Regulations
- Public Charge – The Trump Administration finalized a rule that would reimpose the public charge rule. The public charge rule would allow immigration offices to deny green cards to applicants who use or receive public assistance like Medicaid, APTCs, or food stamps. KFF estimates that 1.4 to 4.1 million Medicaid beneficiaries could disenroll as a result of the rule.
- Provider Tax Rule – CMS also released a proposed rule that would implement the restrictions on provider tax revenue for Medicaid provisions of the reconciliation bill. The bill would phase down, starting in FY2028, the amount of provider taxes states can impose. It also gives CMS broader authority over taxes on health insurers. Overall, the rule is estimated to reduce Medicaid spending by about $230 billion between 2026 and 2035.
CMS Withholds Medicaid Funding – CMS announced it would be withholding more than $1 billion in Medicaid funding for California and Minnesota over alleged fraud and non-compliance. The allegations center on in-home care programs. HHS announced it would also be seeking to expand its authority to remove participants due to suspected fraud.
Prescription Drug Tariffs – President Trump announced he would be imposing a 100% tariff on imported prescription drugs starting in August of 2028 and increasing it to 200% in 2029. Further details were not provided.
Congress
- House Republicans passed a third reconciliation bill to fund the Defense Department and other security agencies. It did not include any offsets (i.e., no health care provisions). Consequently, it’s very unlikely that Congress will act on any health care items until after the midterm elections.
- Several health care items did make some progress in committees – namely increased transparency requirements on providers/payers, PBM reform, and insulin price caps. These bills could be attached to a year-end budget bill.
No Surprises Act – The Wall Street Journal ($) reported on the growing impact of the NSA (the arbitration process around surprise billing) on commercial costs. In 2025 providers were awarded $15 billion, triple the amount in 2024.
