Gregg's Top Three Health Policy Articles

If you can only read three things about health policy this week, I suggest...

The Top Three...

NBC News: Top Three Insurers Reaped $7.3 Billion Through Their Drug Middlemen's Markups, FTC Says The three largest drug middlemen inflated the costs of numerous life-saving medications by billions of dollars over the past few years, the Federal Trade Commission said in a report Tuesday. The top pharmacy benefit managers (PBMs) — CVS Health’s Caremark Rx, Cigna’s Express Scripts and UnitedHealth Group’s OptumRx — generated roughly $7.3 billion through price hikes over about five years starting in 2017, the FTC said. (Kopack and Kaplan, 1/14)

Modern Healthcare: 3 Biden Healthcare Regulations Trump Will Have To Finalize When President-elect Donald Trump returns to the White House next Monday, his administration faces key decisions on healthcare policies President Joe Biden left uncompleted. Regulations governing Medicare, remote prescribing of controlled substances, and billing disputes between health insurers and providers top the list of proposed rules the Trump administration will have to retain, modify or eliminate. To be sure, the Biden administration could opt to rush out final rules in his last days, but they are more likely to fall to the new team. (Early, 1/13)

Politico: Medicaid, ACA, Climate Measures On GOP Chopping Block House Republicans are passing around a “menu” of more than $5 trillion in cuts they could use to bankroll President-elect Donald Trump’s top priorities this year, including tax cuts and border security. The early list of potential spending offsets obtained by POLITICO includes changes to Medicare and ending Biden administration climate programs, along with slashing welfare and “reimagining” the Affordable Care Act. (Leonard, Hill and Tamborrino, 1/10)

For a Deeper Dive...

The Hill: Mike Pence-Founded Group Urges Senators To Vote Against Robert F. Kennedy, Jr. The conservative group founded by former Vice President Mike Pence is calling on senators to vote against confirming Robert F. Kennedy Jr. as Health and Human Services (HHS) Secretary because of his previous support for abortion. “Whatever the merits of RFK Jr’s Make America Healthy Again initiative—indeed, whatever other qualities a nominee might possess—an HHS Secretary must have a firm commitment to protect unborn children, or else bend under the pressure and pushback surrounding these daily, critical decisions,” Advancing American Freedom President Tim Chapman and Board Chairman Marc Short wrote in a letter to senators. (Weixel, 1/15)

Becker's Hospital Review: Trump's Plans For HHS: 13 Knowns President-elect Donald Trump's HHS appointees represent a broad spectrum of healthcare perspectives and are poised to significantly influence public health, pharmaceuticals and health systems. With a $1.8 trillion budget in 2024, the department's leadership will have the authority to direct policy, allocate resources, and oversee pivotal agencies — including the CDC, FDA, CMS and NIH — affecting the lives of hundreds of millions of Americans. (Emerson and Gamble, 1/15)

Politico: Employers Outline Health Priorities Under Trump Groups representing employers that offer health insurance are gearing up to defend and try to bolster the largest source of health coverage for people under 65 in the U.S., your host reports. Donald Trump’s election and Republican majorities in Congress have raised some uncertainty on what’s coming down the pike for employer-sponsored health insurance, which covers almost 165 million Americans. (Hooper, 1/16)

The New York Times: Online Therapy Boom Has Mainly Benefited Privileged Groups, Studies Find The number of Americans receiving psychotherapy increased by 30 percent during the pandemic, as virtual sessions replaced in-person appointments — but new research dampens the hope that technology will make mental health care more available to the neediest populations. In fact, the researchers found, the shift to teletherapy has exacerbated existing disparities. (Barry, 1/15)

Politico: SCOTUS Agrees To Hear Challenge To Obamacare’s Preventive Care Coverage The Supreme Court on Friday agreed to hear a broad challenge to the Affordable Care Act’s coverage of preventive services in its upcoming term, the latest in more than a decade of battles over the health reform law. A ruling for the conservative Texas employers who filed the case would erode the coverage of tens of millions of people who get their health insurance from their employer or through Obamacare’s marketplace, removing requirements that insurers cover the full cost of everything from birth control to vaccines to mental health screenings. (Ollstein and Gerstein, 1/10)

The War Horse: Republicans Propose Bills That Steer More Veterans Into Private Health Care With the new Congress sworn in and President-elect Trump poised for his second inauguration, Republicans have queued up a number of bills that could widely expand veterans’ access to the private health care system, setting up the latest battle over VA’s reliance on what’s known as community care. Efforts to reform how the Department of Veterans Affairs provides health care to millions of veterans are heating up in 2025 as pressures to bring down costs and lower wait times for care mount. (Marshall-Chalmers, 1/16)

Modern Healthcare: Private Equity, Consolidation Concerns Highlighted In Report Three federal agencies on Wednesday said "more effective and vigorous" enforcement is needed to protect patients harmed by healthcare's continued consolidation. In a report released just days before a new administration takes over, the Health and Human Services Department, Federal Trade Commission and Justice Department said comments they sought earlier this year on the state of the industry made clear that worries about access to services and costs have intensified as consolidation and private equity's role have grown. (DeSilva, 1/16)

The Washington Post: Dr. Oz’s Medicare Leadership Team At CMS Takes Shape President-elect Donald Trump appears poised to tap a trio of health policy experts to serve as top deputies to Mehmet Oz, his pick to oversee the Centers for Medicare and Medicaid Services, according to seven people who spoke on the condition of anonymity to discuss private conversations. (Diamond, 1/14)

The Hill: Patient Groups Call On Trump Administration To Let Medicare Cover Obesity Drugs A coalition of obesity-related patient advocacy groups is calling on the incoming Trump administration to finalize a proposal that would allow Medicare to cover obesity medications. Led by the Obesity Care Advocacy Network (OCAN), more than 70 organizations said in a statement that addressing, treating and managing obesity is key to making America healthier. The groups pointed to a study that found if nothing is done, 213 million Americans will be overweight or obese by 2050. (Weixel, 1/13)

KFF Health News: Can Medical Schools Funnel More Doctors Into The Primary Care Pipeline? Throughout her childhood, Julia Lo Cascio dreamed of becoming a pediatrician. So, when applying to medical school, she was thrilled to discover a new, small school founded specifically to train primary care doctors: NYU Grossman Long Island School of Medicine. Now in her final year at the Mineola, New York, school, Lo Cascio remains committed to primary care pediatrics. But many young doctors choose otherwise as they leave medical school for their residencies. In 2024, 252 of the nation’s 3,139 pediatric residency slots went unfilled and family medicine programs faced 636 vacant residencies out of 5,231 as students chased higher-paying specialties. (Freyer, 1/13)

For the Visual Among Us...

A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD