Policy Digest — February 16, 2026

Weekly Spotlight

RFK Jr.’s First Year at HHS: Broken Promises, Eroding Trust, and a Push to Reshape American Health Policy

One year into Robert F. Kennedy Jr.’s tenure as HHS secretary, his Make America Healthy Again agenda is generating activity on multiple fronts, but drawing fire from public health experts, congressional allies, and the American public alike.

Kennedy’s most visible move this week came on CBS’s 60 Minutes, where he said the FDA will act on former FDA chief David Kessler’s citizen petition to revoke the “Generally Recognized as Safe” designation for sweeteners including corn syrup, though he stopped short of committing to new regulations, saying “our job is to make sure that everybody understands what they’re getting” (Axios). A comprehensive Politico review of his first year found Kennedy has turned his agencies toward skepticism of processed food and vaccines but faced pushback at every turn, including from Republicans (Politico). Separately, his allies are petitioning the Supreme Court to allow physicians to buck medical establishment consensus when advising patients on vaccines, seeking to shield anti-vaccine doctors from state medical board discipline (Politico).

Behind the public-facing agenda, Kennedy is consolidating control. HHS elevated four political appointees to senior advisory roles, including Medicare director Chris Klomp as chief counselor overseeing all HHS operations in a de facto chief of staff role. CNN reports the shakeup is designed to tighten White House control ahead of November midterms (Politico; Healthcare Dive).

The public is not impressed. KFF data show the share of Americans trusting the CDC on vaccines dropped roughly 10 percentage points to 47%, Gallup shows CDC approval fell from 40% to 31%, and MMR vaccine support dropped from 90% to 82% in just nine months. The AMA and the University of Minnesota’s Vaccine Integrity Project announced an independent process for reviewing respiratory virus vaccine safety, saying it’s needed because the government has stopped conducting systematic reviews (MedPage Today).

Despite pledging “radical transparency,” a MedPage Today investigation documents the opposite: the CDC’s abortion surveillance report was never posted, the DAWN overdose tracking system was shut down, youth smoking surveys were never released, food safety pathogen tracking was cut from eight germs to two, and LGBTQ youth health information was removed from CDC websites (MedPage Today).

APHA Executive Director Georges Benjamin said Kennedy broke “every single promise” he made to Sen. Bill Cassidy (R-La.), including assurances to maintain ACIP vaccine recommendations and preserve CDC statements that vaccines do not cause autism (MedPage Today). HHS has shed more than 17,000 jobs since Kennedy took over: FDA lost 4,332 employees, NIH 4,049, CDC 2,889, and CMS 1,051 (MedPage Today). A KFF poll found 59% of Americans disapprove of Kennedy’s overall moves and 62% disapprove of his handling of vaccine policy.

Tags: #ALL

Other Regulatory News

Centers for Medicare and Medicaid Services (CMS)

ACA Exchanges Face Enrollment Decline and Sweeping Proposed Rule Changes After Subsidy Expiration

ACA enrollment dropped to approximately 23 million for 2026, down about 1.2 million from last year’s record, following the expiration of enhanced premium subsidies. States are reporting sharply higher cancellation rates—Colorado up 83%—and many enrollees are shifting to lower-cost bronze plans with higher deductibles, though experts warn the full impact won’t be known for months. In response, CMS proposed a sweeping 2027 exchange rule that would make nearly everyone eligible for catastrophic plans through broadened hardship exemptions, float multi-year insurer contracts of up to 10 years, reintroduce indemnity-style plans with no provider networks, and restrict premium subsidy eligibility based on immigration status. CMS Administrator Mehmet Oz framed the changes as expanding choice; critics including Sen. Ron Wyden and the Robert Wood Johnson Foundation warn they could create significant financial risk for consumers. Separately, tribal insurance programs that give Native Americans access to specialty care beyond the Indian Health Service are threatened by the loss of enhanced subsidies, and House Judiciary Committee Chairman Jim Jordan subpoenaed eight major insurers—including CVS, Elevance, Centene, Kaiser Permanente, and Oscar—over alleged ACA exchange fraud.
Source(s):
ACA enrollment data shows approximately 23 million sign-ups for 2026 (KFF Health News)
CMS plans to roll back limits on non-standard ACA plan options (Fierce Healthcare)
CMS proposes sweeping 2027 ACA exchange rule (Healthcare Dive)
ACA marketplace proposed rule for 2027 (HFMA)
Tribal health programs face enhanced subsidy funding shortages (KFF Health News)
House Republicans subpoena health insurers over ACA fraud (Healthcare Dive)
CMS Wants More ‘Catastrophic’ Health Plans in ACA Exchanges (MedPage Today)
Tags: #ALL

Medicare Advantage Roundup

This week highlighted the growing tensions in the Medicare Advantage market as Humana gambles on growth while health systems push back on payer contracts.

• Why Scripps Health’s Medicare Advantage exit paid off (Becker’s)
• Humana reported a Q4 2025 loss of $1.01 billion but gained roughly 1 million MA members during open enrollment—potentially overtaking UnitedHealthcare as the largest MA insurer by year-end. The company maintained generous benefits while competitors cut back, but its medical loss ratio hit 93.1% and it guided 2026 adjusted EPS to ~$9 versus analyst expectations of ~$12. Sources: Humana Posts $1B Quarterly Loss, Projects Lower 2026 Earnings as MA Membership Surges by 1 Million (Healthcare Finance News), Humana could end 2026 as the largest Medicare Advantage insurer (Healthcare Dive), Humana stock outlook for 2026 Medicare Advantage profit forecast (STAT), Humana Medicare Advantage enrollment 2026 (Modern Healthcare)

Tags: #PAYER #PROVIDER #HOSPITAL

TAVR Roundup

Several developments this week on the coverage, commercial, and clinical research fronts for transcatheter aortic valve replacement.

• Cardiologists propose new ‘coronary risk zone’ approach for redo TAVR planning (Cardiovascular Business)
• Edwards Lifesciences reported Q4 TAVR sales of $1.16 billion (up 12% YoY), crediting the EARLY TAVR trial for creating urgency to treat asymptomatic patients. CMS is reconsidering its national coverage determination with potential changes including asymptomatic coverage and removal of CED requirements; medical societies and clinicians are divided on whether the changes go too far too fast. Sources: Edwards Lifesciences Posts Double-Digit TAVR Sales Growth, Credits Asymptomatic Treatment Shift (MedTech Dive), Edwards celebrates double-digit TAVR sales growth in Q4 (Cardiovascular Business), Medical societies, medtech companies and clinicians weigh in as CMS considers sweeping TAVR changes (Cardiovascular Business)
• New research finds women continue to face higher stroke risk after TAVR than men, a persistent finding researchers hope to address through refined patient selection. Sources: Stroke risk after TAVR still higher in women: sex paradox lives on (Cardiovascular Business)

Tags: #DEVICE #PROVIDER #PAYER

Medicaid Work Requirements Set to Hit Middle-Aged Adults and Unpaid Caregivers Hardest

The 2025 Budget Reconciliation Act’s Medicaid work requirements—mandating 80 hours of monthly work for an estimated 18 million adults beginning January 2027—will disproportionately disrupt coverage for middle-aged adults and unpaid family caregivers, not the unemployed young people lawmakers have cited. Nearly 8 million unpaid caregivers who rely on Medicaid may find their daily caregiving labor doesn’t qualify as approved work activity, forcing them to choose between maintaining coverage and providing essential care that prevents costlier institutional placements. CBO estimates the requirements could increase the uninsured population by nearly 5 million by 2034.
Source(s):
New Medicaid Work Rules Likely To Hit Middle-Aged Adults Hard (KFF Health News)
Opinion: Medicaid work requirements will particularly hurt unpaid caregivers (STAT)
Tags: #PATIENT #PROVIDER #PAYER

CMS Innovation Models Roundup

CMS innovation programs saw a mix of cancellations, launches, and payer commitments this week.

• Clinics Sour on CMS After Agency Scraps 10-Year Primary Care Program Only Months In (KFF Health News)
• Payers sign pledge to join CMMI ACCESS Model (Fierce Healthcare)
• Examining the Potential Impact of Medicare’s New WISeR Model (KFF)

Tags: #PROVIDER #PAYER #HOSPITAL

Prior authorizations are the biggest hassle most patients face, KFF poll finds

A KFF poll found that prior authorization is the single largest burden insured adults face navigating the U.S. healthcare system, with 47% reporting denied, delayed, or altered care over the past two years due to coverage approval requirements.
Source(s): Prior authorizations are the biggest hassle most patients face, KFF poll finds (HealthExec)
Tags: #PAYER #PATIENT #PROVIDER

What doctors want from the Medicare payment system

Medical societies told House members developing Medicare payment overhaul plans that doctors want increased reimbursement and more payment pathways, as Congress works on physician payment system reform.
Source(s): What doctors want from the Medicare payment system (Modern Healthcare)
Tags: #PROVIDER #HOSPITAL

The IRA Has Improved Coverage of Drugs Selected for Medicare Price Negotiation

A KFF analysis found that the IRA’s Medicare Drug Price Negotiation Program has improved formulary coverage of selected drugs, since the law requires all Part D plans to cover each negotiated drug in all dosages and forms once negotiated prices take effect.
Source(s): The IRA Has Improved Coverage of Drugs Selected for Medicare Price Negotiation (KFF)
Tags: #DRUG #PAYER #PATIENT

Food and Drug Administration (FDA)

Vaccine Policy Roundup

Vaccine policy was one of the week’s most active fronts, with regulatory refusals, independent oversight efforts, legal challenges, and new safety research all making news.

• How Pediatricians Found Themselves at War With RFK Jr. (STAT)
• RFK Jr. Allies Target States to Overturn Vaccine Mandates for Schools (New York Times)
• No Link Between COVID Shot in Pregnancy and Kids’ Autism Symptoms (MedPage Today)
• Opinion: The new childhood vaccine guidelines have a paid leave problem (STAT)
• The FDA declined to review Moderna’s mRNA influenza vaccine application, issuing a refuse-to-file letter that Moderna says contradicts prior agency guidance and federal procedural rules. The decision, directed by top vaccine regulator Vinay Prasad, is the latest sign of heightened scrutiny under HHS Secretary Kennedy; analysts say it reflects a sharp departure in regulatory posture between administrations. Sources: FDA refuses Moderna flu vaccine (The Hill), Moderna FDA influenza mRNA refuse to file (BioPharma Dive), FDA declines to review Moderna mRNA flu vaccine application (MedPage Today), Moderna Says FDA Refusal to Review mRNA Flu Vaccine Contradicts Federal Rules, Prior Guidance (MedCity News), With the FDA’s Moderna decision, vaccine makers face increasingly uncertain regulatory environment (Fierce Biotech)
• The AMA and the Vaccine Integrity Project announced they will independently assess vaccine safety and effectiveness for the 2026-2027 respiratory virus season, as CDC trust plummets following the cut of universally recommended childhood vaccines from 17 to 11. Sources: AMA and Vaccine Integrity Project to independently review vaccine safety (MedPage Today)

Tags: #DRUG #PATIENT #PROVIDER

GLP-1 Roundup

GLP-1 drug development and awareness continued to make news this week.

• Lilly’s pre-launch inventory of oral GLP-1 candidate swells ahead of expected FDA obesity nod (Fierce Pharma)
• Fatigue, low energy, or something more serious: What sudden weight loss could mean, even from GLP-1s (The Independent)

Tags: #DRUG #PATIENT

FDA’s new guidance on consumer wearables makes the medtech market more complex

An industry analysis argues the FDA’s recent guidance on consumer wearables clarifies rather than redraws the boundary between general wellness products and regulated medical devices, but adds strategic complexity for manufacturers navigating where their products fall on that spectrum.
Source(s): FDA’s new guidance on consumer wearables makes the medtech market more complex (Medical Design & Outsourcing)
Tags: #DEVICE

Department of Health and Human Services (HHS)

CDC Faces Grant Clawbacks Targeting Blue States and a Prolonged Leadership Vacuum

The Office of Management and Budget is directing the CDC to cancel approximately $600 million in grants to California, Colorado, Illinois, and Minnesota—part of a broader $1.5 billion clawback from four Democrat-led states. The affected CDC grants fund public health workforce development, HIV/AIDS surveillance (over 20 grants), STI prevention, pediatric clinician training, and health equity initiatives, as well as grants to universities and nonprofits including $7.2 million to the AMA and over $1 million to the AAP. All four states’ governors say they have not received formal notice. Meanwhile, the CDC may go the remainder of the second Trump administration without a Senate-confirmed director: Susan Monarez, the only confirmed director, was fired after less than 28 days for clashing with Kennedy over vaccination policy, and Trump has not nominated a replacement.
Source(s):
Trump Administration Moves to Cut ~$600M in CDC Grants from Democrat-Led States (MedPage Today)
CDC moves to cut $600 million in grants to Democrat-led states (Healthcare Dive)
Blue states prepare to lose federal health dollars (Politico)
STAT+: Exit of CDC’s acting director highlights agency’s lack of leader (STAT)
Tags: #ALL

340B Rebate Model: Courts Block Pilot, HRSA Publishes RFI Seeking New Path Forward

HRSA published a Federal Register RFI seeking stakeholder input on whether and how to shift the 340B program from up-front discounts to after-the-fact rebates, with comments due March 19. The RFI follows a turbulent legal path: the original rebate pilot was blocked by preliminary injunction from the U.S. District Court for the District of Maine on December 29, the 1st Circuit denied a stay on January 7, and HHS conceded on February 5 that further litigation would not be fruitful. The court vacated and remanded the program on February 10. HRSA sent the White House a revised plan on February 6—just one day after telling the court it would scrap the pilot. The RFI requests input on administrative costs, cash-flow impacts, rebate denial procedures, and program integrity safeguards. AHA VP Aimee Kuhlman said the association welcomes the information-gathering but urged HHS to reconsider policies that shift costs to hospitals serving vulnerable communities. In 2024, covered entities purchased $81.4 billion of covered outpatient drugs under the 340B program.
Source(s):
HRSA Issues Request for Information on 340B Rebate Model Pilot Program (Federal Register)
HHS Sends White House Updated Plan To Test 340B Rebate Model (Inside Health Policy)
HHS seeks feedback on 340B rebate model (Becker’s)
Tags: #DRUG #HOSPITAL #PATIENT

National Cancer Institute studying ivermectin’s ‘ability to kill cancer cells,’ alarming career scientists

The National Cancer Institute, under Trump-appointed director Anthony Letai, is conducting a preclinical study of ivermectin’s potential anticancer properties, with results expected in a few months. Career NCI scientists expressed alarm, saying it diverts funds from promising research. There is no evidence ivermectin is safe or effective against cancer in humans; clinicians report patients are already delaying effective treatments in favor of ivermectin based on social media claims.
Source(s): National Cancer Institute studying ivermectin’s ‘ability to kill cancer cells,’ alarming career scientists (STAT)
Tags: #DRUG #PATIENT #PROVIDER

Congress paused all federal layoffs for 3 months. That’s set to change this week.

The congressional moratorium on federal reductions in force, included in spending legislation that ended the 43-day shutdown, is set to expire after February 13. Federal agencies last attempted RIFs in October targeting approximately 4,000 employees across HHS, Commerce, Education, HUD, Interior, Treasury, EPA, and other agencies before a judge and Congress intervened.
Source(s): Congress paused all federal layoffs for 3 months. That’s set to change this week. (GovExec)
Tags: #ALL

Health IT and Interoperability Roundup

Several interoperability milestones and mandates made news this week.

• 500 million records exchanged through TEFCA, federal health IT office boasts (Fierce Healthcare)
• Preparing providers and payers for interoperability mandates (Healthcare Finance News)
• The next frontier of interoperability: additional clinical data sources (MedCity News)

Tags: #PROVIDER #PAYER #HOSPITAL

Heard on the Hill

PBM Roundup

PBM scrutiny escalated this week on both the congressional and regulatory fronts.

• PBM Trade Group CEO Apologizes to Lawmakers at House Hearing (MedPage Today)
• Feds target PBMs’ hidden fees to benefit consultants (Modern Healthcare)

Tags: #DRUG #PAYER #PATIENT

Over 50 conservative leaders sign letter against Trump drug pricing policy codification

More than 50 leaders of conservative and free-market organizations—including Grover Norquist (Americans for Tax Reform), Stephen Moore (Unleash Prosperity Now), and Pete Sepp (National Taxpayers Union)—signed a letter to Congress opposing codification of Trump’s most favored nation drug pricing executive order. The letter argues MFN would import socialist price controls and depress R&D investment. The administration has already struck MFN deals with 16 pharmaceutical companies, and a bipartisan House bill to codify the policy was introduced last year.
Source(s): Over 50 conservative leaders sign letter against Trump drug pricing policy codification (The Hill)
Tags: #DRUG #PATIENT #PAYER

A legislative win at last, but delays were costly for children with rare diseases

The Mikaela Naylon Give Kids a Chance Act was signed into law as part of a broader appropriations package after five years of stalled progress, restoring incentives for developing treatments for pediatric cancers and rare childhood diseases. Only about one in nine FDA oncology approvals over the past decade were for pediatric indications. The bill passed unanimously in the House but was temporarily blocked in the Senate by Sen. Sanders over a dispute about community health center funding.
Source(s): A legislative win at last, but delays were costly for children with rare diseases (The Hill)
Tags: #DRUG #PATIENT

In farm bill, GOP takes another swing at pesticide protections loathed by MAHA

A House Republican farm bill draft includes a provision preventing states and courts from penalizing pesticide makers for failing to include health warnings beyond those formally recognized by the EPA—language that could preempt failure-to-warn lawsuits like those that have cost Bayer billions over glyphosate. Similar language was stripped from an EPA appropriations package earlier this year after pushback from Democrats and MAHA-aligned Republicans. The Supreme Court is set to review the broader federal preemption question for pesticide lawsuits this year.
Source(s): In farm bill, GOP takes another swing at pesticide protections loathed by MAHA (The Hill)
Tags: #ALL

Notable Notes

EPA Revokes Endangerment Finding, Dismantling Legal Basis for Climate Regulation

The EPA revoked its 2009 endangerment finding—the scientific conclusion that greenhouse gases endanger public health—which for 16 years served as the central legal basis for regulating emissions under the Clean Air Act. The action repeals all greenhouse gas emissions standards for cars and trucks and could prevent future administrations from proposing climate rules without restarting a years-long scientific and legal process. Physicians warn of direct clinical consequences: more asthma exacerbations, higher preterm birth risk, increased cardiovascular events during heat waves, and disproportionate harm to children and low-income communities. Environmental groups are expected to challenge the revocation in court.
Source(s):
EPA set to repeal landmark finding that climate change endangers the public (The Hill)
EPA Revokes Endangerment Finding, Dismantling Legal Basis for Climate Regulation (MedPage Today)
Climate Checkup: Physicians warn of clinical consequences (MedPage Today)
Tags: #ALL

Cardiovascular Roundup

Several cardiovascular developments this week spanned device safety, clinical outcomes, legislative advocacy, and emerging technologies.

• New heart catheter for cell therapy delivery 1 step closer to FDA approval (Cardiovascular Business)
• MRI scans evaluate heart failure risk—no invasive catheterization required (Cardiovascular Business)
• Universal heart screening for all athletes? Not so fast, cardiologists warn (Cardiovascular Business)
• Safety update: new recommendations for managing patients with high-risk defibrillation leads (Cardiovascular Business)
• Impella use fails to improve mortality in elderly patients (Cardiovascular Business)
• Cardiologists urge Congress to pass new bills focused on PAD and Medicare coverage (Cardiovascular Business)

Tags: #DEVICE #PROVIDER

AI in Healthcare Roundup

AI developments this week spanned patient safety concerns, payer adoption, federal policy, and industry partnerships.

• Humana and Google partner on healthcare AI ‘Agent Assist’ for improved member support (HealthExec)
• A Reuters investigation found rising reports of patient injuries linked to AI-enabled surgical devices, including botched surgeries and misidentified body parts. Separately, health plans are deploying AI for claims processing and member experience, and HHS National Coordinator Thomas Keane discussed easing prior authorization burdens and what AI may mean for physicians. Sources: AI enters operating room, reports arise of botched surgeries and misidentified body parts (Reuters), From claims payer to care partner: what AI really changes in health insurance (MedCity News), HHS National Coordinator discusses AI and prior authorization (MedPage Today)

Tags: #ALL

MedTech Roundup

Several medtech industry developments made news this week, from leadership changes to strategic partnerships.

• AdvaMed names new EVP of technology and regulatory affairs (Medical Design & Outsourcing)
• Siemens Healthineers, Mayo Clinic partner on neurodegenerative disease, cancer (MedTech Dive)

Tags: #DEVICE #PROVIDER

Revenue and payer-mix pressures continue to weigh on long-term sustainability

Kaufman Hall’s latest National Hospital Flash Report, based on data from more than 1,300 hospitals, describes 2025 as a “new normal” with modestly improved margins but growing structural challenges. Rising bad debt, charity care, and a higher share of government-program patients mean higher volumes are not translating into stronger financial results.
Source(s): Revenue and payer-mix pressures continue to weigh on long-term sustainability (Healthcare Finance News)
Tags: #HOSPITAL #PAYER #PROVIDER

Top Causes of Maternal Death May Not Be What You Think

An analysis of 7,901 maternal deaths from 2018-2023 published in the New England Journal of Medicine found drug overdoses, homicides, and suicides collectively accounted for more than a quarter of all deaths among pregnant and postpartum women—exceeding the combined total from cardiovascular causes, hypertension, infection, and hemorrhage. Researchers argue expanding the CDC’s maternal mortality definition to include these causes could improve prevention strategies.
Source(s): Top Causes of Maternal Death May Not Be What You Think (MedPage Today)
Tags: #PROVIDER #PATIENT #HOSPITAL

Colorectal Cancer Is Rising in Younger Adults. Who’s At Risk and What Are the Signs?

Colorectal cancer is now the top cancer killer of Americans younger than 50, with mortality in that age group rising 1.1% annually since 2005. The American Cancer Society estimates more than 158,000 new diagnoses and over 55,000 deaths this year across all ages.
Source(s): Colorectal Cancer Is Rising in Younger Adults. Who’s At Risk and What Are the Signs? (MedPage Today)
Tags: #PROVIDER #PATIENT

HEDIS® Public Comment Period Is Now Open

NCQA opened its public comment period (through March 13) for seven proposed new HEDIS measures and revisions to three existing ones. New measures include follow-up after positive colorectal cancer screening, continuous glucose monitoring utilization, intimate partner violence screening, person-centered outcome goal-setting, and prenatal syphilis screening.
Source(s): HEDIS® Public Comment Period Is Now Open (NCQA)
Tags: #PAYER #PROVIDER #HOSPITAL

Closing the CKD Care Gap with Value-Based Care Models

A MedCity News analysis argues value-based care models deliver significant benefits for chronic kidney disease management by coordinating medical, behavioral, and social support through multidisciplinary teams, enabling providers to personalize care and use data-driven strategies to identify high-risk patients.
Source(s): Closing the CKD Care Gap with Value-Based Care Models (MedCity News)
Tags: #PROVIDER #PAYER #PATIENT

Social Security Death Data: Do Not Pay System Has Yielded Financial Benefits

A GAO report finds Treasury’s Do Not Pay system identified $113.5 million in improper payments in its first pilot year (2024), a 23x return on its $4.6 million cost, with projected 3-year net benefits exceeding $337 million. However, GAO found SSA did not obtain required state cost documentation during contract negotiations.
Source(s): Social Security Death Data: Do Not Pay System Has Yielded Financial Benefits, but SSA Should Better Evaluate States’ Cost to Obtain Data (GAO)
Tags: #PAYER #HOSPITAL