What a week

This is a hectic week, and it got off to an early start with President Trump on Sunday evening breaking the embargo on his announcement of plans to lower drug prices. Hours later, the details of Medicaid cuts were published.

Today, the House Energy and Commerce Committee will begin marking up its part of the budget reconciliation bill – the part with the Medicaid cuts. That mark-up could go long into the night, and it might even last days.

On Wednesday, HHS Secretary Robert F. Kennedy Jr. will testify about the HHS budget.

And Medicare issued draft guidance on the third cycle of drug price negotiations. Because why not?

drug pricing

MFN is dead. Long live MFN

Remember when the Trump campaign said in October that he wasn't going to pursue the most-favored nation policy of tying U.S. drug reimbursement to price abroad? Yeah, that wasn't true.

It's not crystal clear how Trump plans to secure lower, international prices for Americans, according to Daniel Payne and Ed Silverman. The plan relies on drugmakers striking deals with the U.S. government to lower their prices, with a threat of new government regulation and legal investigations if they don't. It calls for basing U.S. drug prices on those paid by other countries, aiming to slash prices in the U.S. and push them up overseas through trade policy.

If drugmakers don't strike suitable deals, a White House official said, the administration will use government programs to force the price down.

The official wouldn't preview specific actions but said Medicare would be "a key focus." Read more from Daniel. On Friday, Daniel and I wrote about the possible ways Trump could pursue his favored-nation plan through Medicare, including using foreign prices as criteria in the Medicare price negotiation program.

medicaid

Medicaid cuts unveiled

There's been a lot of speculation, and negotiation, over the past several months about how House Republicans plan to cut federal Medicaid funding. Now we know.

The House Energy and Commerce Committee released its part of the budget reconciliation bill on Sunday night, ahead of the bill's markup today. The bill includes work requirements, reduced federal Medicaid funding for states that cover undocumented immigrants, and restrictions on common tactics that states use to increase federal funding for their Medicaid programs.

The bill leans heavily on work requirements for savings. Typically, they apply to adults aged 19 to 55, and House Republicans would apply it to people up to 64 years old. The health section of the bill could save more than $700 billion over a decade, according to a preliminary review of the bill by the nonpartisan Congressional Budget Office. Read more.

medicare

Better pay for doctors

One significant measure in the reconciliation bill got a little lost in all the fuss over Medicaid cuts: Doctors would get a pay raise.

Doctors have been lobbying Congress to index their Medicare pay rates to inflation for a long time. They didn't quite get what they were asking for, but the bill includes an important precedent.

It would, for the first time, increase Medicare pay rates to doctors based on inflation. The bill would increase pay by 75% of the rate of inflation in 2026, and by 10% of inflation in subsequent years.

The measure would ensure that doctors return to Congress, every year, asking for at least the 75% they got in 2026.

layoffs

Volunteering isn't so easy for laid-off CDC scientists

After being laid off from the Centers for Disease Control and Prevention, a scientist volunteered to help Milwaukee test public school students for lead exposure. It wasn't that simple, Eric Boodman reports.

The city health commissioner who received the offer needed the help, but he worried that accepting it would jeopardize plans to possibly hire laid-off CDC workers.

Read more about the catch-22 in which former public servants find themselves and the confusing statements HHS has made to make things worse.

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