Top News
Health Subcommittee Advances 15 Bipartisan Healthcare Bills
On June 25th, the House Energy & Commerce Health Subcommittee held a markup in which they considered 15 bipartisan healthcare bills. The bills largely targeted addressing illicit drugs, increasing healthcare price transparency, and strengthening the oversight of prior authorization. The 15 bills considered included bills to increase fentanyl testing in hospitals and communities, increase the supply of opioid overdose reversal drugs, and improve price transparency. Notably, the widely anticipated Lower Costs, More Transparency Act (H.R. 9393), which would codify existing federal regulations around pricing transparency requirements for hospitals, health plans, labs, and other health care industry stakeholders was considered. Additionally, one third of bills would reform Medicare Advantage (MA):
- The Premium Transparency Act (H.R.9397) aims to improve the transparency of premium calculations for MA and Affordable Care Act marketplace plans by requiring health insurance issuers to publish overhead costs and claim payments.
- The Prior Authorization Accountability Act (H.R. 9396) aims to advance prior authorization transparency by requiring the public reporting of approval and denial rates, appeal decisions, and AI use in individual and group plans subject to the Public Health Service Act (PHSA) and Employee Retirement Income Security Act (ERISA).
- The Improving Seniors’ Timely Access to Care Act (H.R. 3514), would require all MA plans that utilize prior authorization to implement an electronic prior authorization program and send information about prior authorization requirements, denial rates, appeals rates, among other utilization and procedural prior authorization practices.
- The Medicare Advantage Cost Transparency Act (H.R.9392) mandates MA plans to submit encounter data on the item or service allowed amount, amount of cost sharing imposed, and indicate that an at-home risk assessment was conducted for the individual prior to the furnishing of any at-home items or services.
- H.R.5243 would amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under MA by requiring MA organizations to submit enrollee-level data on supplemental benefits offered, utilized, and associated out-of-pocket costs to the Department of Health and Human Services (HHS) which would be aggregated and published publicly.
- Transparency in Medicare Advantage Steering Act (H.R.9395) aims to improve the visibility of the scope and role of third-party companies, agents, and brokers in MA enrollment by requiring MA organizations to send data on whether a beneficiary was enrolled in the MA plan by an agent, broker, or third party, how much the agent, broker, or third party was compensated for that individual’s enrollment, the total value of compensation the MA organization paid to agents, brokers, and third parties to HHS which then would be published publicly.
The bundle of bills reviewed represent a desire to increase transparency, accountability, and affordability in the healthcare system, a pursuit shared by Democrats and Republicans on the Committee alike. Unfortunately, most of the MA bills did not acknowledge the existence of the group MA market, resulting in multiple bills failing to account for the unique considerations of MA Employer Group Waiver Plans (EGWPs). All 15 bills were approved by the subcommittee and forwarded to the full committee by voice vote. The Roundtable will continue to monitor these bills as they move through the House.
Analysis Finds H.R. 1’s Rural Health Program Funding Is Outweighed by Bill’s Other Health Program
A new Commonwealth Fund issue brief found that the $50 billion Rural Health Transformation Program authorized in the One Big Beautiful Bill Act (H.R. 1) will be outweighed by the law’s much larger cuts to Medicaid programs, the Affordable Care Act (ACA) marketplaces, and the Supplemental Nutrition Assistance Program (SNAP). Using IMPLAN economic modeling, the authors project that in 2026 alone, the $10 billion in rural health transformation program funding and resulting job gains will be eclipsed by $31 billion in ACA marketplace funding losses tied to the expiration of enhanced premium tax credits, producing a net loss of 229,000 jobs nationwide. The authors project that Southern non-expansion states like Georgia, Texas, and Florida will experience the greatest overall direct federal funding, state and local tax revenue, and job losses. Additionally, Maine, Alaska, New Hampshire, Nevada, and Washington are expected to experience marginal increases in federal funding, state and local tax revenue, and employment.
By the time all of the law’s provisions are implemented in 2029, the economists project the combined federal funding cuts of $160 billion will shrink states’ Gross Domestic Products (GDPs) by $197 billion and eliminate 1.65 million jobs, roughly a 1.0 percentage point rise in the national unemployment rate. The authors note that state and local tax revenues will fall by over $14 billion in 2029, compounding the fiscal squeeze, and argue the rural health funding offsets only a small fraction of the broader economic damage, particularly in the larger, more urban states that drive most of the national job losses. A full breakdown of H.R.1’s impact on all 50 states and the District of Columbia is available in Appendix 1 of the brief.
Administrative Action
HHS Moves to Fast-Track Early Drug Trials
The Department of Health and Human Services (HHS) released a blueprint on Monday aimed at making it faster and cheaper for drug companies to launch early-stage clinical trials in the U.S. in the wake of biotechnology firms moving to China. The Food and Drug Administration (FDA) plans to specify exactly what data is needed for Investigational New Drug applications, allow more flexible trial protocols that avoid formal amendments for minor changes, and pilot a consultation network plus a “rolling submission” platform to give developers faster feedback. HHS is also examining whether trials could legally pay patients cash stipends beyond expense reimbursement while the National Institutes of Health (NIH) plans to leverage telehealth, remote monitoring, and artificial intelligence tools to help rural and underserved patients enroll in studies.
The plan fits into a broader federal push to protect domestic pharmaceutical manufacturing competitiveness, especially compared to Chinese biotechnology. Currently, many biotechnology companies are developing products in China because the country allows researchers to begin drug trials within 18 months of a molecule’s discovery. Former FDA Commissioner Scott Gottlieb argued the U.S. has natural strengths in early trials but risks losing its competitive edge if cost and speed gaps with China continue widening. Most of the proposal must undergo formal rulemaking or pilot testing before taking effect, and the potential for offering study participants a stipend raises unresolved issues around anti-kickback laws and patient consent.
Department of Justice Announces Largest to Date Health Care Fraud Enforcement Action
The Department of Justice (DOJ) announced criminal charges against 455 individuals, including 90 physicians and other licensed health care professionals, in what officials described as the largest health care fraud enforcement action in departmental history. Prosecutors allege the defendants participated in schemes involving more than $6.5 billion in fraudulent claims submitted to federal health programs and private insurers. The cases span a range of alleged misconduct including Medicaid fraud, illegal kickbacks, opioid diversion, and billing for medically unnecessary services. The DOJ seized more than $182 million in assets and took actions against thousands of providers by suspending payments, revoking provider billing privileges, and pressing civil charges.
The announcement highlighted several large-scale schemes involving wound care products, behavioral health services, and hospice care. DOJ stated that the enforcement action required state, national, and international cooperation, underscoring the scale of transnational fraudulent schemes. When announcing the enforcement activity, CMS announced that they entered an agreement with the DOJ’s Fraud Division to facilitate the deployment of advanced data analytics algorithms and artificial intelligence tools to identify fraudulent activity. Additionally, CMS solicited pledges from Medicaid, Managed Care, and other Medicare Part B claims stakeholders to participate in the development of a Claims Core processing system with electronic attestation, identification verification, and IP address log-in.
White House Estimates Major Savings From Banning Certain Hospital Contracting Practices
The White House Council of Economic Advisers (CEA) released a report estimating that banning hospital systems from deploying anti-steering, anti-tiering, and other all-or-nothing contracting practices could significantly reduce healthcare costs for employers and workers. The CEA estimated that one in four employer-sponsored insurance covered lives are in metropolitan statistical areas, referred to as markets, where these contracts are prevalent and producing measurable effects. They estimate that eliminating these practices would reduce hospital and affiliated physician prices by an 18 percent in affected markets, resulting in average savings of roughly $4,100 per inpatient admission. These savings would translate into a 6.5 percent reduction in employer-sponsored insurance (ESI) premiums in affected markets, saving families approximately $1,800 and individuals about $600, per year. The White House research suggests that lower health care costs could improve employment, wages, and federal tax revenues by reducing cost pressures on non-health care employers, especially those operating in rural communities. The analysis follows recent Department of Justice (DOJ) antitrust lawsuits alleging that OhioHealth and New York-Presbyterian deployed anti-steering provisions that suppress competition and limit insurers’ ability to encourage patients to seek care in lower cost hospitals and selectively contract with some hospitals instead of the entire health system.
President Nominates Chis Klomp as HHS No. 2
Last week, President Trump nominated Chris Klomp to be Deputy Secretary of the Department of Health and Human Services (HHS) while apparently retaining his role as the Deputy Administrator of the Centers for Medicare and Medicaid Services (CMS) and Director of the Center for Medicare. In addition to serving in the CMS, Klomp has also served as a Chief Counselor to HHS Secretary Robert F Kennedy (RFK) Jr. since April 2025. Deputy Administrator Klomp has been credited for negotiating lower drug prices with 17 manufacturers under the President’s Most Favored Nations (MFN) initiative. Klomp has also been instrumental in major HHS leadership changes including the decision to oust Food and Drug Administration (FDA) Commissioner Marty Makary, proposing Erica Schwartz as the nominee for the Director of the Centers for Disease Control and Prevention (CDC), and filling other senior roles at the CDC including the Chief Operating Officer, Chief Medical Officer, and Principle Deputy Commissioner.
Prior to his work in the second Trump administration, Klomp has been involved with multiple health technology companies including a real-time care notification platform, a health care payment platform, and a telehealth company specializing in fertility. Additionally, Klomp supported President Trump in his first term as an advisor to the President’s response to COVID-19.
In public engagements, Klomp presents as intelligent, competent, disciplined, and strongly aligned with the President’s agenda. Some Democratic Senate aides claim that Klomp’s role as HHS Chief Counselor is to “babysit” RFK Jr. To assume the role as HHS Deputy Secretary, Klomp must undergo nomination hearings in the Senate Finance Committee (SFC) and likely the subcommittee on Health. To achieve the nomination, Klomp must successfully navigate a fractured Republican party who has struggled to push presidential nominations through with their slim majority. Notably, the SFC Subcommittee on Health is chaired by Senator Bill Cassidy (R-LA) who recently lost his primary election to a Trump-backed Republican opponent. On the full Committee, Senator John Corynyn (R-TX) also lost his primary to a Trump-backed challenger and Senator Thom Tillis (R-NC) elected to retire at the end of the current Congressional session due to disagreements with the President.
Congressional Action
House Democrats Outline Potential Oversight Targets Among the Trump Administration
Democrats on the House Committee on Oversight and Government Reform released a 105-page report criticizing the Trump administration’s health policies and outlining areas that could face heightened scrutiny if Democrats regain control of the House after the 2026 midterms. The report leverages more than 80 interviews and 100 case studies to argue that cuts to research funding, staffing reductions across the Department of Health and Human Services (HHS), and increased political involvement in scientific decision-making have weakened the nation’s public health infrastructure. The report specifically highlights disruptions to National Institutes of Health (NIH) grants funding HIV and chronic disease research as well as workforce reductions at federal health agencies.
The report also criticizes changes to federal vaccine policy under HHS Secretary Robert F. Kennedy Jr., including revisions to vaccine recommendations and the restructuring of the CDC’s Advisory Committee on Immunization Practices (ACIP). Led by Ranking Member Robert Garcia (R-CA-42), the Oversight and Government Reform minority representatives argue the administration has undermined public confidence in vaccines and increased political influence over research funding and scientific communications. HHS spokespeople pushed back on the report’s findings, saying the department’s policies advance the administration’s Make America Healthy Again (MAHA) agenda and deliver significant public health reforms.
Judicial Action
Supreme Court Sides with Pesticide Product in Federal Preemption Case
The Supreme Court ruled in favor of Monsanto in Monsanto v. Durnell, in a 7-2 decision authored by Justice Brett Kavanaugh, hindering states from requiring businesses to label potentially harmful products beyond federal requirements. Monsanto produces Roundup, a common weed killer, that includes glyphosate as an active ingredient. Under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), the Environmental Protection Agency (EPA) did not require Monsanto to label Roundup active ingredient as a carcinogen; however, some state laws require the label to indicate the potential to cause cancer.
John Durnell sued Monsanto in Missouri, claiming that 20 years of using Roundup caused his blood cancer. Thousands of other plaintiffs have sued Monsanto across the country for failing to warn them of the carcinogenic effect of Roundup. On the other hand, Monsanto and the Trump administration had argued that because the EPA does not require a cancer warning on glyphosate, states cannot compel one through failure-to-warn litigation. Industry groups like PhRMA backed that position, warning that a ruling against the company would weaken federal preemption more broadly, potentially opening FDA-regulated products like medical devices, food, and drugs to stricter state standards and increased litigation.
Make America Healthy Again (MAHA) advocates have been particularly frustrated by the administration’s stance on pesticides and position in this case, given that reducing pesticide exposure was a stated MAHA priority. President Trump signed an executive order in February of this year that promoted the domestic production of glyphosate-based herbicides, including Roundup.
The Supreme Court ruled that the federal FIFRA law’s uniformity clause does not allow states to “…impose or continue in effect any requirements for labeling or packaging in addition to or different from those required [under the law].” The majority decision ruled that FIFRA preempts the Missouri law allowing Durnell to sue Monsanto for failure to claim because a successful suit would require the Roundup manufacturer to label their product in any way other than the EPA requirement. Justice Ketanji Brown Jackson and Justice Neil Gorsuch dissented, agreeing with almost all state and federal courts that rejected the preemption argument, instead arguing that the failure-to-warn claim was equivalent to FIFRA’s labeling requirement. Ultimately, the thousands of other failure-to-warn suits against Monsanto are expected to be found in Monsanto’s favor to align with the majority opinion.
Industry News
Research Projects Substantial Healthcare Spending Growth Over Next Decade
New research published in Health Affairs projects national health spending to reach nearly $9.0 trillion in 2034, representing more than a fifth of the national gross domestic product (GDP). In 2024, domestic health care spending was $5.3 trillion (18.0% of GDP). By 2034, the researchers anticipate that health care spending will reach $9.0 trillion (20.6% of GDP), representing a $3.7 trillion (2.6% GDP) increase in spending. The spending increase is driven by higher utilization of medical services, high demand for expensive prescription drugs, and demographic trends. Although key provisions of the One Big Beautiful Bill Act (H.R.1) are expected to reduce health care spending by moderating Medicaid spending growth and decreasing the number of people with health insurance over the next ten years, aggregate spending on medical goods and services are expected to outpace these savings. The researchers encouraged policy makers to explore options to address financing challenges while considering goals related to technological advancements, improved population health, and the benefit of health insurance coverage.
Save the Date: 2026 Annual Conference
HealthCare Roundtable 22nd Annual Conference
November 4-6, 2026
The Mayflower Hotel
Washington, D.C.
