Summary
This week, Congress will be focused on addressing President Trump’s Iran operation, with Congressional leaders being briefed today, a full Congressional briefing tomorrow, Senate war powers votes on Tuesday and the House vote planned for Thursday.
In a lookback, below we recap health care takeaways from last week’s State of the Union Address:
- Affordable Care Act Subsidies: President Trump called for stopping “all payments to big insurance companies and instead give that money directly to the people so they can buy their own healthcare, which will be better healthcare at a much lower cost.” This speaks to his Great Healthcare Plan approach of ending subsidy payments, along with funding a cost-sharing reduction program. President Trump also emphasizes the importance of “maximum price transparency,” which is also a feature of his healthcare plan.
- Prescription Drugs: President Trump touted his prescription drug achievements, including the Most Favored Nation (MFN) agreements and the launch of the direct-to-consumer platform TrumpRx.gov. He also called on Congress to codify the MFN agreements, however interest to do so from Congressional Republicans seems limited at this point.
- Medicare and Medicaid: President Trump committed to “always protect Social Security and Medicare, and Medicaid,” but did not provide any details on what this protection would look like. He notably did not address the Medicaid cuts that were included in H.R. 1.
- Gender Affirming Care: The President also mentioned the need to address fraud in government programs and preventing minors from accessing gender-affirming care without parental consent.
Additionally, the President did not address the Administration’s changes to the vaccine schedule, or the downsizing of the Department of Health and Human Services, which previously served as priorities during his campaign.
Regulatory Update
The Office of Management and Budget completed its review of the following:
- Immigration Status. A Department of Labor proposed rule titled, “Improving Wage Protections for H-1B and PERM Employment in the United States.”
OMB is also reviewing:
- Coverage and Payment:
- Medicaid:
- State Directed Payments. A proposed rule titled, “Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments.” The proposed rule appears intended to advance a presidential memorandum released on June 6, which directs HHS to “eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law.” On February 27, the title of the proposed rule was revised to include Medicaid FFS targeted Medicaid practitioner payments.
- Medicaid Tax Waivers. A proposed rule titled, “Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes.”
- FY 2027 payment proposed rules for hospitals and long-term care hospitals, inpatient psychiatric facilities, hospice facilities, and skilled nursing facilities.
- Medicare Advantage. The Contract Year 2027 Policy and Technical Changes to Medicare Advantage, Medicare Prescription Drug Benefit, Medicare Cost Plan, and Programs of All-Inclusive Care for the Elderly Programs final rule.
- No Surprises Act. A final rule titled, “Independent Dispute Resolution Operations.” Thing long-awaited rule was proposed in November 2023 by the Biden Administration.
- Prescription Drugs
- Prior Authorization. A proposed rule on interoperability standards and prior authorization for drugs.
- Price Negotiation. A proposed rule titled, “Medicare Drug Price Negotiation Program.”
- Oversight and Integrity
- Fraud and Abuse. A proposed rule titled, “Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).”
- Accrediting Organizations. A final rule titled, “Strengthening Oversight of Accrediting Organizations (AO), Burden Reduction, and Related Provisions.”
- Other Topics:
- Health Technology. A final rule titled, “Administrative Simplification: Adoption of Standards for Health Care Attachment Transactions and Electronic Signatures.”
- An interim final rule titled, “Unaccompanied Children Program Foundational Rule; Update to Include Proof of Identity and Income Verification Standards.”
- Nutrition Assistance. A proposed rule titled, “Supplemental Nutrition Assistance Program: Reforming Categorical Eligibility.”
- Medication-Assisted Treatment. A final rule titled, “Implementation of the SUPPORT Act: Dispensing and Administering Controlled Substances for Medication-Assisted Treatment.”