Gregg's Top Three Health Policy Articles

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

The Top Three...

Politico: Trump Picks Dr. Oz To Be CMS Administrator Oz has been a major supporter of Medicare Advantage, the Medicare-approved private option that has grown in popularity but has come under intense scrutiny for care denials and alleged overbilling. During his Senate campaign, Oz pushed a “Medicare Advantage for All” plan that would expand the program. “These plans are popular among seniors, consistently provide quality care and have a needed incentive to keep costs low,” Oz said in an AARP candidate questionnaire. In August, he posted a YouTube video to his nearly 2 million subscribers on “the benefits of enrolling” in Medicare Advantage. (Leonard and King, 11/19)

The Washington Post: Millions May Not Have Health Coverage If Subsidies Return To Pre-Biden Level But eliminating the subsidy increase poses political risks. If subsidies fall to their pre-2021 level, experts say, many new subscribers would choose not to renew their coverage — the nonpartisan Congressional Budget Office predicted that 3.4 million more people would become uninsured — and many of them live in states that lean heavily Republican. Health policy research organization KFF said that if the subsidy expansion expires, premiums would more than double in 12 heavily Republican states — including Texas, West Virginia and Alaska — while rising less sharply in many blue states. (Weil, 11/17)

The New York Times: Medicaid May Face Big Cuts And Work Requirements With Republicans set to control Washington, conservative lawmakers and policy experts who could advise the next Trump administration are discussing long-sought cuts to Medicaid, the government health program that covers roughly a fifth of all Americans and makes up about 10 percent of the federal budget. Some of the changes are being proposed as a way to pay for a law that would extend the tax cuts from the first Trump administration, most of which benefited corporations and wealthier Americans. The policies might slash funding for Obamacare’s Medicaid expansion — which added roughly 23 million people to the program — or require that many enrollees work in order to receive benefits. (Kliff and Weiland, 11/20)

For a Deeper Dive...

KFF Health News: What To Know About RFK Jr.'s Stances On Key Health Issues And What He Could Do At HHS Robert F. Kennedy Jr., President-elect Donald Trump’s pick to lead the Department of Health and Human Services, is coming into the nomination process in an unusual position, with a long list of his own policy priorities separate from the president-elect’s, and a public promise by Trump to let him “go wild” on his ideas. (Gounder, 11/15)

The Washington Post: RFK Jr. Weighs Major Changes To How Medicare Pays Physicians Robert F. Kennedy Jr. and his advisers are considering an overhaul of Medicare’s decades-old payment formula, a bid to shift the health system’s incentives toward primary care and prevention, said four people who spoke on the condition of anonymity to discuss private deliberations. The discussions are in their early stages, the people said, and have involved a plan to review the thousands of billing codes that determine how much physicians get paid for performing procedures and services. (Diamond, 11/21)

KFF Health News: Washington Power Has Shifted. Here’s How The ACA May Shift, Too President-elect Donald Trump’s return to the White House could embolden Republicans who want to weaken or repeal the Affordable Care Act, but implementing such sweeping changes would still require overcoming procedural and political hurdles. Trump, long an ACA opponent, expressed interest during the campaign in retooling the health law. In addition, some high-ranking Republican lawmakers — who will now have control over both the House and the Senate — have said revamping the landmark 2010 legislation known as Obamacare would be a priority. They say the law is too expensive and represents government overreach. (Armour, Whitehead and Rovner, 11/21)

The Hill: GOP Senators Warn Trump Against Aggressive Recess Appointment Move Republican senators are pouring cold water on the idea that President-elect Trump could force the Senate into an extended recess next year so that he would be able to fill key positions in his Cabinet without going through the Senate confirmation process. Republican senators and aides say that Trump allies who claim that the incoming president would have power under Article II, Section 3 of the Constitution to force an extended recess don’t understand how Congress really works. (Bolton, 11/22)

Modern Healthcare: PBM Bill May Pass Congress As Part Of Telehealth Extension Congress has tried for much of the last two years to pass legislation to rein in pharmacy benefit managers, only to have negotiations fall just short. With lawmakers back for a post-election lame duck session, analysts see one last chance — but also a likelihood the effort may wait until Republicans take control of Capitol Hill next year. (McAuliff, 11/15)

Politico: Project 2025 Author Rejected For Top Health Position Donald Trump’s transition team has rejected a push to install a prominent Project 2025 author in a senior role at the Department of Health and Human Services over concerns that his strident anti-abortion views would prove too controversial. Anti-abortion groups had been lobbying Trump’s HHS secretary nominee, Robert F. Kennedy Jr., to select Roger Severino, a longtime anti-abortion stalwart, as the department’s deputy secretary. The installation of Severino, director of HHS’ Office for Civil Rights during the first Trump administration, was aimed at allaying some of the groups’ concerns about Kennedy’s abortion record. But senior Trump officials rejected Severino because of the anti-abortion policies he outlined in the health care section of Project 2025, according to six people familiar with the situation. (Messerly and Cancryn, 11/21)

KFF Health News: TV’s Dr. Oz Invested In Businesses Regulated By Agency Trump Wants Him To Lead President-elect Donald Trump’s choice to run the sprawling government agency that administers Medicare, Medicaid, and the Affordable Care Act marketplace — celebrity doctor Mehmet Oz — recently held broad investments in health care, tech, and food companies that would pose significant conflicts of interest. Oz’s holdings, some shared with family, included a stake in UnitedHealth Group worth as much as $600,000, as well as shares of pharmaceutical firms and tech companies with business in the health care sector, such as Amazon. (Tahir, 11/21)

Stat: The Health Care Industry Is Girding For Trump’s Tariffs —And Pushing Hard For Carveouts President-elect Trump campaigned on imposing broad, steep tariffs to create more jobs in the U.S. and combat China. If enacted, these taxes would send the U.S. health care industry scrambling and could eventually force patients and insurers to shell out more for medical care. But no one in the industry is in a tizzy just yet, at least not publicly. There are two reasons for that. One: No one knows what Trump is actually going to do. Two: They’re pushing hard for carve-outs behind the scenes. (Bannow and Silverman, 11/21)

Modern Healthcare: Underinsured Patients At Risk If ACA Subsidies Lapse More people may face gaps in insurance coverage, have trouble affording medical care or not be able to pay for coverage if certain Affordable Care Act subsidies aren't renewed next year, the Commonwealth Fund said Thursday. The independent healthcare research organization's 2024 report on health insurance found 44% of Americans are underinsured, face coverage gaps or are uninsured, despite improvements in lowering the number of uninsured citizens. In its 2022 report, the group pegged the percentage at 43%. (DeSilva, 11/20)

The Times: Dr Oz And RFK Jr: What Are Their Plans For US Health Care? Oz is passionate about wacky — and often widely debunked — medicines. In 2010, he said that sleeping with a bar of lavender soap could help to prevent restless leg syndrome. On an episode of The Dr. Oz Show, which ran for 13 seasons, he said: “I know this sounds crazy, but people put it under their sheets.” It was widely refuted by medical experts. A group of ten doctors later demanded that Oz be fired from Columbia University’s medical faculty, arguing that he had “repeatedly shown disdain for science and for evidence-based medicine”. The university did not take action. (Agnew, 11/20)

Stars and Stripes: Sweeping Bill To Expand Veteran Health Care Outside VA Passes House The House passed a sweeping package of measures Monday to expand and strengthen private-sector medical care outside the Department of Veterans Affairs. The package will increase coverage for in-home care of disabled and aging veterans, fund mental health counseling for home-based caregivers and better integrate information on private clinicians in the VA’s computer system to facilitate appointments and sharing patient records. The omnibus package — known as the Sen. Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act —was approved 389-9, with support fairly even along party lines. (Hersey, 11/19)

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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