Morning Briefing
Summaries of health policy coverage from major news organizations
25 States Challenge Medicaid Work Requirements
AP: Half Of States Sue Trump Administration Over Medicaid Work Rules
Democrats in 25 states and the District of Columbia on Monday sued the Trump administration over its recent guidance on new Medicaid work requirements, arguing the strict rules will prevent eligible Americans from accessing the care they need. The attorneys general and governors who filed the lawsuit allege that an interim final rule released earlier this month by the Centers for Medicare and Medicaid Services oversteps the text of the law last summer that set in motion the changes to Medicaid. (Swenson, 6/29)
More on the high cost of insurance —
New Hampshire Public Radio: Ambetter Health Is Pulling Out Of New Hampshire’s ACA Marketplace In 2027
Ambetter Health has announced that it will no longer offer healthcare plans on the health insurance marketplace in New Hampshire starting next year. (Richardson, 6/29)
Modern Healthcare: Why Northwell, CommonSpirit Are Leaning Into Direct Contracting
Employers ranging from guitar shops to large chain grocery stores are contracting directly with providers to offer health benefits to employees, altering their longtime relationships with payers. The health systems and employers are negotiating reimbursement rates themselves with bundled pay arrangements. They share in the risks and savings. (Hudson, 6/29)
KFF Health News: These Church Members Disagree On Politics. Together They’re Wiping Out Medical Debt
Some issues, like immigration or student loans, are too divisive to unite Trinity Moravian Church.This story also ran on NPR. It can be republished for free. “We’ve got quite a spread of political beliefs,” said the Rev. John Jackman, who leads this 114-year-old red-brick church near Winston-Salem’s old textile mills. Conservative Republicans sit with liberal Democrats. Supporters of President Donald Trump mix with his fierce critics. “It’s definitely a purple congregation,” Jackman said. (Levey, 6/30)
Politico: Health Insurers Are Looking For MAHA Wins
Insurers and doctors’ groups, often divided over how to rein in health care costs, are now facing off over the Make America Healthy Again movement. The insurance industry is embracing MAHA, while the doctors’ lobby is pushing against the movement’s leader, Health Secretary Robert F. Kennedy Jr., who many physicians see as a danger to public health. The opposing forces could shape Kennedy’s policy decisions on issues ranging from how much doctors earn to treat Medicare patients to how the government regulates medical services. (Hooper, 6/28)
On the high cost of prescription drugs —
Stat: Trump Low-Cost GLP-1 Plan A Likely Boost For Eli Lilly, Novo Nordisk
The Trump administration’s grand bargain with drugmakers on GLP-1s was based on a simple premise: lower prices in exchange for higher sales volume. Instead, the companies secured higher volume without the lower prices in some cases. (Wilkerson, 6/30)
Stat: AstraZeneca To Pay $34M To Settle Kickback Charges Filed By Texas AG
AstraZeneca agreed to pay $34 million to settle claims that the company paid kickbacks to improperly influence prescriptions paid for by Texas Medicaid. (Silverman, 6/29)
MedPage Today: Loss Of Payment Assistance For AMD Drugs Strains Patients And Ophthalmologists
Loss of copayment assistance for drugs to treat neovascular age-related macular degeneration (nAMD) significantly disrupted patient care, including switching to less costly (and perhaps less effective) therapy, reliance on samples, and higher out-of-pocket costs, a small prospective study showed. (Bankhead, 6/29)
The Hill: PBM Lobbying Group Goes On Offense Against Pharmaceutical Industry
The nation’s top pharmacy benefit manager (PBM) lobbying group is going on the offensive, stepping up its advocacy efforts against the pharmaceutical industry after Congress passed a PBM industry overhaul last winter. The pharmaceutical industry spent years pointing fingers at pharmacy benefit managers as the reason for high drug costs, and Congress finally was able to get PBM reforms over the finish line as part of a larger government funding bill. (Weixel, 6/29)
