House GOP inches closer to Medicaid cuts

Presented by the Coalition for Medicare Choices: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

Feb 26, 2025 View in browser   By Kelly Hooper and Chelsea Cirruzzo Presented by the Coalition for Medicare Choices With Alice Miranda Ollstein Driving The Day House Speaker Mike Johnson secured a narrow victory on a GOP budget framework that demands $880 billion in total spending cuts, which could largely target Medicaid. | Francis Chung/POLITICO BUDGET BLUEPRINT APPROVED — House Republicans advanced their budget framework for President Donald Trump’s sweeping domestic policy agenda late Tuesday, a key step toward advancing GOP plans to make deep cuts to Medicaid, POLITICO’s Katherine Tully-McManus and Meredith Lee Hill report. The 217-213 vote was almost entirely along party lines, with every Democrat voting against the measure and only GOP Rep. Thomas Massie of Kentucky joining them. The approval moves Republicans closer to passing the “big, beautiful bill” that Trump and House Speaker Mike Johnson have called for — one that includes border security, tax and energy provisions that the president campaigned on. The approval also moves Republicans a step closer to majorly cutting Medicaid: It would task a key committee with jurisdiction over the program to find $880 billion in funding cuts over a decade. The bulk of those cuts would likely come from Medicaid, the health insurance program for low-income people jointly funded by federal and state governments. A faction of the GOP conference — moderate Republicans, many representing swing districts — had qualms about the scale of the Medicaid cuts implied by the budget plan. But by Monday night, some said that a presentation from House leaders had moved them closer to supporting the budget plan. By Tuesday, House leaders were confident enough to move toward a final vote. What’s next: The Tuesday vote sets up a harsh reality check between House and Senate Republicans. The Senate, which passed a competing plan last week, is looking to avoid deep cuts to Medicaid, while the House is relying on the cuts for significant cost-shifting. The two chambers will now have to reconcile the differences between the two fiscal blueprints, potentially jeopardizing the fragile GOP support for the House measure. WELCOME TO WEDNESDAY PULSE. The White House has revealed that Amy Gleason is the administrator of President Donald Trump’s Department of Government Efficiency — and she has a health background. Gleason most recently served as chief product officer at Nashville health care firm Russell Street Ventures. Send your tips, scoops and feedback to khooper@politico.com and ccirruzzo@politico.com, and follow along @Kelhoops and @ChelseaCirruzzo.    A message from the Coalition for Medicare Choices: Protect Medicare Advantage: 34 million seniors are counting on it. Over half of America's seniors choose Medicare Advantage because it provides them better care at lower costs than fee-for-service Medicare. With their coverage and care on the line, seniors are watching closely to see whether policymakers keep the bipartisan promise to protect Medicare Advantage by ensuring this vital part of Medicare is adequately funded. Learn more at https://medicarechoices.org/   At the White House President Donald Trump signs an executive order as HHS Secretary Robert F. Kennedy Jr. (left) and Commerce Secretary Howard Lutnick look on. | Pool photo TRUMP’S PRICE TRANSPARENCY MOVE — President Donald Trump signed an executive order Tuesday that doubles down on the hospital price transparency rules he shepherded in his first term, Chelsea reports. The order directs HHS and the departments of Treasury and Labor to crack down on price transparency rules for hospitals and propose updated guidance or rules to ensure “pricing information is standardized and easily comparable across hospitals and health plans.” “The departments will update their enforcement policies to ensure hospitals and insurers are in compliance with requirements to make prices transparent,” the order states. Key context: It’s not yet clear how HHS will implement the order, which calls on the department to “ensure hospitals and insurers disclose actual prices, not estimates, and take action to make prices comparable across hospitals and insurers, including prescription drug prices.” Background: In 2019, Trump signed an executive order requiring hospitals to disclose the rates they negotiate with private insurers. The regulations went into effect at the start of 2021, but HHS watchdog groups have found that many hospitals don’t comply. The Biden administration fined more than a dozen hospitals for noncompliance, but Trump and price transparency advocates say that it didn’t do enough to enforce price transparency.   Donald Trump's unprecedented effort to reshape the federal government is consuming Washington. To track this seismic shift, we're relaunching one of our signature newsletters. Sign up to get West Wing Playbook: Remaking Government in your inbox.     In Congress PBM REFORM SNAG — Senate rules might complicate a bid to lower drug costs in Republicans’ budget package, POLITICO’s Ben Leonard reports. Rep. Buddy Carter (R-Ga.) said in an interview Tuesday that new regulations for pharmacy intermediaries in the commercial market aren’t expected to qualify under the procedural rules that dictate which provisions can be included in a bill passed through budget reconciliation. But Carter, chair of the House Energy and Commerce Health Subcommittee, said it was his “understanding” that new regulations in Medicare and Medicaid for pharmacy benefit managers — or PBMs, which negotiate drug costs for insurers and employers — would qualify for inclusion in a reconciliation bill. Why it matters: A bifurcation of those policies could complicate the passage of so-called PBM reform, which has wide bipartisan support and often includes policies adding new transparency requirements on business practices or delinking the payments PBMs get from the drug list price. REPUBLICANS’ MEDICAID MUSINGS — House Republicans are assuring members of their caucus concerned about Medicaid cuts that those will come from rooting out waste, fraud and abuse, not reducing benefits.  But it’s hard to see how the numbers add up, POLITICO’s Robert King reports. The Government Accountability Office, Congress’ investigative arm, estimates that Medicaid made about $31 billion last year in improper payments. The budget blueprint the House passed Tuesday night tasks the Energy and Commerce Committee with coming up with nearly three times as much money in savings — $88 billion a year over 10 years — to pay for the tax cuts, border security and energy exploration they want in the bill. The most likely target in the committee’s jurisdiction is Medicaid. Even so: E&C Chair Brett Guthrie (R-Ky.) told POLITICO: “Massive cuts in the program just aren’t going to happen.” That message, seconded by Speaker Mike Johnson in a meeting with Republicans concerned about Medicaid cuts Monday, resonated and won over holdouts. Guthrie told POLITICO on Tuesday the committee is looking at a “menu of items” that are sources of wasteful spending, including improper payments. HEARINGS COMING SOON — The Senate HELP Committee will vote on the confirmation of the FDA commissioner nominee, Dr. Marty Makary, in early March, POLITICO’s David Lim and Lauren Gardner report. The Johns Hopkins surgeon has kept a low profile since President Donald Trump tapped him for the job but has met with several senators over the past few weeks. Makary met with Sen. Bill Cassidy (R-La.), chair of the Senate Health, Education, Labor and Pensions Committee, on Feb. 12, Cassidy spokesperson Ty Bofferding told POLITICO. “We will bring transparency to our vaccines, food, and MAKE AMERICA HEALTHY AGAIN,” Alabama Sen. Tommy Tuberville, a Republican on the committee, posted on X earlier this month after meeting with Makary. Makary was spotted at the Make America Healthy Again inaugural ball in January with Kentucky Republican Rand Paul, a Senate HELP member, and his wife. And the Senate committee that oversees the National Institutes of Health is also expected to hold a confirmation hearing as early as next week for Trump’s pick to lead the agency, Dr. Jay Bhattacharya, POLITICO’s Erin Schumaker reports. The Stanford health policy professor has been making the rounds on Capitol Hill in recent weeks, meeting with Cassidy and other senators, including Jim Banks (R-Ind.), Chuck Grassley (R-Iowa), Markwayne Mullin (R-Okla.), Tammy Baldwin (D-Wis.), Tim Kaine (D-Va.) and Patty Murray (D-Wash.). “Excellent conversation with Dr. Jay,” Cassidy posted on X on Feb. 20. "He has a vision to restore faith in medical research for the American people, protect and improve the institution, and better distribute the benefits." Bhattacharya is telling senators he wants to ensure the NIH is funding research that scientists can verify by reproducing the work and investing more in high-risk, high-reward studies.   A message from the Coalition for Medicare Choices:   Abortion THE ONGOING ABORTION PILL BATTLE — GenBioPro, the sole manufacturer of the generic version of the drug mifepristone, which is used in most abortions, petitioned a federal court in Texas on Tuesday to intervene in the ongoing legal battle over whether and how patients can access the medication, Alice reports. The case is a version of the challenge to FDA regulation of the pills that the Supreme Court punted on last year in a ruling finding that the anti-abortion doctors who were the plaintiffs lacked standing. The attorneys general of Idaho, Kansas and Missouri are now attempting to lead the charge against a series of FDA decisions since 2016 making the drugs available by telemedicine and by mail and authorizing the sale of GenBioPro’s generic version. “This case should be dismissed outright on procedural grounds, and at a minimum, it cannot proceed in Texas,” said Daphne O’Connor of the law firm Arnold & Porter, which represents GenBioPro, in a statement. “The lawsuit itself is also meritless because FDA regulates generic mifepristone based on decades of experience and extensive scientific evidence, and there is no basis for a court to second-guess FDA’s reasoned decision-making.” Danco, the manufacturer of the brand name version of mifepristone, is already a party in the case defending the FDA’s power to regulate access. The FDA did not immediately respond to a request for comment. Names in the News Mollymae Metheny has joined Porter Novelli as vice president of health. She previously served as director of public affairs at PhRMA. Regina Black has joined the Biotechnology Innovation Organization as senior director for international policy and market access on the association’s agriculture and environment team. She was previously a senior adviser to former Agriculture Secretary Tom Vilsack. WHAT WE'RE READING The Wall Street Journal’s Christopher Weaver and Anna Wilde Mathews report that Sen. Chuck Grassley (R-Iowa) is probing UnitedHealth Group’s medical billing practices. The New York Times’ Norimitsu Onishi writes about how a woman facing early-onset Alzheimer’s pushed Quebec to allow people to choose medically assisted death years in advance. The Washington Post’s Vivian Ho reports on an unknown illness that’s killed 53 people in a northwest region of the Democratic Republic of Congo.   A message from the Coalition for Medicare Choices: Medicare Advantage helps seniors prevent and manage chronic disease. Medicare Advantage outperforms fee-for-service Medicare in preventive care and supporting seniors living with chronic disease. Seniors in Medicare Advantage experience fewer readmissions, fewer preventable hospitalizations, lower rates of high-risk medications and better outcomes. Learn more at https://medicarechoices.org/     Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Lauren Gardner @Gardner_LM Sophie Gardner @sophie_gardnerj Kelly Hooper @kelhoops Robert King @rking_19 David Lim @davidalim Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

To change your alert settings, please log in at https://login.politico.com/?redirect=https%3A%2F%2Fwww.politico.com/settings This email was sent to salenamartine360.news1@blogger.com by: POLITICO 1000 Wilson Blvd Arlington, VA, 22209, USA Unsubscribe | Privacy Policy | Terms of Service