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Week in Washington 05/01/25

Congress House Republicans continue to debate what should be included in the reconciliation bill, with no consensus emerging, yet. The leading contender for savings within the health policy realm would be to target large cuts to Medicaid expansion savings either via a per capita cap or reductions in FMAP rate for this population. There is ... Read more

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Newsworthy Findings

Supreme Court Rules Against Hospitals in DSH Formula Case

The high court ruled 7-2 against hospitals that argued the HHS was undercounting the number of low-income Medicare beneficiaries who should figure into their disproportionate share hospital payments.

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Editor's Note
In its majority opinion, the Court held that noncash benefits—such as Medicare Part D subsidies—do not qualify as income and therefore should not be included in the DSH calculation. The dissent argued that the intent of the program is to account for the number of low-income individuals served by hospitals, regardless of whether they receive cash benefits, especially given the financial instability often faced by people living in poverty.

Republican Lawmakers Urge CMMI to Focus on Cost Savings, Transparency

The letter from lawmakers on the House Ways and Means Committee that CMMI has also “promoted a political agenda ahead of its Congressionally mandated purpose,” like focusing on health equity.

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Editor's Note
A 2023 Congressional Budget Office report found that CMMI increased federal spending by $5.4 billion during its first decade. To redirect the agency toward its original goals, lawmakers are calling for more transparent model development, greater support for rural health, and a renewed focus on generating measurable cost savings.

Humana Posts ‘Really Good’ First Quarter on Stable Medical Costs

Humana beat earnings expectations for the first quarter and reaffirmed its 2025 guidance after medical costs came in as predicted. It’s a positive development for the insurer, which has been rocked by higher spending in privatized Medicare plans and the safety-net Medicaid program.

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Editor's Note
Humana reported strong first-quarter results for 2025, beating earnings expectations and posting $1.2 billion in profit — a 68% year-over-year increase — driven by stable medical costs and growth in Medicare drug plan and Medicaid membership.

The Debate About Enhanced Premium Tax Credits Begins to Emerge (Finally)

With the focus on Medicaid cuts, the dismantling of the Department of Health and Human Services and so much more that has been part of the “flood the zone” tactics of the Trump administration, one big health policy issue—the looming expiration of the enhanced Affordable Care Act (ACA) tax credits—has not received the attention it deserves. That may change soon.

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Editor's Note
Enhanced ACA premium tax credits, set to expire at the end of 2025, have helped boost Marketplace enrollment to 24.3 million people, particularly benefiting red states, the self-employed, rural residents, and older adults. Despite their high cost—$335 billion over 10 years—letting them lapse could cause average premiums to rise over 75%.

A Pulse Check on Healthcare 100 Days In

In the first months of President Trump’s second term, sweeping changes to federal healthcare policy—including agency restructuring, funding cuts, and regulatory rollbacks—have raised significant concern among public health experts and industry leaders.

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Editor's Note
The Trump administration’s policy changes have introduced uncertainty for health plans, with potential impacts on Medicaid funding, ACA enrollment, and rising supply chain costs from new tariffs.

Bonus Article

Just for Fun

Math Joke:

I told my math book I had problems… It said, “Same.”

Prior Week

Q: What’s the one shape you should avoid at all costs?
A: A Trap-ezoid

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