Weekly Health Care Policy Update – February 14, 2025

February 21, 2025

In this update: 

  • Administration Updates
    • White House Announces Make America Healthy Again Commission
    • RFK Jr. Confirmed as HHS Secretary
    • Peter Nelson Chosen to Lead CCIIO
  • Legislative Update
    • House and Senate Budget Committees Move Forward on Budget Blueprints
  • Federal Agencies
    • Judge Issues Motion to Enforce Against Trump Administration in Federal Funds Freeze Case
    • NIH Announces 15% Indirect Rate on Grants; Judge Issues Nationwide Stay
    • DOJ Changes Position on SCOTUS Trans Youth Care Case
    • Judge Orders CDC/FDA to Restore Website Content
    • CMMI to Stop Collecting Demographic Data
    • Medicare Removes Gender/Sexual Identity Questions from Enrollment Forms

Administration Updates

White House Announces Make America Healthy Again Commission 
On February 13th, President Trump signed an Executive Order establishing the Make America Healthy Again Commission, to be chaired by newly-confirmed Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. The Commission is tasked with “investigating and addressing the root causes of America’s escalating health crisis, with an initial focus on childhood chronic diseases” including allergies, autism, autoimmune diseases, fatty liver disease, prediabetes, obesity, cancer, and overmedication. The Commission has four policy directives: 

  • “Empower Americans through transparency and open-source data and avoid conflicts of interest in all federally funded health research”;
  • “Prioritize gold-standard research on why Americans are getting sick in all health-related research funded by the federal government”;
  • “Work with farmers to ensure that U.S. food is the [sic] healthy, abundant, and affordable”; and
  • “Ensure expanded treatment options and health coverage flexibility for beneficial lifestyle changes and disease prevention.”

Within 100 days, the Commission will produce “an assessment that summarizes what is known and what questions remain regarding the childhood chronic disease crisis, and include international comparisons.” This document will be followed by a “strategy…to improve the health of America’s children” within 180 days. The Commission will hold public hearings, meetings, roundtables, and similar events to receive expert input.

The Executive Order is available here.

RFK Jr. Confirmed as HHS Secretary
On February 13th, the Senate voted nearly along party lines to confirm Robert F. Kennedy Jr. as the new Secretary of HHS. The 52-48 vote included only one Republican defector, former Republican leader, Senator Mitch McConnell. A polio survivor, Senator McConnell said he could not “condone the relitigation of proven cures.”

Peter Nelson Chosen to Lead CCIIO
On February 7th, President Trump named Peter Nelson as director of the Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare & Medicaid Services (CMS). This position, which oversees Affordable Care Act (ACA) marketplaces and other ACA matters, does not require Senate confirmation. During the previous Trump administration, Nelson served as a senior advisor to then-CMS Administrator Seema Verma, where he was involved in drafting regulations and guidance for the ACA. Nelson returns to CMS from the Minnesota-based Center for the American Experiment, where he was a senior policy fellow. In the past, Nelson has criticized the enhanced premium tax credits as not addressing the ACA plan affordability and argued for the use of Health Care Choice Compacts, which would allow for the purchase of health insurance across state lines, to stabilize health insurance marketplaces. The Compacts are authorized by section 1333 of the ACA but have not been established by any states.

Legislative Update

House and Senate Budget Committees Move Forward on Budget Blueprints 
​​This week, Republicans in both the House and the Senate released blueprints for a potential budget resolution, which establishes spending and revenue targets for the year. These draft budget resolutions also include reconciliation instructions, which direct congressional committees to report legislation that either increases or decreases the deficit by a specific dollar amount. The House blueprint includes a $4.5 trillion cap on the deficit impact of the Trump 2017 tax cuts and a $4 trillion increase in the debt limit. Notably, the outline also includes $880 billion in deficit reduction for the Energy and Commerce Committee, most of which would likely be Medicaid cuts. It also specifically notes a goal of cutting $2 trillion in mandatory spending. Fiscal conservatives have insisted that tax cuts should be contingent on the amount of spending cuts paired with them. The House Budget Committee began a markup of the blueprint on Thursday.
 
Senate Republicans are moving forward with their own process in parallel, with generally lower deficit reduction goals. For example, the Senate blueprint directs the House Energy and Commerce Committee to find at least $1 billion in deficit reduction. However, the Senate  plan calls for two separate budget reconciliation measures, with the first bill addressing border and defense issues and a second bill addressing tax cuts. Speaker Johnson has expressed his opposition to a two-bill process. The Senate Budget Committee marked up its blueprint on Wednesday, with Republicans rejecting all 45 amendments introduced by Democrats and passing it out of committee by a party-line vote of 11-10.
 
Reconciliation legislation requires that the House and Senate pass identical budget resolutions. If successful, a reconciliation bill can then pass with a simple majority vote in both chambers (avoiding the need for 60 votes to end debate in the Senate). Committees will have until March 7th to craft reconciliation language once the resolution is passed in both chambers.
 
The Senate Budget Resolution can be found here. The House Budget Resolution can be found here.

Federal Agencies

Judge Issues Motion to Enforce Against Trump Administration in Federal Funds Freeze Case
On February 10th, Federal Judge John J. McConnell Jr. of Rhode Island announced that the Trump Administration had defied his order to release billions of dollars in federal grants. The case originated on January 29th, when Judge McConnell ordered the Trump Administration to unfreeze federal funds the Administration had locked until they could determine whether the spending was in line with the President’s agenda. On February 7th, attorneys general from 22 states appealed to Judge McConnell, saying that the Administration was not complying with the order. The Justice Department responded by claiming that certain spending (for clean energy and transportation projects) were exempt from McConnell’s order, but McConnell rejected this argument, granting the attorneys general their request for a motion to enforce, and noting that, “persons who make private determinations of the law and refuse to obey an order generally risk criminal contempt even if the order is ultimately ruled incorrect.”
 
Judge McConnell’s ruling on the motion to enforce is available here.
 
NIH Announces 15% Indirect Rate on Grants; Judge Issues Nationwide Stay 
On February 7th, the Office of the Director of the National Institutes of Health (NIH) announced a “standard indirect rate of 15% across all NIH grants for indirect costs in lieu of a separately negotiated rate for indirect costs in every grant.” Indirect costs traditionally support expenses not directly linked to a scientific project, including administrative, facility, and other costs. Today, universities, medical centers, and other grant recipients negotiate their indirect rate directly with NIH, many of whom are supported by a rate of 50% or more. The Trump administration said that the change would save the government $4 billion per year.
 
On February 10th, attorneys general in 22 states, including Connecticut, New Jersey, and New York, sued the Trump Administration to block the new policy. Subsequent lawsuits were also filed by the Association of American Medical Colleges (AAMC), the American Association of Colleges of Pharmacy, the Association of Schools and Programs of Public Health, the Conference of Boston Teaching Hospitals, the Greater New York Hospital Association, the Association of Public and Land-grant Universities (APLU), the Association of American Universities (AAU), and the American Council on Education (ACE). Plaintiffs argued that the policy violates the Administrative Procedure Act and ignores congressional powers.
 
By late Monday, U.S. District Court Judge Angel Kelly for the District of Massachusetts issued a temporary nationwide order halting the policy and set hearings in both cases for February 21st.
 
The NIH announcement is available here.
 
DOJ Changes Position on SCOTUS Trans Youth Care Case 
On February 7th, the Department of Justice (DOJ) Office of the Solicitor General announced that the United States government is changing its position in United States v. Skrmetti. This case challenges the constitutionality of Tennessee’s SB1, which prohibits providers from administering gender-affirming treatment to a minor with gender dysphoria. The Biden Administration sued over the ban, leading oral arguments before the Supreme Court in December. The current Administration no longer supports this suit but believes the Court should still consider the merits of the case. If the Court keeps the case on its docket, a decision is expected in June.
 
This case has broad implications for the regulation of medicine. The American Academy of Pediatrics, the American Medical Association and almost two dozen other professional medical organizations filed an amicus brief with evidence of the benefits of gender-affirming care for minors. Should the Supreme Court rule in favor of Tennessee, floodgates would open for state challenges to other laws related to sex-based discrimination and health care, including Section 1557 of the ACA. This would push the regulation of medical care further into state purview, with potential implications for contraception, vaccination, HIV care, and substance use disorder (SUD) treatment. Many advocates also fear that should this ban on care for minors stand, bans on care for transgender adults are imminent.
 
The announcement is available here.
 
Judge Orders CDC/FDA to Restore Website Content
On February 11th, a federal judge ordered federal health agencies to restore several webpages and datasets that were removed in compliance with President Trump’s executive order related to “gender ideology.” The resources were identified in a temporary restraining order requested by Doctors for America as critically important to the provision of medical care. The Centers for Disease Control and Prevention (CDC) restored nine webpages and data sets pertaining to adolescent health (Youth Risk Behavioral Surveillance System), HIV, contraception, and health equity. The Food and Drug Administration (FDA) restored pages pertaining to women in clinical trials and sex-specific data on regulatory submissions.
 
Public health professionals are also tracking other changes to the CDC’s website. Recent reports show that users that search “abortion” are now redirected to results from the word “adoption.” It is not clear when this change occurred, but most speculate it happened when many of the CDC’s webpages went dark earlier in February. Beyond topics related to abortion, though, many experts are voicing concern over potentially tampered information between the sites going offline and coming back online.
 
CMMI to Stop Collecting Demographic Data 
On February 11th, the Center for Medicare and Medicaid Innovation (CMMI) announced that it would no longer collect demographic data on payment model participants, including race, ethnicity, sexual orientation, gender identity and preferred language. This move was triggered by President Trump’s executive order related to diversity, equity, and inclusion. According to an email sent to CMMI managers, the Center will consider continuing to allow self-reported disability status among participants. Under the Biden Administration, CMMI made a push to include more demographic data in an effort to expand value-based payment models into rural and medically underserved areas.
 
Medicare Removes Gender/Sexual Identity Questions from Enrollment Forms
On February 12th, CMS removed questions related to sexual orientation and gender identity from Medicare Advantage, prescription drug plan, and Limited Income Newly Eligible Transition (LI NET) enrollment forms. These optional questions were introduced during open enrollment in fall 2024 with the intent to gather a “more granular and better understanding of the diversity of the Medicare population.” They were removed in response to President Trump’s executive order related to “gender ideology.”