. Court of Appeals for the Federal Circuit. The court ruled the president did not have the authority to declare national emergencies to justify the tariffs. The tariffs remain in effect to allow an appeal to the Supreme Court.
The tariffs struck by the court include a 10% baseline tariff on all foreign imports and 50% additional tariffs on certain trading partners. The additional tariffs were largely suspended to allow for negotiations. Some tariffs imposed remain in effect. The ruling does not appear (but could) impact a negotiated deal with the EU providing for 15% tariffs on brand drugs.
#drugpricing #tariffs
Court Stay Of Exchange Rule Explained
I told you about a federal court staying the implementation of a Trump administration rule tightening enrollment and eligibility in the exchanges. A Health Affairs Forefront blog does a good job analyzing the ruling. The court stayed the rule’s provisions related to the below list. The court found some of these provisions to be inconsistent with the text of the Affordable Care Act while other policies were found arbitrary and capricious.
- $5 premium penalty for certain automatic re-enrollees
- New special enrollment period (SEP) verification requirements
- New income verification requirements
- A provision that eliminates credits for those who fail to file taxes or fail to reconcile their claimed credits
- A new premium nonpayment policy
- Changes to the de minimis ranges for actuarial value (AV) calculations.
— Marc S. Ryan
