Weekly Health Care Policy Update – June 20, 2025

June 27, 2025

In this update: 

  • Legislative Updates
    • Senate Committees Release Reconciliation Bill Language
    • Reports Estimate Effects of House-Passed Reconciliation Bill
  • Administration Update
    • AP Reports Trump Administration Gave Personal Medicaid Data to Immigration Officials
  • Federal Agencies
    • Judge Deems Some NIH Grant Cancellations Void and Illegal
    • FDA Launches Commissioner’s National Priority Voucher Program
  • Other Updates
    • Fired ACIP Members Respond in JAMA Commentary
    • SCOTUS Upholds Tennessee Ban on Gender Affirming Care
  • New York State Update
    • DOH Draft Amendment Seeks to Raise NHTD Waiver Cap to 9,400 Participants Starting July 2025

Legislative Updates

Senate Committees Release Reconciliation Bill Language
On June 16th, the Senate Finance Committee released its portion of the “One Big Beautiful Bill Act” (OBBBA). The text includes several key departures from House-passed provisions, generally calling for even deeper cuts to Medicaid. Key changes from the House bill include:  

  • Medicaid Work Requirements: Requiring “nonpregnant, nondisabled, childless adults, aged 19-64, to complete a minimum of 80 hours” of work, community service or other qualifying activities in order to qualify for Medicaid. The House-passed version exempts adults with dependent children of any age, while the Senate version only exempts parents of children 14 years or younger.
  • Provider Taxes: Lowering the current 6 percent cap on provider tax rates to 3.5 percent in expansion states, with a phase-in until 2031. The House-passed version grandfathers current provider tax rates and bans new or increased taxes.
  • State-Directed Payments (SDPs): Establishing a new cap of 100 percent of Medicare rates for expansion states and 110 percent for non-expansion states. Currently approved SDPs would be reduced by 10 percent annually to meet this new cap. The House-passed version freezes existing SDPs and caps new ones.
  • Pharmacy Benefit Managers (PBMs): Removing the House-passed provision that would delink PBM compensation from drug prices in Medicare Part D.
  • Medicaid Eligibility Checks: Increasing frequency of eligibility verifications with additional requirements for eligibility documentation.

Providers and other stakeholders immediately condemned the Committee’s text with the American Hospital Association (AHA) saying it “moves in the wrong direction.”

On June 10th, the Health, Education, Labor, and Pensions (HELP) Committee released its reconciliation language, which includes an appropriation for cost-sharing reduction payments to Affordable Care Act (ACA) plan issuers beginning with plan year 2026. This language mirrors the same provision in the House-passed reconciliation bill, which would end silver loading and, according to the Congressional Budget Office (CBO), reduce total Silver plan premiums by 12% but cause approximately 300,000 people to lose health coverage nationwide. Notably, the HELP Committee’s title does not include provisions to codify the Marketplace Integrity and Affordability proposed rule, which was included in the House-passed bill.

The Finance Committee bill text is available here, and the section-by-section is available here. The HELP Committee bill text is available here, and the section-by-section is available here.

Reports Estimate Effects of House-Passed Reconciliation Bill
As the Senate continues drafting its text of the OBBBA, new reports have been released that estimate the effects of the House’s version. 

  • CBO Estimates OBBBA Will Result in $1 Trillion Loss for Health Care, $2.8 Trillion Increase in Deficit: On June 17th, the Congressional Budget Office (CBO) released a new, dynamic estimate of the economic effects of the OBBBA. In this new estimate, CBO confirms that the health care sector would experience a loss of $1 trillion over 10 years. CBO also estimates a higher federal budget deficit of $2.8 trillion, an increase from its earlier estimate of $2.4 trillion. In this dynamic estimate, which House rules require for major legislation, CBO estimates not only the direct budgetary effects of a bill, but also the changes in the size of the economy and other macroeconomic variables. The report is available here.
     
  • Urban/RWJF Says OBBBA Will Reduce Hospital Payments by $321 Billion, Physician Payments by $81 Billion: On June 13th, the Urban Institute and the Robert Wood Johnson Foundation (RWJF) released a report on the House’s OBBBA impact on health care spending and uncompensated care. Overall, national health care spending would decline by $797 billion over the next decade. California, Florida, Texas, and New York would bear over one-third of this loss. Of this shortfall, hospitals would face a $321 billion decline in spending while physicians would face a $81 billion decline. This is on top of a $262 billion decline from the loss of enhanced premium tax credits, already scheduled to expire at the end of this year. Over the next decade, the report projects a combined $283 billion increase in uncompensated care, $85 billion of which would fall on hospitals, and $34 billion on physicians. The report is available here.
     
  • Study Estimates OBBBA Will Increase Deaths by Over 16,000 Per Year: On June 17th, a paper published in the Annals of Internal Medicine quantified the impact of Medicaid cuts as outlined in the OBBBA. Researchers found that, with reduced Medicaid coverage and more cost-related nonadherence, the rate of medically preventable deaths will spike. According to mid-range estimates, OBBBA will increase the number of deaths by 16,642 annually. The report is available here.

Administration Update

AP Reports Trump Administration Gave Personal Medicaid Data to Immigration Officials 
On June 14th, the Associated Press (AP) reported that the Trump Administration released personal Medicaid data to immigration officials as part of the Administration’s ongoing deportation efforts. According to an internal memo and emails obtained by the AP, two advisors to Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. ordered that the dataset, containing information on enrollees in California, Illinois, Washington, and Washington D.C., be released by the Centers for Medicare and Medicaid Services (CMS) despite objections, and transmitted to the Department of Homeland Security (DHS). The dataset includes names, addresses, social security numbers, and claims data.
 
HHS spokesperson Andrew Nixon maintained that HHS “acted entirely within its legal authority” in overseeing the data transfer. The data was initially shared with CMS by California, Washington, and Illinois as part of a Trump Administration audit of states that provide Medicaid coverage regardless of citizenship status, financed by non-federal dollars. New York, Oregon, Minnesota and Colorado, the remaining states that provide such coverage, have not submitted their identifiable data to CMS yet. California Governor Gavin Newsom and Senators Alex Padilla and Adam Schiff have expressed alarm over this potential violation of federal privacy laws.
 
The original story is available here.

Federal Agencies

Judge Deems Some NIH Grant Cancellations Void and Illegal 
On June 16th, a federal judge in Massachusetts ruled that some of the grant terminations initiated by the National Institutes of Health (NIH) are “void and illegal.” Judge William Young ruled in a pair of lawsuits that the grant terminations were “arbitrary and capricious” and had “no force and effect.” This ruling requires that the NIH restore the grants identified in the lawsuits. The specifics of the ruling will take shape over the coming weeks, but the decision was welcome news for other plaintiffs with similar suits. According to a spokesperson, the Trump Administration has not yet decided on its response to the ruling.
 
FDA Launches Commissioner’s National Priority Voucher Program 
On June 17th, the Food and Drug Administration (FDA) launched the Commissioner’s National Priority Voucher (CNPV) Program. Under this novel priority program, the FDA can grant priority review to U.S. drug companies “aligned with U.S. national priorities,” supposedly cutting review time from ten to twelve months to one to two months. In reviewing applications, the FDA will recognize the following priorities: addressing a health crisis, delivering more innovative cures, addressing unmet public health needs, and increasing domestic drug manufacturing.
 
The new review process will convene experts across FDA to meet for a one-day “tumor board style” meeting, rather than transmitting applications across offices. This approach “will allow companies to submit the lion’s share of the drug application before a clinical trial is complete.” Products reviewed through this program may also receive accelerated approval. The announcement came one day after China announced a proposal to cut its clinical trial review waiting period to one month. The FDA has maintained that this program does not need congressional authorization.
 
The announcement is available here, and an FAQ is available here.

Other Updates

Fired ACIP Members Respond in JAMA Commentary
On June 16th, the former members of the Advisory Committee on Immunization Practices (ACIP) for the Centers for Disease Control and Prevention (CDC) penned an opinion piece in JAMA. In the article, the former members write that Secretary Kennedy’s decision to remove all 17 members and appoint new members has “left the U.S. vaccine program critically weakened.” The opinion piece outlines both historic and recent wins for American vaccine development, arguing that stripping the “program of the institutional knowledge and continuity that have been essential to its success over decades” will have devastating consequences.
 
The piece is available here.
 
SCOTUS Upholds Tennessee Ban on Gender Affirming Care 
On June 18th, the Supreme Court upheld a Tennessee law that bars providers from offering puberty-delaying medication or hormone therapy or performing surgery intended to treat gender dysphoria in minors. United States v. Skrmetti was brought by three transgender minors, their parents, and a doctor to challenge Tennessee’s SB1 under the Equal Protection Clause of the Fourteenth Amendment. The 6-3 decision ruled that the law did not involve discrimination on the basis of sex. This decision largely shields similar laws in over 20 states from litigation.

New York State Updates

DOH Draft Amendment Seeks to Raise NHTD Waiver Cap to 9,400 Participants Starting July 2025 
On June 16th, the New York State (NYS) Department of Health (DOH) announced a proposed amendment to the Nursing Home Transition and Diversion (NHTD) 1915(c) Waiver program that seeks to increase the number of participants that can be enrolled in the program. The NHTD program enables Medicaid-eligible older adults and people with physical disabilities receive comprehensive, community-based services so they can remain at home instead of entering nursing facilities.
 
The amendment proposed to raise the cap on the number of unduplicated participants to 9,400 in Waiver Years 3–5 (July 1 2025 – June 30 2028). The current waiver caps enrollment at 6,529 in Year 3, 7,200 in Year 4, and 7,870 in Year 5. DOH says the previous ceiling will be insufficient to meet projected demand.
 
The amendment is available here. Public comment may be submitted to waivertransition@health.ny.gov with the subject line “NHTD Waiver Amendment” through July 18th.