Gregg's Top Three Health Policy Articles

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

The Top Three...

The Washington Post: Internal Budget Document Reveals Extent Of Trump Health Program Cuts The Trump administration is seeking to deeply slash budgets for federal health programs, a roughly one-third cut in discretionary spending by the Department of Health and Human Services, according to a preliminary budget document obtained by The Washington Post. The HHS budget draft, known as a “passback,” offers the first full look at the health and social service priorities of President Donald Trump’s Office of Management and Budget as it prepares to send his 2026 fiscal year budget request to Congress. (Sun, Johnson, Roubein, Achenbach and Weber, 4/16)

Modern Healthcare: Hospitals To See Medicare Rate Increase For 2026 In CMS Proposal Medicare reimbursements for inpatient hospital care would increase 2.4% in fiscal 2026 under a proposed rule the Centers for Medicare and Medicaid Services published Friday. Long-term care hospitals would get a 2.6% pay hike under the same draft regulation. A separate rule issued Friday calls for a 2.4% boost to inpatient psychiatric facility rates next fiscal year, which begins Oct. 1. (Early, 4/11)

The Washington Post: DOGE Pauses Health-Care Grants, Freezing Payments For Review The U.S. DOGE Service is putting new curbs on billions of dollars in federal health-care grants, requiring government officials to manually review and approve previously routine payments — and paralyzing grant awards to tens of thousands of organizations, according to 12 people familiar with the new arrangements. The effort, which DOGE has dubbed “Defend the Spend,” has left thousands of payments backed up, including funding for doctors’ and nurses’ salaries at federal health centers for the poor. Some grantees are waiting on payments they expected last week. (Diamond, Johnson and Natanson, 4/17)

For a Deeper Dive...

Stat: Supreme Court To Hear Challenge To ACA Rule Requiring Free Preventative Care, Cancer Screenings For a decade and a half, Americans have been guaranteed that no matter their health insurer, certain preventive care like cancer screenings are free of charge. That’s because an Affordable Care Act provision has required insurers to fully cover services given an A or B recommendation by an expert task force. (Chen, 4/17)

MedPage Today: RFK Jr. Says The Medical System Has 'Perverse Incentives' For Doctors HHS is trying to change the "perverse incentives" in the medical system, including the way doctors are paid, HHS Secretary Robert F. Kennedy Jr. said Tuesday. "A lot of the negative behavior and self-destructive behavior in both the medical system -- how we pay for healthcare -- and how we eat is driven by perverse incentives," Kennedy said at a press conference at the Indiana State Library in Indianapolis. "Today, we have a healthcare system that reimburses doctors and hospitals for procedures rather than for health outcomes. We have to change that." (Frieden, 4/15)

The Washington Post: NIH Science Board Purge Hits Women And Minorities Hardest, Review Shows Thirty-eight of 43 experts cut last month from the boards that review the science and research that happens in laboratories at the National Institutes of Health are female, Black or Hispanic, according to an analysis by the chairs of a dozen of the boards. The scientists, with expertise in fields that include mental health, cancer and infectious disease, typically serve five-year terms and were not given a reason for their dismissal. About a fifth of the roughly 200 board members — who provide an independent, expert layer of review for the vast research enterprise within the NIH — were fired. (Johnson, 4/16)

KFF Health News: Beyond Ivy League, RFK Jr.’s NIH Slashed Science Funding Across States That Backed Trump The National Institutes of Health’s sweeping cuts of grants that fund scientific research are inflicting pain almost universally across the U.S., including in most states that backed President Donald Trump in the 2024 election. A KFF Health News analysis underscores that the terminations are sparing no part of the country, politically or geographically. About 40% of organizations whose grants the NIH cut in its first month of slashing, which started Feb. 28, are in states Trump won in November. (Bichell and Pradhan, 4/17)

Stat: Trump Targets Health Care Costs With Executive Order On Drug Price Negotiations, Hospital Payments President Trump unveiled a wide-ranging executive order on Tuesday that aims to lower drug prices, boost transparency into fees charged by middlemen, and limit Medicare payments for outpatient services provided by hospitals. Much of the order would require further rulemaking or other actions to have any effect. (Bannow and Oza, 4/15)

Roll Call: Health Groups Urge RFK Jr. To Reinstate Injury Center Staff A group of more than 40 organizations is urging Health and Human Services Secretary Robert F. Kennedy Jr. to reinstate staff who were purged at the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control. (DeGroot, 4/14)

Politico: RFK Jr. Says Deep State ‘Is Real,’ Called FDA Employees ‘Sock Puppet’ Of Industry HHS Secretary Robert F. Kennedy Jr.’s visit to the FDA Friday was supposed to introduce him as a trusted leader to agency employees. It did anything but. Over the course of 40 minutes, Kennedy, in largely off-the-cuff remarks, asserted that the “Deep State” is real, referenced past CIA experiments on human mind control and accused the employees he was speaking to of becoming a “sock puppet” of the industries they regulate. (Cancryn, Gardner and Lim, 4/11)

KFF Health News: Covid Worsened Shortages Of Doctors And Nurses. Five Years On, Rural Hospitals Still StruggleEven by rural hospital standards, Keokuk County Hospital and Clinics in southeastern Iowa is small. The 14-bed hospital, in Sigourney, doesn’t do surgeries or deliver babies. The small 24-hour emergency room is overseen by two full-time doctors. CEO Matt Ives wants to hire a third doctor, but he said finding physicians for a rural area has been challenging since the covid-19 pandemic. He said several physicians at his hospital have retired since the start of the pandemic, and others have decided to stop practicing certain types of care, particularly emergency care. (Krebs, 4/18)

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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