Weekly Health Care Policy Update – June 6, 2025

June 13, 2025

In this update: 

  • Administration Update
    • Trump Administration Transmits HHS Budget Request to Congress
  • Legislative Update
    • CBO Says Reconciliation Bill Will Reduce Coverage by 10.9 Million
  • Federal Agencies
    • Staffing Updates at HHS/CMS
    • CMS Rescinds Biden-era EMTALA Guidance
    • CMS to Adopt New Technology Initiatives
    • CDC Contradicts HHS Secretary on Pediatric Covid Vaccine Recommendation
  • Other Updates
    • AHA Publishes Report on the Cost of Violence in Hospitals

Administration Update

Trump Administration Transmits HHS Budget Request to Congress 
On May 30th, the Trump Administration transmitted its Department of Health and Human Services’ (HHS) Budget in Brief with Congressional Justifications to Congress. Overall, the request proposes $94.7 billion in discretionary spending for HHS in fiscal year (FY) 2026, a $32 billion decrease from the prior fiscal year. These documents build on the “skinny budget” released in May and are primarily messaging documents, since congressional appropriators have final budget authority. Some of the programmatic changes, though, can be done under executive authority.

Broadly, these documents formalize the ongoing reorganization of the Department, carving new roles for the Make America Healthy Again (MAHA) initiative. The Trump Administration is proposing a reduction in HHS operating divisions from 28 to 15. Specifically: 

  • Administration for a Healthy America (AHA): The proposal calls for the establishment of the AHA as the “primary federal agency” to advance population health, with a requested $14 billion in discretionary funding and $5 billion in mandatory funding. Under President Trump’s budget request, the programs carried out by the Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), and several centers at the Centers for Disease Control and Prevention (CDC) would be centralized under AHA. The 340B program, currently overseen by HRSA, would be absorbed by the Centers for Medicare and Medicaid Services (CMS);
  • Food and Drug Administration (FDA): With an added focus on MAHA food initiatives ($240 million), the proposal includes $3.2 billion in discretionary funding and $3.6 billion in user fees. The proposal does not make major changes to FDA’s medical product safety programs;
  • National Institutes of Health (NIH): The proposal allocates $27.5 billion in discretionary funding for the NIH, cutting funding by $18 billion, while consolidating the institutes to eight. Despite ongoing court battles, the budget includes a cap on indirect cost rates at 15%. The proposal makes note of efforts to study the rise in autism;
  • The Administration for Children, Families, and Communities (ACFC):The new agency will combine the Administration for Children and Families (ACF) and the Administration for Community Living (ACL), with $29.3 billion in discretionary funding; and 
  • Centers for Medicare and Medicaid Services (CMS): Notably, the budget materials do not tackle mandatory spending on Medicare and Medicaid, but, overall CMS’ budget would be cut by $661 million. The Trump Administration is also moving to increase discretionary spending ($941 million) for the Healthcare Fraud and Abuse Control program.

HHS Secretary Kennedy is expected to continue to testify before Congressional Committees on the budget proposal.

The Budget in Brief is available here, and the Congressional Justifications are available here.

Legislative Update

CBO Says Reconciliation Bill Will Reduce Coverage by 10.9 Million; Senate Negotiations Continue
On June 4th, the Congressional Budget Office (CBO) released its full estimate of the budgetary and coverage impacts of the One Big Beautiful Bill Act as passed by the House of Representatives. CBO projects that, if enacted, the bill will result in an additional 10.9 million people being uninsured by 2034. Most of these coverage losses (7.8 million) are due to Medicaid policy changes such as work requirements and more frequent eligibility checks. Notably, CBO’s estimates do not include the effect of expiration of the Affordable Care Act (ACA) enhanced premium tax credits at the end of this year, which it separately estimated would increase the number of uninsured by 4.2 million by 2034. Overall, CBO estimates the House-passed bill would increase the federal deficit by $2.4 trillion over the 10-year budget window.
 
In the Senate, Majority Leader Thune (R-SD) announced that the complete text of the Senate’s reconciliation bill will be available by the end of next week. The Republican caucus is still actively negotiating several issues, including many related to health care. The Majority Leader can only afford to lose three Republican votes but has at least three Senators who object to the Medicaid cuts in the House-passed bill and at least three Senators who say the bill does not reduce spending enough. Senate Republicans still point to July 4th as their deadline for final passage.
 
The full estimate is available here.

New York State Updates

Staffing Updates at HHS/CMS
In the last week, the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) have announced a number of staffing changes, including: 

  • CMMI Announces Staffing Updates: The Center for Medicare and Medicaid Innovation (CMMI) introduced its new leadership team:
    • Abe Sutton, Director of CMMI and Deputy Administrator for CMS: Abe Sutton comes to CMMI with both government and private sector experience, including as a Principal at Rubicon Founders where he co-founded two health services companies and at McKinsey & Company. He also spent time at HHS during the first Trump Administration.
    • Amy Turner, Acting Deputy Director for Policy: Assuming the role from Ellen Lukens, Amy Turner comes to CMMI from her role as Deputy Director for Policy in CMS’s Center for Program Integrity. She also spent time in the Department of Labor (DOL), including as Deputy Assistant Secretary at DOL’s Employee Benefits Security Administration.
    • Gita Deo, Chief of Staff: Gita Deo comes to CMMI from McKinsey & Company, where she served as an Associate Partner focusing on long-term delivery strategy. Previously, she spent time as a Practice Manager at Maimonides Medical Center.
    • Gary Bacher, Chief Strategy Officer: Gary Bacher returns to CMMI after serving during the first Trump Administration of CINQCARE, where he served as the Chief Strategy Officer and President for ACOs & Value Based Care Initiatives.
  • CMS Medicaid Director Announces Resignation: Director and Deputy Administrator for the Center for Medicaid and CHIP Services (CMCS), Drew Snyder, is leaving the agency for personal reasons. Dr. Caprice Knapp, the former North Dakota Medicaid Director, will serve as interim Acting Director of CMCS.
  • Jim O’Neill Approved as HHS Deputy Secretary: The Senate voted Thursday to confirm Jim O’Neill as Deputy Secretary of HHS by a vote of 52-43. O’Neill previously worked at HHS during the George W. Bush Administration, and as a policy volunteer to the Trump transition team. He is co-founder of the Thiel Fellowship.
  • Thomas Keane Named ONC Head: Dr. Thomas Keane has been named the second Assistant Secretary for Technology Policy (ASTP) and the ninth National Coordinator for Health Information Technology, roles he will serve concurrently. Dr. Keane, an interventional radiologist by training, has worked in several posts at HHS, including as a senior advisor to the Deputy Secretary of HHS. Dr. Keane’s biography is available here.

CMS Rescinds Biden-era EMTALA Guidance 
On June 3rd, the Centers for Medicare and Medicaid Services (CMS) rescinded July 2022 guidance titled, “Reinforcement of EMTALA Obligations specific to Patients who are Pregnant or are Experiencing Pregnancy Loss” and sent a letter to providers explaining that the previous guidance does “not reflect the policy of this Administration.” The guidance, issued shortly after the Dobbs ruling, affirmed that lifesaving abortion treatment falls within the requirements of EMTALA – requiring hospitals to provide abortions when necessary to stabilize a patient’s health – and thus preempting any state laws to the contrary. The rescission introduces new uncertainty for providers offering emergency abortion care.

The policy is at the center of ongoing litigation challenging bans on abortion care, including the Idaho case that resulted in a temporary stay from the Supreme Court. The announcement is available here. The letter is available here.

CMS to Adopt New Technology Initiatives 
On June 3rd, the Centers for Medicare and Medicaid Services (CMS) announced its intention to move forward with a number of health technology initiatives. The initiatives span five main domains: 

  • Building an interoperable national provider directory;
  • Streamlining credentials through a new identity verification process on Medicare.gov;
  • Expanding CMS’ use of Blue Button 2.0 interface;
  • Expanding the Data at Point of Care pilot; and
  • Deepening CMS’ participation in trusted data exchange.

The ongoing Health Technology Ecosystem Request for Information (RFI) will remain open until June 16th. 

The announcement is available here.

CDC Contradicts HHS Secretary on Pediatric Covid Vaccine Recommendation
On May 29th, the Centers for Disease Control and Prevention (CDC) issued an updated vaccine schedule for healthy children six months to 17 years old, keeping the Covid-19 vaccine as a recommended vaccine. This move came days after Department of Health and Human Services (HHS) Secretary Kennedy announced that the shots would be omitted from the federal immunization schedule. The schedule added a new stipulation for the vaccines: that children and caregivers engage in “shared decision-making” in consultation with their provider. By retaining their place on the schedule, the vaccines will remain available for about 38 million children enrolled in the Vaccines for Children program and will continue to be covered without cost-sharing by Affordable Care Act (ACA) plans. Recommendations for adults have not been finalized.

The vaccine schedule is available here.

Other Updates

AHA Publishes Report on the Cost of Violence in Hospitals 
On June 2nd, the American Hospital Association (AHA) released a new report on the cost of violence within hospital and health system settings. Researchers estimated that, in 2023, the total cost of violence in hospitals was $18.27 billion. The figure incorporates post-event costs such as victim treatment ($14.65 billion) and pre-event costs including the need for security staff and violence prevention training ($3.62 billion). The report also notes extensive invisible costs including reduced job satisfaction and/or restricted work activity. The AHA is advocating for the passage of the Save Healthcare Workers Act, a bipartisan bill to make assault on a hospital worker a federal crime.
 
The report is available here, and the announcement is available here.