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State AGs Want Healthcare Entities With PBMs Broken Up A bipartisan group of state attorneys general wants Congress to pass legislation that would break up healthcare entities that own both pharmacy benefits managers (PBMs) and pharmacies. This targets UnitedHealth Group, CVS Health, and The Cigna Group, which control somewhere between 68% and 80% of the PBM market. At issue, too, is co-manufacturing of specialty medications. More and more state regulation of PBMs is passing. There is a growing bipartisan consensus in Congress for the need to reform PBMs. Additional article: https://insidehealthpolicy.com/inside-drug-pricing-daily-news/state-ags-demand-congress-ban-pbms-owning-pharmacies (Articles may require a subscription.) #pbms #drugpricing https://www.modernhealthcare.com/politics-policy/cvs-caremark-express-scripts-arkansas-vermont Fitch Says MA Rate Hike Will Help Stabilize Recovery Fitch, a rating agency, says the increased Medicare Advantage (MA) 2026 rate hike of over 5% “will likely significantly support the recovery” of MA plans as they face rising medical costs. But the rater notes that they do not resolve all the

Drug Imports Will Get Tariffs The Trump administration is preparing to levy tariffs on imported pharmaceuticals within the next month or two. This is after drugs got a reprieve recently. Lobbies for the generic and biosimilar industries say tariffs could deepen existing drug shortages, raise prices, and harm patient access. In addition, the Department of Commerce has launched an investigation to assess the impact of pharmaceutical imports on U.S. national security. Additional articles: https://insidehealthpolicy.com/inside-drug-pricing-daily-news/commerce-says-pharmaceutical-tariffs-coming-next-month-or-two and https://www.beckershospitalreview.com/hospital-management-administration/federal-government-launches-probe-on-drug-imports-5-notes/ #tariffs #healthcare #drugpricing https://thehill.com/policy/healthcare/5245652-trump-tariffs-pharma-drug-shortages-trade-war-hhs-kennedy UnitedHealth Antitrust Suit Goes To Arbitration The Justice Department’s antitrust lawsuit aimed at blocking UnitedHealth Group’s $3.3 billion acquisition of Amedisys will go to mediation. The government alleges that United’s purchase of Amedisys would create an anti-competitive environment in the home health industry given its existing assets. Additional article: https://www.modernhealthcare.com/legal/unitedhealth-amedisys-antitrust-lawsuit-doj-mediation (Some articles may require a subscription.) #antitrust #doj #unitedhealthcare #homecare https://www.fiercehealthcare.com/payers/unitedhealth-group-amedisys-plan-divest-facilities-bid-close-33b-merger Physician Pay Jumps Medscape’s latest physician compensation report finds

Senate In A Quandary Over Spending Cuts Conservatives and more moderate members are at odds in the upper chamber after President Trump and the House GOP held firm with a target of at least $1.5 trillion in spending cuts in the budget reconciliation process. Commitments by Trump and Johnson to rightists in the House was the only reason the bill passed. But Senate Majority Leader John Thune says he has a number of moderates and pragmatic conservatives who have warned that deep spending cuts in healthcare and other areas could mean they are off any final budget bill. Two of the members are in tight re-election campaigns in 2026, which could significantly erode the Senate GOP majority if they lose. That said, insufficient cuts could doom the bill in the House and perhaps even in the Senate. #budgetreconciliation #spending #trump #congress https://thehill.com/homenews/senate/5243579-senate-republicans-divided-budget-cuts/?tbref=hp United Bullying Physicians To Pay Back Cyberattack Loans

House Passes Senate Version Of Budget Reconciliation Framework The House passed the Senate’s watered-down budget reconciliation framework on a party-line 216-214 vote. While the spending threshold in the bill did not change (it is de minimis), enough conservative Republicans jumped back on the bill after meetings with and pressure from House Speaker Mike Johnson, Senate Majority Leader Jon Thune, and President Trump. Conservatives are distrusting but got commitments from Trump and Johnson that as much as $1.5 trillion in cuts will be in the bill. Senate Leader Jon Thune gave a much softer commitment on levels of cuts. The House vote likely means that Congress will go after deeper cuts than not. Also controversial is the Senate bill assumes “current policy” not “current law” for budget scoring, which many, including I, call a gimmick that could lead to huge increases in deficits and debt in the future. The ongoing process

House GOP Abandons Budget Reconciliation Vote Tonight House Speaker Mike Johnson, R-LA, abandoned a vote on Senate reconciliation bill framework after rebellion by conservatives would have sunk the vote. Conservatives are upset by the Senate framework that has almost no spending reductions. In addition, the bill adopts a current-policy vs. current-law scoring of spending and taxes. The conservatives say the budget gimmick is disingenuous and would set a horrible precedent and drive up deficits and the national debt. The conservatives said they couldn’t move forward as they do not believe the Senate will agree to deep cuts if they pass the framework. The House GOP will now regroup on the issue and see if they can gather votes later in the week to pass the framework. Additional article: https://www.modernhealthcare.com/politics-policy/house-budget-resolution-medicaid-tax-cuts (Some articles may require a subscription.) #budgetreconciliation #congress #trump #spending #medicaid #healthcare https://thehill.com/homenews/house/5241418-johnson-vote-trump-budget-blueprint-conservative-opposition Study Pushes Back On MedPAC Assertions A new

Trump Backs Deep Spending Cuts Emerging from a meeting with Speaker Mike Johnson, R-LA, and House Republicans, President Trump declared he is supportive of major spending cuts. The meeting was meant to allay concerns of rightists in the House GOP caucus. Trump wrote on Truth Social: “I let them know that, I AM FOR MAJOR SPENDING CUTS! WE ARE GOING TO DO REDUCTIONS, hopefully in excess of $1 Trillion Dollars, all of which will go into ‘The One, Big, Beautiful Bill.’” Trump urged the House GOP to support a watered-down budget reconciliation framework from the Senate in the meantime but promised to help assemble meaningful reductions, most of them likely from healthcare. Trump said he would “be pushing very hard” to get deeper cuts. The budget bill looks to be a battle of the House and conservatives against the Senate and some more moderates who disagree on the level of

Medicare Advantage Plans Getting Higher Rates For 2026 The 2026 Medicare Advantage (MA) Final Notice was released this evening by the Centers for Medicare and Medicaid Services (CMS). After the Advance Notice in January, MA plans complained about a paltry rate hike of 2.23%. They asked the Trump administration to intervene and either tweak the risk model change phase-in or the one related to medical education reductions. Well, the Trump administration didn’t have to really do anything to drive up the 2026 rate. CMS did not change any policies on rates between the advance notice and final one. But the rate hike surged to 5.06% because the rate setting growth factor increased dramatically between the two notices. The change is projected to result in an increase of 5.06%, or over $25 billion, in MA payments to plans in CY 2026. MA plans and actuaries warned that trends in the program