Policy Blog

This week in health policy: Medicaid faces pressure on multiple fronts as work requirements approach and fraud enforcement intensifies. Meanwhile, CMMI launches a major pediatric model, the No Surprises Act arbitration system draws scrutiny, and the White House releases its AI legislative framework.

This week, a federal court’s preliminary injunction against RFK Jr.’s vaccine policy overhaul set off confusion across states and clinicians as the Trump administration announced plans to appeal; KFF data revealed the human cost of the ACA subsidy expiration, with 80% of re-enrollees facing higher premiums and middle-aged adults delaying care until Medicare; and the Medicaid fraud crackdown expanded to Florida—exposing deepening partisan divisions over enforcement that critics warn is harming vulnerable beneficiaries.

This week’s digest covers mounting congressional and regulatory scrutiny of Medicare Advantage; the FDA’s launch of a unified adverse event monitoring system; back-to-back cybersecurity breaches at two major device makers; and a broad set of drug pricing, Medicaid, and NIH funding developments that will shape policy through 2027.

This week, Medicaid dominated the policy agenda as new analyses put a $664 billion price tag on federal spending reductions and states began grappling with implementation costs under the One Big Beautiful Bill Act. At FDA, Vinay Prasad’s second departure raised fresh questions about Commissioner Makary’s leadership and the agency’s regulatory direction. And an AI buildout continued across payers, providers, and federal agencies—including a high-profile ban on Anthropic’s Claude at HHS.

This week in health policy: the expiration of enhanced ACA marketplace subsidies hit roughly 22 million enrollees with sharp premium increases, while the Trump administration launched a sweeping healthcare fraud crackdown under the CRUSH initiative. Vaccine policy continued to roil as 15 states sued over childhood immunization rollbacks and the Casey Means surgeon general nomination drew bipartisan skepticism. Novo Nordisk announced list price cuts of up to 50% for Wegovy and Ozempic, and midsize biotechs organized against the Most Favored Nation drug pricing policy.

This week in health policy: HHS undergoes a major leadership reshuffle with NIH Director Bhattacharya taking on the CDC role, the FDA adopts a single-study default for drug approvals while reversing course on Moderna’s flu vaccine, Grail’s multi-cancer blood test fails its landmark NHS trial, and Novo Nordisk’s CagriSema loses a head-to-head battle with Lilly’s Zepbound.

This week’s digest features our deep dive into RFK Jr.’s first year at HHS, marked by broken promises, eroding public trust, and a push to reshape American health policy. Elsewhere, ACA exchanges face enrollment declines and sweeping proposed rules after subsidy expiration, the CDC confronts both grant clawbacks and a leadership vacuum, Medicaid work requirements advance toward impacting millions, and vaccine policy turmoil continues on multiple fronts.