Weekly Spotlight
Listen to the spotlight here.
The healthcare landscape in the United States faces dramatic transformation through several major policy initiatives and structural changes. President Trump’s “One Big Beautiful Bill” proposes substantial modifications to Medicaid and the Affordable Care Act, with the Congressional Budget Office projecting approximately 11 million Americans could lose health insurance. The bill’s estimated $2.4 trillion cost has sparked intense debate, particularly in the Senate where lawmakers scrutinize its implications for healthcare access and fiscal responsibility.
Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services, defends the changes as necessary to “future proof” the program, specifically targeting undocumented immigrants and able-bodied individuals. However, healthcare groups express serious concerns about increased paperwork requirements and eligibility restrictions that could limit access for low-income Americans. The White House maintains these reforms will ensure resources reach those who truly need them, though critics argue the changes primarily impact vulnerable populations.
The administration’s 2026 budget proposal introduces sweeping changes across healthcare agencies. While Medicaid receives a $57.5 billion increase, the proposal reduces federal matching funds for state administrative expenses by $1.2 billion. Non-defense spending faces cuts exceeding 22%, including $12 billion from federal education programs and over $60 billion from health, housing, and community development. The National Institutes of Health faces a dramatic 40% reduction to its discretionary budget, dropping to $27.5 billion, with plans to consolidate its 27 institutes into just eight.
The three forty B drug pricing program would transfer to CMS after three decades at hersa, raising concerns about oversight and effectiveness. Additionally, the budget eliminates $1.5 billion from HIV prevention and surveillance funding, despite increasing needs for preexposure prophylaxis among at-risk populations. This decision contrasts with continued support for the Ending the HIV Epidemic initiative, highlighting complex priorities in public health funding
A significant organizational shift is occurring with the creation of the Administration for a Healthy America, HHS’s first new agency in nearly 25 years. Under Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” agenda, this agency will centralize various health functions currently managed by existing agencies. The restructuring includes eliminating approximately 10,000 jobs and several agencies, while requesting $7.1 billion for primary care, $1.1 billion for maternal health, and $5.8 billion for mental health initiatives.
In the pharmaceutical sector, the government’s stance on mRNA technology has shifted dramatically. The cancellation of a $700 million contract with Moderna for developing mRNA flu vaccines signals growing skepticism, despite its success during the COVID-19 pandemic. This change reflects broader vaccine skepticism and raises concerns about future pandemic preparedness. The shifting political support has led to decreased investor confidence, potentially stifling innovation in biotechnology.
CMS has implemented new rules for Medicare Advantage health plan evaluation, emphasizing patient outcomes over processes in their Star Ratings system. This fundamental change requires health plans to quickly adapt their strategies for improving patient care and performance metrics to maintain their ratings and attract members. The shift impacts reimbursement rates and quality measurements across the healthcare system.
Diversity in cardiac surgery has emerged as a critical issue, with research led by Dr. Mario Gaudino highlighting the importance of including more women and minorities in clinical trials. The ROMA WOMEN trial, focusing solely on women in coronary artery bypass grafting, and the RECHARGE trial, targeting Black and Hispanic patients, aim to address historical underrepresentation in cardiac research. Simultaneously, a concerning trend shows limited interest from Black medical students in cardiothoracic surgery, with 73% perceiving it as a racially biased specialty. Only 16% of surveyed Black medical students had successfully shadowed a cardiothoracic surgeon, despite 56% expressing interest.
The structure of medical practice continues evolving significantly. For the first time, fewer than 50% of physicians work in small independent practices – only 42.2% as of 2024, down from 61.4% in 2012 and approximately 80% in the 1980s. This dramatic shift reflects increasing consolidation in healthcare delivery, with more physicians becoming employees of larger healthcare organizations and hospitals, fundamentally changing how medical care is delivered and managed in the United States.
These comprehensive changes represent a fundamental restructuring of the American healthcare system, affecting everything from insurance coverage and research funding to medical practice organization and diversity in specialized fields. The implications of these shifts will likely resonate throughout the healthcare sector for years to come, impacting patients, providers, and healthcare organizations alike.
Articles consulted:
Dr. Oz on the future of Medicaid, Trump’s megabill and AI avatar health care
Dr. Oz pushes back on GOP criticism of proposed Medicaid changes
White House insists Medicaid policy won’t cut people who deserve it
Breaking: Nearly 11 million would lose insurance under Trump’s tax cut bill, CBO projects
GOP bill would leave 11 million more uninsured: CBO
House GOP gets megabill’s official price tag: $2.4T
5 things to watch as the Senate takes up ‘One Big Beautiful Bill’
ACA coverage losses in the One Big Beautiful Bill
Health Groups Concerned About Cuts in Trump’s Proposed 2026 Budget
HHS budget proposal cuts NCI funding by 37%
HHS faces $31B cuts in proposed FY ’26 budget: 6 notes
HHS releases more detailed 2026 budget disclosing scope of cuts
STAT+: New HHS document details deep NIH cuts as part of Trump budget request
Trump Admin Proposes $1.5 Billion In Cuts To HIV/AIDS Funding
Trump agencies tell Congress what to chop in 22 percent budget slashing
340B may move from HRSA to CMS: What you need to know
The lack of diversity in cardiac surgery trials may be harmful to patients
Black medical students have little interest in cardiothoracic surgery
How mRNA became a government target
Meet the Administration for a Healthy America, HHS’ newest agency
Other Regulatory News
Centers for Medicare and Medicaid Services (CMS)
CMS’ Medicaid director to depart the agency
The article reports on the impending departure of the Medicaid director from the Centers for Medicare & Medicaid Services (CMS).
#ALL
CMS commits to tech initiatives to give Medicare patients, providers easier access to health data
The Centers for Medicare & Medicaid Services (CMS) is focusing on technology initiatives aimed at improving access to health data for patients and providers, which could enhance healthcare delivery and patient outcomes.
#PATIENT, #PROVIDER, #PAYER
Overestimate tripled budget-neutrality Medicare physician pay cut – American Medical Association
The article critiques the overestimation of budget-neutrality in proposed Medicare physician pay cuts, raising concerns about the potential impact on physician compensation and patient care.
#PAYER, #PROVIDER, #ALL
How AI Can Help Fix Medicare Advantage Coding
The article discusses ongoing investigations into aggressive coding practices within Medicare Advantage plans and suggests that artificial intelligence (AI) could be a viable solution to address these issues and improve compliance and accuracy in coding.
#PAYER, #PROVIDER, #HOSPITAL
Medicare is a target as Senate GOP faces megabill math issues
Senate Republicans are considering potential cuts to Medicare as they attempt to offset costs in their megabill, despite the political challenges this poses. Discussions have emerged about targeting waste, fraud, and abuse within the program, especially with a self-imposed deadline approaching. However, there is significant opposition from within the Senate GOP and concerns from House moderates regarding any changes to Medicare.
#PAYER, #PROVIDER, #PATIENT
STAT+: Senate GOP eyes Medicare Advantage reforms as a way to pay for tax cuts
In light of the need for funding tax cuts, Senate Republicans are reconsidering Medicare reforms, despite previous commitments to keep Medicare off-limits. Proposed changes could affect eligibility and payment rates, and may lead to significant cuts if the bill increases the deficit.
#PAYER, #PROVIDER, #PATIENT
Food and Drug Administration (FDA)
NIH, FDA diverge on AI strategy
The article discusses differing strategies between the NIH and FDA regarding the use of artificial intelligence in health research and regulation, highlighting the complexities of integrating AI into healthcare.
#ALL
FDA asked to set up public database of device labels
The FDA has been requested to create a public database for medical device labels, aiming to improve transparency and accessibility for consumers and healthcare professionals.
#DEVICE, #PROVIDER, #PATIENT
FDA’s AI tool for medical devices struggles with simple tasks
The agency announced Monday that a separate AI tool, called Elsa, had been rolled out to all FDA employees. Sources say it also has issues.
#ALL
Health and Human Services (HHS)
HHS has a new national health IT coordinator
The Department of Health and Human Services has appointed Thomas Keane as the new National Coordinator for Health Information Technology.
#ALL
HHS watchdog spotlights $16B in health savings: 5 notes
The HHS Office of Inspector General reported potential cost savings of $16.6 billion from October 2024 to March 2025. The report highlighted recommended policy changes that could yield significant savings, particularly in Medicare.
#ALL
Massive NIH study challenges use of race as a proxy for genetic ancestry in research
A new NIH study emphasizes that self-reported race is a poor indicator of genetic ancestry, which has significant implications for understanding health disparities and the framing of racial categories in research.
#ALL
Hill Happenings
Trump, Senate GOP grapple with the House’s SALT math
Senate Republicans are discussing potential changes to the House’s state and local tax (SALT) deduction deal as they work to advance a significant tax and healthcare bill. The negotiations highlight differing priorities among party members.
#ALL
STAT+: Lawmakers lobby doctors to keep quiet — or speak up — on Medicaid cuts in Trump’s tax bill
Lawmakers are engaging healthcare groups, particularly those representing doctors, to either voice opposition or remain silent regarding proposed Medicaid cuts in President Trump’s tax bill. Both Democrats and Republicans have been holding meetings, with Democrats urging these groups to publicly express the potential negative impacts of the cuts on providers and patients. The situation is complicated by the fact that Republicans can enact these cuts without Democratic support.
#PAYER, #PROVIDER, #PATIENT
Opinion: America is running out of doctors. Congress must step up
Tom Price argues that the recent pause on student visa interviews has impacted thousands of J-1 physician visa holders, jeopardizing their residency opportunities. This situation exacerbates the existing physician shortage in the U.S., emphasizing the urgent need for legislative action to retain these medical professionals.
#PROVIDER, #HOSPITAL, #PAYER
Senate Confirms Tech-Connected O’Neill As Deputy HHS Secretary
The Senate confirmed Jim O’Neill, a former Silicon Valley executive, as the new Deputy Secretary of Health and Human Services with a vote of 52-43.
#PROVIDER, #PAYER, #DEVICE
Notable Notes
Heart patients benefit when cardiologists follow a standardized TAVR protocol
A study highlighted in the article reveals that using a standardized approach, particularly the cusp overlap technique, when implanting Medtronic’s self-expanding TAVR valves leads to improved outcomes for heart patients. The research tracked over 600 patients globally and was published in the Journal of the Society for Cardiovascular Angiography and Interventions (JSCAI).
#DEVICE, #PROVIDER, #PATIENT
Cardiologist became paralyzed after wearing heavy aprons in the cath lab for decades—but he fought back
Dr. Dean J. Kereiakes shares his experience of becoming paralyzed due to severe orthopedic issues from wearing heavy aprons in the cath lab for decades. After a long recovery, he emphasizes the importance of workplace safety for interventional cardiologists.
#HOSPITAL, #PROVIDER
Congenital heart surgeon named president of the American Association for Thoracic Surgery
Dr. Emile Bacha, a renowned leader in congenital cardiac surgery, has been appointed president of the American Association for Thoracic Surgery, marking a significant achievement in his career.
#HOSPITAL, #PROVIDER
Real-world data favor SAVR over TAVR when younger patients need aortic valve replacement
Researchers in Italy found that traditional surgical aortic valve replacement (SAVR) is associated with a lower long-term risk of mortality compared to transcatheter aortic valve replacement (TAVR) in younger patients aged 65-80.
#HOSPITAL, #PROVIDER
TAVR specialists come together to explore new data, patient selection and much more
A webinar featuring cardiologists and a cardiothoracic surgeon will focus on treatment considerations for patients with severe aortic stenosis, highlighting the importance of patient selection and recent data.
#DEVICE, #PATIENT, #PROVIDER
FAH CEO Chip Kahn to retire this year
Chip Kahn, the president and CEO of the Federation of American Hospitals, is set to retire at the end of the year after 24 years in leadership.
#HOSPITAL, #PROVIDER, #PAYER
More Than Half of Americans are Lonely, Survey Shows
A survey by The Cigna Group indicates that 57% of Americans experience loneliness, with younger generations feeling the most isolated despite being more digitally connected. The findings highlight the mental and physical health implications of loneliness and suggest strategies for fostering social connections.
#PATIENT, #PROVIDER, #ALL
STAT+: Internal document shows how UnitedHealth executives prepared to tamp down investor unrest
This article reveals that an internal document from UnitedHealth Group, mistakenly sent to STAT, outlines how company leaders planned to address investor concerns during a shareholder meeting. The document addresses the company’s financial and legal challenges, including missed revenue targets and investigations. It emphasizes the leadership’s attempt to reassure investors amidst a backdrop of significant turmoil, including a high-profile executive’s murder and stock price decline.
#PAYER, #PROVIDER, #HOSPITAL
Number of physicians working for small practices drops below 50% for the first time, AMA says
A report from the American Medical Association reveals that for the first time, less than 50% of physicians are working in small practices, indicating a trend towards consolidation in the healthcare industry.
#PROVIDER, #HOSPITAL, #PAYER
