‘A HUGE WIN’ — The nursing home industry sees President-elect Donald Trump’s victory as a reason to be optimistic, at least when it comes to the Biden administration’s health staffing rule that’s been roiling the industry for months, POLITICO’s Daniel Payne and Robert King report. Trump could rescind the regulation, finalized earlier this year, that would for the first time set staffing minimums for nursing homes. Unless overturned, the rule would require nearly 80 percent of long-term care facilities to add staff. Advocates for elderly people have argued the rule would improve care in the wake of the industry’s pandemic failures. But the industry says the additional hiring costs would likely to cause cash-strapped nursing homes to close. Some industry groups have reached out to the Trump team to discuss the rule’s future, seeing it as an urgent priority for the new year. But they aren’t relying on just the incoming administration. Long-term care providers are challenging the rule in court and continue to ask Congress to intervene. THE CMS CHANGES WE’RE WATCHING — A second Trump administration will likely make an imprint on CMS, an agency with the power to reshape how U.S. health care is, Robert reports. Here’s what we’ll be keeping our eyes on: — Reforms to value-based care: The Center for Medicare and Medicaid Innovation was created as part of the ACA to test alternative payments and care delivery under Medicare. If a model generates a certain amount of savings, it becomes a permanent part of Medicare. A Trump CMS could make changes to the types of models that CMMI pursues. A payment model is also an easy avenue for the administration to impose its policies without Congress. Republican lawmakers seem unimpressed by the alleged savings, noting during a June hearing that the Congressional Budget Office found the center has increased Medicare spending by roughly $5.5 billion since its inception. — Medicare Advantage changes: Privately run Medicare Advantage plans have gained popularity since Trump left office in 2021. The plans make up more than 32 million enrollees and encompass over half of all Medicare enrollment. That’s up from 24.2 million in 2020. However, the Biden administration has locked horns with insurers over changes to the program. They include what insurers call a slight pay cut to MA rates and an overhaul to how plans are audited. Trump’s CMS could be more amenable to MA plans’ requests, mirroring what happened during his first term when CMS hiked payment rates. However, there have been bipartisan concerns about some parts of the program, such as the use of prior authorization that requires providers to obtain insurer approval before a procedure or a prescription. — Medicaid waivers: Trump could turn to Medicaid waivers to avoid congressional approval for program reforms, as he did in his first term. Chief among among those are work-requirement programs that CMS encouraged during Trump’s term. CMS approved 13 waivers for states to implement work requirements for the population eligible for coverage under Obamacare’s Medicaid expansion. However, federal judges struck down some programs. Some states could try again in a second Trump administration, like Arkansas, one of the few states to implement a work-requirements program before it was struck down.
STAT reports on what a second Trump presidency means for Medicaid. The New York Times reports that upcoming dietary guidance may punt on making a recommendation on ultra-processed foods. | 
