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The Senate parliamentarian has advised that a Medicaid provider tax overhaul central to President Donald Trump’s tax cut and spending bill does not adhere to the chamber’s procedural rules, delivering a crucial blow as Republicans rush to finish the package this week. Guidance from the parliamentarian is rarely ignored and Republican leaders are now forced to consider difficult options. Republicans were counting on big cuts to Medicaid and other programs to offset trillions of dollars in Trump tax breaks, their top priority. Additionally, the parliamentarian, who is the Senate’s chief arbiter of its often complicated rules, advised against various GOP provisions barring certain immigrants from health care programs. (Mascaro, 6/26)

Much of the savings in the bill come from Medicaid cuts, and the ruling impacts several of the largest and most controversial ones, including a plan to slash states’ use of health care provider taxes as well as several measures related to health care for immigrants.That provider tax proposal would have generated hundreds of billions of dollars in savings to offset the cost of the legislation, and MacDonough’s decision is sending Republicans back to the drawing board.  (Swanson, 6/26)

Senate Majority Leader John Thune (R-S.D.) on Thursday said he will not overrule the parliamentarian after she rejected key Medicaid provisions in the GOP’s tax and spending megabill, dealing a blow to Republicans’ plan to pay for tax cuts in the package. “No. That would not be a good outcome for getting a bill done,” Thune told reporters at the Capitol. Senate Parliamentarian Elizabeth MacDonough rejected a plan that would cap states’ ability to collect more federal Medicaid funding via healthcare care provider taxes. (Weaver, 6/26)

�鶹Ů�� Health News: Thune Says Health Care Often ‘Comes With A Job.’ The Reality’s Not Simple Or Straightforward

Millions of people are expected to lose access to Medicaid and Affordable Care Act marketplace health insurance plans if federal lawmakers approve the One Big Beautiful Bill Act, President Donald Trump’s domestic policy package, which is now moving through the Senate. Senate Majority Leader John Thune discussed health care and the pending legislation in an interview with KOTA, a South Dakota TV station. But he focused on a different kind of health insurance — employer-sponsored insurance. (Zionts, 6/27)

More than 670,000 North Carolinians have enrolled in Medicaid since the state expanded access to the government-funded health insurance program in December 2023. Medicaid expansion, which passed with bipartisan support after years of resistance from most Republicans in the N.C. General Assembly, raised the state’s strict income threshold for Medicaid. That opened up the program to many working adults with lower incomes who previously made too much money to qualify. (Baxley, 6/27)

UCHealth, Colorado’s largest health care provider, has prevailed for now in an exceptionally complicated fight with the state Medicaid agency over hospital provider fee money — a dispute that could see as much as $50 million a year shift away from public hospitals and move to private hospitals, according to state officials. (Ingold, 6/27)

Home-based primary care companies promise to do for kids what others are doing for older adults: keep them healthy and out of hospital emergency rooms. Start-up companies such as Nest Health, Imagine Pediatrics and Bluebird Kids Health are partnering with Medicaid managed care organizations to provide a variety of primary care services to low-income kids where they live. Easy access to care could help prevent more costly interventions down the road and save money as states face hundreds of billions of dollars in potential federal funding cuts to their Medicaid programs. (Eastabrook, 6/26)

�鶹Ů�� Health News: Too Sick To Work, Some Americans Worry Trump’s Bill Will Strip Their Health Insurance

Stephanie Ivory counts on Medicaid to get treated for gastrointestinal conditions and a bulging disc that makes standing or sitting for long periods painful. Her disabilities keep her from working, she said. Ivory, 58, of Columbus, Ohio, believes she would be exempt from a requirement that adult Medicaid recipients work, but she worries about the reporting process. “It’s hard enough just renewing Medicaid coverage every six months with the phone calls and paperwork,” she said. (Galewitz and Armour, 6/27)

While there's little disagreement that speeding drug approvals would be a good thing, there are more questions than answers about the FDA's new national priority voucher program, experts told MedPage Today. Earlier this month, FDA Commissioner Marty Makary, MD, MPH, announced the creation of the Commissioner's National Priority Voucher (CNPV) program .Essentially, companies that meet criteria for aligning with a set of national health priorities will receive a voucher that entitles them to a speedier review -- one that's been advertised as taking 1 to 2 months instead of 10 to 12 months. (Fiore, 6/26)

At his confirmation hearing in March, National Institutes of Health Director Jay Bhattacharya assured the Senate health committee that he would restart grant reviews, after a months-long suspension by the Trump administration, and get all of the agency’s congressionally appropriated money out the door. When the key committees resumed meeting the next month, it appeared to be a positive step toward restoring the flow of billions of dollars in biomedical research funding to universities and medical schools. (Molteni and Parker, 6/27)

Federal prosecutors on Thursday unveiled charges against 11 Eastern Europeans they accused of running a sophisticated, $10.6 billion Medicare fraud scheme in what appears to be one of the largest such busts in government history. According to an indictment unsealed in federal court in New York, the group based in Russia and elsewhere submitted billions of dollars in false health care claims using personal information stolen from more than 1 million Americans in all 50 states. (Roebuck and Diamond, 6/26)

�鶹Ů�� Health News’ ‘What The Health?’ Podcast: Live From Aspen — Governors And An HHS Secretary Sound Off

It’s not exactly news that our nation’s health care system is only a “system” in the most generous sense of the word and that no one entity is really in charge of it. Notwithstanding, there are some specific responsibilities that belong to the federal government, others that belong to the states, and still others that are shared between them. And sometimes people and programs fall through the cracks. (Rovner, 6/26)

Former U.S. Rep. Carolyn McCarthy, who successfully ran for Congress in 1996 as a crusader for gun control after a mass shooting on a New York commuter train left her husband dead and her son severely wounded, has died. She was 81. News of her death was shared Thursday by several elected officials on her native Long Island and by Jay Jacobs, chair of the New York State Democratic Committee. Details about her death were not immediately available. (Eltman, 6/26)