Morning Briefing
Summaries of health policy coverage from major news organizations
House Passes Trump鈥檚 Big Tax Bill Promising Changes For Medicaid, HSAs
Americans could see major changes to Medicaid, food stamps, border security and taxes under a sweeping Republican bill that passed the U.S. House early on May 22. The proposal, which President Donald Trump has dubbed the "big, beautiful bill," would enact Trump's major campaign promises like eliminating taxes on workers' tips and overtime and is likely to be one of the most significant pieces of legislation that will be passed during his second term in the Oval Office. (Beggin, 5/22)
House Republicans leaders are planning to accelerate new Medicaid work requirements to December 2026 in a deal with ultra-conservatives on the giant tax bill, according to a lawmaker familiar with the discussions. The revised version of President Donald Trump鈥檚 economic package 鈥 which party leaders hope to release Wednesday 鈥 calls to move up work requirement to December 2026 from 2029, the lawmaker said, who requested anonymity to discuss private talks. (Wasson and Cohrs Zhang, 5/21)
House GOP leadership has agreed to a series of last-minute changes to its sweeping tax and spending package designed to win over holdouts. The manager鈥檚 amendment includes changes to the state and local tax (SALT) deduction cap and proposed Medicaid reforms, along with other proposals, as leadership works to satisfy various factions of the GOP conference to lock down sufficient support to secure its passage. (Folley and Frazin, 5/21)
House Republicans made substantial changes to the Medicaid portion of the GOP megabill in amendments unveiled Wednesday night, including accelerating work requirements and paying states not to expand the program under the Affordable Care Act. The proposal will move up the start date of Medicaid work requirements from Jan. 1, 2029, to Dec. 31, 2026, in a concession to conservative hard-liners who have been pushing for deeper cuts to the program. (Leonard, Lee Hill and King, 5/21)
Rep. Judy Chu (D-Ca.) said she worries over the future of at-home care for seniors if President Donald Trump鈥檚 federal funding package passes in the House. Trump鈥檚 鈥渂ig, beautiful bill鈥 proposes cutting billions from social benefit programs, including $800 billion from Medicaid and $300 billion from the Supplemental Nutrition Assistance Program (SNAP). Chu called the proposed reduction in Medicaid funding the most 鈥渄evastating cut to services for seniors in our lifetime鈥 since it will force states to heavily reduce the amount of money they spend on at-home care for older people and people with disabilities.聽(O鈥機onnell-Domenech, 5/21)
The group says a provision barring it from receiving Medicaid funds could lead to one-third of its health centers closing. Planned Parenthood said about 200 centers are at risk 鈥 most of them in states where abortion is legal. The nation鈥檚 largest abortion provider also offers other health services, including birth control and cancer screening. State Medicaid money covers abortion in some states, but not others. (Mulvihill, 5/22)
Not to be lost within a sprawling Republican-backed budget bill are new flexibilities designed to increase usage of heath savings accounts (HSAs), individual coverage health reimbursement arrangements (ICHRAs) and direct primary care (DPC) arrangements. These changes, wrapped inside a one-sided reconciliation bill, are much less controversial than other provisions to reduce Medicaid spending, drive down enrollment in the Affordable Care Act (ACA) exchanges and impose a long-term moratorium on artificial intelligence regulations. (Tong, 5/21)
Health systems are cutting support staff as they brace for potential federal funding cuts, a move that could limit hospital capacity and care quality. Providers have laid off thousands of workers over the last several months 鈥 predominantly nonclinical employees 鈥 as Congress looks to decrease federal spending through potential聽cuts to National Institutes of Health grants and Medicaid. (Kacik, 5/21)
On Medicare Advantage 鈥
President Trump鈥檚 federal Medicare agency will expedite audits of Medicare Advantage insurers, a move that could claw back nearly $500 million a year for taxpayers, according to previous federal estimates. However, the audits remain mired in a two-year-old lawsuit initiated by Humana, making it unclear how the Trump administration will implement its new strategy. (Herman, 5/21)
A bipartisan bill aiming to reform prior authorization has been reintroduced in the Senate. The Improving Seniors' Timely Access to Care Act seeks to streamline the prior auth process in Medicare Advantage (MA), which would ease administrative burdens on providers and reduce delays in accessing care for patients. (Minemyer, 5/21)
