at the agencies
Layoffs, confusion disrupt CMS
Leaders at the Centers for Medicare and Medicaid Services still haven't formally received a list of who was fired in the initial round of cuts from the Trump administration. They think at least 300 of the agency's 6,700 employees have been let go — but don't know for sure, Bob Herman reports.
It's the latest round in upheaval, confusion and flagging morale across the federal health agencies. The administration is getting pushback: On Friday, a top career official retired, and on his way out, excoriated the federal human resources officer who carried out the firings.
Two divisions within CMS have been hit especially hard: the Center for Medicare and Medicaid Innovation and the Center for Consumer Information and Insurance Oversight, which oversees ACA plans. More from Bob.
budget talks
Checking the Medicaid math
Republicans are looking for a politically palatable way to potentially cut hundreds of billions in Medicaid spending to offset tax cuts. It's a thorny prospect that has riled constituents across multiple lawmakers' town halls these past weeks. But as my colleague John Wilkerson writes, Republicans are finding their way to Medicaid cuts through another approach, and a favorite buzzword of this administration: fraud.
They're getting crucial new support for that effort from influential conservative think tanks the Paragon Health Institute and the Economic Policy Innovation Center. On Monday, they released a paper estimating that Medicaid made about $1.1 trillion in improper payments over the past decade. The paper argued that policies to lower that figure could save hundreds of billions of dollars.
Still, other analysts argue those figures are not signs of fraudulent spending but missing documentation and other errors. In 2024, for example, CMS estimated that about $31.1 billion of payments were improper, or about 5.1% of the total projected by conservatives aimed at reining in Medicaid spending. More from John.
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