In this update:
- Legislative Updates
- House Adopts Amendment to One Big Beautiful Bill; CBO Releases “Distributional Effects” Scoring
- Bipartisan Congressional Report Criticizes U.S. Organ Procurement Organizations
- Administration Update
- White House Publishes Memo Dictating Medicaid Prices No Higher Than Medicare
- Federal Agencies
- NIH Seeks Comment on Strategic Plan for AI
- RFK Jr. Fires Entire CDC Vaccine Advisory Committee and Announces New Members
- Hundreds of NIH Employees Send “Bethesda Declaration” Protest Letter to Jay Bhattacharya
- Other Updates
- MACPAC Releases June 2025 Report to Congress
- MedPAC Releases June 2025 Report to Congress
- New York State Updates
- Governor Hochul Announces Projected Marketplace Premium Increases Tied to Expiring Federal Tax Credits
Legislative Updates
House Adopts Amendment to One Big Beautiful Bill; CBO Releases “Distributional Effects” Scoring
On June 11th, House Republicans adopted an amendment to the budget reconciliation bill the chamber passed last month, the One Big Beautiful Bill Act. The amendment includes a series of changes intended to ensure the bill complies with the stricter Senate rules governing consideration of a budget reconciliation bill: that all provisions directly affect federal spending, revenue, or the debt limit. Even so, Senate Republicans anticipate additional rulings from the Senate Parliamentarian regarding provisions of the bill that do not comply with the Byrd rule, which could necessitate additional changes. Republicans are still hoping to pass their bill before the July 4th recess.
On June 12th, the Congressional Budget Office released a report on the “distributional effects” of the One Big Beautiful Bill Act, as passed by House Republicans. The report shows that the country’s lowest-income households will lose $1,600 per year in federal resources under the plan, while the country’s highest-income households will gain $12,000 each. Middle-income households are expected to gain $500 to $1,000 per year. Overall, the changes mean an average loss of 4% of resources for the lowest-income households and an average gain of 2% of income for the highest-income households.
The amendment is available here. The CBO report is available here.
Bipartisan Congressional Report Criticizes U.S. Organ Procurement Organizations
On June 10th, Senate Finance Committee Ranking Member Senator Ron Wyden (D-OR) and Senator Chuck Grassley (R-IA) released a report on their investigation into Organ Procurement Organizations (OPOs). The report validates ongoing concerns over the pancreata loophole, which enables OPOs to boost recertification numbers and inflate performance scores. The Senators also found that the Centers for Medicare and Medicaid Services (CMS) does not require uniform conflict of interest policies and the Organ Procurement and Transplantation Network (OPTN) is not required to collect details on financial relationships that could amount to conflicts. The report includes a handful of recommendations to address these policy failures.
The announcement is available here, and the report is available here.
Administration Update
White House Publishes Memo Dictating Medicaid Prices No Higher Than Medicare
On June 6th, the White House sent a memo to the leaders of the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) titled “Eliminating Waste, Fraud, and Abuse in Medicaid.” The memo criticizes the growth of State Directed Payments (SDPs) under the Biden Administration as a way to increase Medicaid payment rates beyond those of Medicare. SDPs, which are approved by CMS on a case-by-case basis, are a financing mechanism for states to direct managed care organization (MCO) payments to certain providers in hopes of stabilizing provider participation and improving access for beneficiaries. The memo claims that SDPs allow states to pay providers almost three times the Medicare rate. To cut down on waste, fraud, and abuse, the White House is directing HHS to ensure that “Medicaid payments (sic) rates are not higher than Medicare, to the extent permitted by applicable law.” Ongoing reconciliation deliberations also involve policies pertaining to SDPs.
The memo is available here.
Federal Agencies
NIH Seeks Comment on Strategic Plan for AI
On June 3rd, the National Institutes of Health (NIH) requested comments on a forthcoming NIH Artificial Intelligence (AI) Strategic Plan. Principal Deputy Director Matthew Memoli, M.D. announced the request for information (RFI) at a meeting of the Coalition for Health AI, noting that this is “the start of an ongoing public-private partnership to shape the NIH approach to AI.” The Strategic Plan will include a one-year action plan and longer-term priorities.
The NIH is looking to expand the use of AI across biomedical discovery, public health, and clinical decision support through the development of “fully autonomous, self-documenting AI beings.” Specifically, the NIH is requesting stakeholder input across seven key domains: strategic architecture, research and innovation actions, intramural-extramural synergy, operational excellence, facilitating and validating AI in health care delivery, reciprocity and trust, and partnerships and ecosystem building. In keeping with President Trump’s executive actions surrounding AI, the NIH is seeking additional collaboration with the Food and Drug Administration (FDA) and Veterans Administration (VA).
The NIH will accept comments through July 15th. The announcement is available here.
RFK Jr. Fires Entire CDC Vaccine Advisory Committee and Announces New Members
On June 9th, Health and Human Services (HHS) Secretary Kennedy announced the complete reconstitution of the Advisory Committee for Immunization Practices (ACIP), removing all 17 current members. ACIP is responsible for making recommendations on the safety, efficacy, and clinical need of vaccines to the Centers for Disease Control and Prevention (CDC). Secretary Kennedy stated that the move amounted to a “bold step in restoring public trust” in vaccines, while limiting industry influence on the Committee. Thirteen of the 17 members were appointed by the Biden Administration with terms slated to last through 2028.
On June 11th, Secretary Kennedy announced eight new members to the Committee. The new members–Dr. Joseph R. Hibbeln, Martin Kulldorff, Retsef Levi, Dr. Robert Malone, Dr. Cody Meissner, Dr. Michael A. Ross, Dr. James Pagano and Vicky Pebsworth–will convene for ACIP’s upcoming meeting on June 25-27 to discuss the Covid-19 and other vaccines. Secretary Kennedy’s new selections come from diverse professional backgrounds, many with a documented history of vaccine skepticism. A number of the new members have worked with Trump Administration officials, including National Institutes of Health (NIH) Director Dr. Jay Bhattacharya and Food and Drug Administration (FDA) Commissioner Dr. Marty Makary.
In order to vote on recommendations during the next ACIP meeting, at least two ex-officio members of HHS will need to be temporarily authorized to vote to ensure quorum is met.
The announcement of terminations is available here, and the announcement of new members is available here.
Hundreds of NIH Employees Send “Bethesda Declaration” Protest Letter to Jay Bhattacharya
On June 9th, hundreds of National Institutes of Health (NIH) employees sent a letter entitled the “Bethesda Declaration” to Director Dr. Jay Bhattacharya. The letter details employees’ “dissent to Administration policies that undermine the NIH mission, waste public resources, and harm the health of Americans and people across the globe.” Ninety-two NIH employees signed the letter with their names and an additional 250 endorsed the letter anonymously. Modeled after Dr. Bhattacharya’s Great Barrington Declaration, which outlined concerns over the Biden Administration’s response to Covid-19, the Bethesda Declaration implores Director Bhattacharya to restore interrupted grant funding, repair global collaboration, center peer-reviewed research, support flexible indirect cost rates, and reinstate terminated employees.
Since the start of the Trump Administration, 2,100 research grants valued at over $12 billion have been terminated. Director Bhattacharya is currently making rounds on Capitol Hill to discuss President Trump’s proposed budget, which includes deep cuts to the NIH.
The letter is available here.
Other Updates
MACPAC Releases June 2025 Report to Congress
On June 11th, the Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2025 Report to Congress. The report includes five chapters related to children and youth with special health care needs (CYSHCN), residential behavioral health treatment services for children, medications for opioid use disorder (MOUD), Program of All-Inclusive Care for the Elderly (PACE), and self-direction for Medicaid home- and community-based (HCBS) services. Of the five domains, MACPAC only included recommendations for CYSHCN, including state strategies for transitions from pediatric to adult care, further Centers for Medicare and Medicaid Services (CMS) guidance related to existing authorities, increased data collection, and additional requirements for inter-agency agreements (IAAs).
The report is available here.
MedPAC Releases June 2025 Report to Congress
On June 12th, the Medicare Payment Advisory Commission (MedPAC) issued its June 2025 Report to Congress. The report includes discussion on a range of topics, including the physician fee schedule, supplemental benefits in Medicare Advantage (MA), home health care delivered through MA, Part D plans, nursing home care, rural provider quality, and cost sharing for outpatient services at critical access hospitals (CAHs). The Commission issued recommendations for the physician fee schedule–aligning payments with inflation–and CAHS–reducing cost-sharing liability for fee-for-service (FFS) beneficiaries.
The announcement is available here, and the report is available here.
New York State Updates
Governor Hochul Announces Projected Marketplace Premium Increases Tied to Expiring Federal Tax Credits
On June 9th, Governor Hochul issued a press release outlining projected health care premium increases for New York residents due to the expiration of the federal American Rescue Plan enhanced premium tax credits. The enhanced tax credits, which reduce the cost of premiums on Affordable Care Act (ACA) marketplace plans, are currently set to expire at the end of 2025. As currently drafted, the “One Big Beautiful Bill Act” moving through Congress does not include a provision to extend the enhanced premium tax credits.
According to state data, the expiration of the enhanced premium tax credits is projected to increase health care coverage costs by an average of 38 percent for 140,000 low-income families and individuals purchasing plans through the New York State marketplace. This translates to an additional $114 per month for individuals and $228 per month for couples.
The Governor’s press release is available here. Additional data on the projected impact are available here.