Pitting city slickers against country folk

Medicaid cuts in the tax bill Republicans passed last summer are expected to hit rural providers and patients especially hard. Much of those cuts are the result of restrictions on some of the ways that states boosted federal funding for their programs.

But Oz, the head of the Centers for Medicare and Medicaid Services, said Tuesday that states with big cities, such as California and New York, have been benefiting from those tactics at the expense of rural communities.

"That Medicaid money wasn't coming to you anyway," he told rural providers at a National Rural Health Association conference.

Republicans have characterized the Medicaid reductions as reining in waste, fraud, and abuse, and said they do not compromise care. Oz's comments on Tuesday are a new twist in the messaging war over affordability.

congress

What sound does a duck make?

Democrats are working to undermine TrumpRx as the president leans into the drug-discount finder as the administration's chief accomplishment in making health care more affordable. They even engaged in a little name-calling.

At a House Energy and Commerce subcommittee hearing on the drug supply chain, Democrats painted TrumpRx as a sham. They decried the secrecy of drug pricing deals that Trump has cut with 16 drugmakers, and Rep. Frank Pallone (N.J.), the panel's ranking Democrat, called health secretary Robert F. Kennedy Jr. and FDA leadership "quacks."

But the hearing wasn't all partisan bickering. Health subcommittee Chair Morgan Griffith (R-Va.) said he'd help Pallone find out "as much information as we can" about Trump's drug pricing deals "without busting up the deals."

"I think we do need to know more about what's going on," Griffith said.

fda

Moderna's flu vaccine application rejected

In a rare move, FDA biologics center director Vinay Prasad overruled the agency's reviewers, rejecting Moderna's application for a new influenza vaccine, Lizzy Lawrence scoops.

A team of career scientists were ready to review the application, and the head of the vaccine office had written a memo explaining why it should be reviewed.

An HHS spokesman said, "there was a diverse set of conclusions among the review team."

Lawrence's scoop also made waves at the E&C hearing. Pallone referenced the news, saying: "I wouldn't be surprised if RFK Jr. said rather than do Moderna's vaccine, I'll watch a Harry Potter film and use some potion."

Read more about why FDA says it rejected the application, and Moderna's response.

insurance

CMS proposes skimpier ACA plan coverage

The expiration of enhanced ACA subsidies is driving up premiums for marketplace plans, but CMS has proposed allowing bare-bones plans in the exchanges to make coverage seem more affordable, Bob Herman and Tara Bannow report.

The agency plans to prioritize making ACA premiums as low as possible by allowing insurers to skip creating networks of hospitals and doctors, and repealing standardized plan options.

Read more about the potential consequences.

addiction

Landmark settlement on addiction treatment

A Christian group announced a potentially landmark legal settlement that could establish new legal protections for addiction harm reduction services, including syringe exchanges, Lev Facher reports.

The Americans with Disabilities Act has been used to preserve access to addiction treatment like methadone and buprenorphine. But the settlement in Lewis County, Wash., sets a precedent in federal law that the ADA also applies to harm reduction services that aim to reduce risks for drug users without demanding abstinence.

maha

MAHA trading posters

Isa Cueto has this dispatch from HHS headquarters:

Yesterday morning, RFK Jr. gathered supporters in downtown D.C. to celebrate the first MAHA Super Bowl commercial. If you missed that spot, it features boxer Mike Tyson talking about obesity, which runs in his family, and how Americans need to "eat real food."

HHS has gone all-in on the "real food" idea: The new food pyramid website designed by former Airbnb executive Joe Gebbia harps on this phrase, and encourages users to ask Grok AI for "REAL FOOD" diet suggestions. At yesterday's rally, poster boards balanced on every seat included the phrase alongside an image of a carrot, egg or apple, or a slab of salmon or beef, among other options.

The posters were a talking point last month, as attendees tried to figure out where to keep them during speeches (they make for very stiff chair-backs). Now they have become something else: cheerleading tools and to some, collectibles. HHS staff stood near the stage on Tuesday, waving posters around and urging the crowd to join in as Kennedy, Gebbia, Tyson, and others spoke. Afterward, attendees poked around looking for a poster to take, or asking to swap the depicted food items.

"Ooh, banana!" one woman crooned. "I already have that one," said another. An event goer who works in the dairy industry said her co-worker brought back a whole milk poster from the dietary guidelines launch.

One poster, in which Tyson's face tattoo is superimposed over a black-and-white photo of Kennedy, was not up for grabs.

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