SAVE THE DATE – March 18, 2025 – 2:00 PM
At the beginning of each new Congress, the Roundtable’s Board of Directors updates our Federal Health Care Policy Priorities in response to changes in the national policy and political environment.
On Tuesday, March 18th, Roundtable staff will discuss these updated Policy Priorities during a webinar scheduled for 2:00 PM. In addition, our policy advisors will discuss the potential ramifications of the early policy and program decisions of the new Trump Administration. Additional details will be announced.
To Register for the March 18th Webinar, click here.
Top News
House Approves Budget Reconciliation Bill Amid Intra-Party Chaos
Last Tuesday, the House of Representatives approved one “big, beautiful [reconciliation] bill” that includes provisions supporting President Trump’s campaign promises on border security, tax, and energy policies. Rep. Tim Burchett (R-TN), Rep. Warren Davidson (R-OH), Rep. Victoria Spartz (R-IN), and Rep. Thomas Massie (R-KY) held out their support for the bill until it included further federal spending cuts and greater awareness of the federal debt ceiling. All Democrats and Independents were joined by Rep. Massie in voting against the bill; however, President Trump, House Majority Leader Mike Johnson (R-LA), and House Majority Whip Tom Emmer (R-MN) were able to wrangle enough members in the hour before the vote to achieve a final vote count of 217-215. Although they ultimately voted in favor of the bill, moderate House Republicans from swing districts expressed concern about the House bill’s extensive cuts to Medicaid funding.
The week prior, the Senate passed a competing plan which avoids deep spending cuts to Medicaid and calls for a permanent extension of President Trump’s 2017 tax cuts. Republicans in both chambers must approve identical reconciliation bills to pass legislation while avoiding a Senate filibuster. As Republicans work to reconcile bill differences, Medicaid funding levels will be a major component of negotiation.
RFK Jr. Seeks to End Public Comment on HHS Policies
Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. has proposed eliminating public participation from many HHS decisions, arguing that it imposes excessive burdens on the department. The proposal, set to be formally published on March 3 in the Federal Register, would rescind a longstanding practice of allowing public comments on agency plans, particularly regarding management, personnel, grants, loans, benefits, and contracts. Critics argue this move contradicts Kennedy’s promise of “radical transparency” and could lead to politically unpopular decisions being made without public scrutiny. Legal and policy experts warn that reducing public engagement undermines good governance and could face pushback from Congress and advocacy groups.
The decision revokes the Richardson Waiver, a policy in place since 1971 that ensured public input on HHS rulemaking. Kennedy justifies the change by stating that the waiver goes beyond legal requirements and hampers agency efficiency. However, experts argue that the agency has always had the discretion to exceed minimum transparency standards, and this rollback represents a concerning departure from established democratic practices. While the policy may not immediately face legal challenges, opponents believe it could harm public trust in HHS and ultimately lead to increased controversy over its decisions.
President Trump Issues Executive Order to Expand Health Care Price Transparency and Reduce Costs
President Donald Trump’s administration has issued an executive order to prioritize health care price transparency to empower patients with clear, accessible, and actionable pricing information. A previous executive order issued during President Trump’s first term laid the groundwork for price transparency in health care, which required hospitals to disclose machine-readable pricing data for all services and a user-friendly display for 300 shoppable procedures while mandating insurers to reveal negotiated rates, out-of-network payments, and prescription drug costs, along with providing an online tool for consumers to compare costs. Following these reforms, the most expensive health care services saw annual price drops of 6.3%. The current order reaffirms the federal commitment to expanding and enforcing price transparency, directing the Departments of Treasury, Labor, and Health and Human Services to ensure accurate, standardized, and enforceable reporting within 90 days. This initiative seeks to enhance patient decision-making and reduce inflated health care costs without creating new legal obligations or entitlements.
FTC Nominee Pledges to Crackdown on PBMs
Federal Trade Commission (FTC) nominee Mark Meador has pledged to aggressively enforce competition laws in the health care sector, with a particular focus on cracking down on pharmacy benefit managers (PBMs) and anti-competitive practices like product hopping. During his Senate confirmation hearing, Meador emphasized his experience in antitrust enforcement at both the FTC and the Department of Justice (DOJ), highlighting his previous work in the agency’s health care division, where he targeted pay-for-delay agreements and product hopping in the pharmaceutical industry. If confirmed, he vowed to work closely with FTC staff and other commissioners to ensure strict enforcement of competition laws. Meador’s nomination comes amid growing concerns over the role of PBMs in driving up drug prices and limiting patient access to affordable medications. His approach aligns with broader efforts by the Biden administration to regulate PBMs more aggressively, as well as ongoing FTC litigation challenging industry practices. As a seasoned antitrust expert with experience in government and private practice, Meador is expected to play a key role in shaping the agency’s response to market consolidation and anti-competitive behavior in the pharmaceutical supply chain.
House Energy and Commerce Health Subcommittee Holds Hearing on PBM Reform
The House Committee on Energy and Commerce Subcommittee on Health held a hearing on ‘An Examination of How Reining in PBMs Will Drive Competition and Lower Costs for Patients’. The hearing focused on the role of pharmacy benefit managers (PBMs) in driving up drug costs, restricting patient access, and disadvantaging independent pharmacies through market control and anti-competitive practices. Lawmakers emphasized the need for transparency, delinking PBM compensation from list prices, and implementing Medicare Part D reforms to curb rising prescription costs. Witnesses, including Hugh Chancy, Pharmacist and Former President of the National Community Pharmacists Association, and Shawn Gremminger, President and CEO of the National Alliance of Healthcare Purchaser Coalitions, detailed how PBMs steer patients toward affiliated pharmacies and manipulate rebate structures, calling for stronger transparency laws. Anthony Wright, Executive Director of Families USA, and Dr. Matthew Fiedler, Senior Fellow at Brookings, underscored the broader economic impact, arguing that PBM consolidation and opaque pricing systems inflate costs and reduce health care access. While there was bipartisan agreement on the need for PBM reform, concerns over Medicaid funding and broader health care affordability remained key points of contention. Healthsperien covered the hearing and the notes are available here.
Study Examines How MA Enrollees Value Supplemental Benefits
A recent survey conducted by the Commonwealth Fund examined how much Medicare Advantage (MA) enrollees value and use supplemental benefits, such as dental, vision, hearing, fitness programs, and over-the-counter (OTC) allowances. These benefits are increasingly offered by MA plans to attract enrollees, yet little research has assessed their actual utilization and impact. The study found that while 89% of enrollees consider these benefits important, only 69% reported using at least one in the past year. Usage varied by type: 41% accessed dental services, 46% used vision care, and nearly half utilized OTC allowances. The findings also highlighted disparities—lower-income enrollees, those with functional limitations, and Black and Hispanic beneficiaries were more likely to value and use these benefits. However, despite their perceived importance, many enrollees did not take advantage of the offerings, suggesting potential barriers such as lack of awareness, administrative hurdles, or difficulties accessing providers.
KFF Publishes Summary of Federal Spending on Health
The Kaiser Family Foundation (KFF) published a brief outlining federal government spending in taxes and subsidies on health care to provide context on the current budget reconciliation discussions. In Fiscal Year (FY) 2024, the federal government spent $1.9 trillion on health care, comprising the largest category of federal spending at 27% of the total. Overall, 80% of federal spending on health services and programs provides or subsidizes health insurance for Medicare (36%), Medicaid and Children’s Health Insurance Program (CHIP) (25%), employment-based health coverage (17%), and Affordable Care Act (ACA) subsidies (5%). $398 billion in forgone tax revenues were from subsidies to Employer Sponsored Insurance (ESI) and Affordable Care Act (ACA) premium tax credits. Less than 13% of federal spending on health programs is discretionary, with over half of the discretionary funds spent on veterans’ hospital and medical care. Additional discretionary spending supports the National Institutes of Health (NIH) (19%), the Centers for Disease Control (CDC) (4%), and global health (4%) activities.
