While we wait for more info on what, exactly, the pharma tariff announcement applies to, reupping this March piece from @martawosinska.bsky.social on pharma tariffs, including how Medicare/Medicaid inflation rebates may limit companies' ability to pass them through. www.brookings.edu/articles/pha...

Those who don't subscribe to the Federal Register might be missing some very unusual developments today on the leucovorin front. There's a notice that FDA is approving a previously withdrawn NDA for leucovorin tablets. That in itself is unusual. /1

Yes! Exactly the types of affordability/access divides that VFC was created in ‘94 to address. (And it’s done so!) The immediate issue here is a pretty niche one—15% of families who opted for a non-preferred option for 1 dose of 1 vaccine—but likely a harbinger of more consequential changes to come.

Thread. ACIP's reversal this morning imposes new financial barriers to accessing the MMRV vaccine for VFC-eligible families, while AHIP's public statements mean that privately insured families will continue to have access with no cost-sharing, at least for now.

True. (And even though not all insurers are part of AHIP—UnitedHealth, most notably—I suspect they’ll all just ignore the ACIP chaos and stay the course.) Bigger complication of this outcome is probably for CHIP, as someone mentioned in the replies

As others have noted, this vote would end the ACA requirement for private insurers to cover these vaccines. BUT recall that AHIP just announced health plans "will continue to cover all ACIP-recommended immunizations... recommended as of September 1, 2025" through 2026. www.ahip.org/news/press-r...

Thread (with context regarding the kinds of questions ACIP members were asking, for further support for Jason's conclusion).

Many new ACIP members claim to want people to be able to choose whether to receive certain vaccines. But some of their votes would remove certain vaccines from VFC purchasing, significantly limiting people's ability to afford them. Stunning that some members appear to not understand this point.

Thread. As @adrianna.bsky.social notes, the scoring system for these funds is confusing. Some elements are scored anywhere from 0-100 based on the "quality of details" in an application. Others are binary - either 0 or 100 (below). Others are tiered - 0, 25, 50, 75, or 100 points. /1

Deeply researched article detailing the Trump admin’s “deliberate and targeted attack” on cancer research. Attacks on NIH are compounded by efforts to undermine FDA (causing many cancer drug reviewers to depart) and to patients’ ability to get and retain insurance. www.nytimes.com/2025/09/14/m...

Thread. Super interesting new article with implications for a wide range of important topics in health policy, including hospital finances, patient outcomes, hospital capacity, insurance design, and more.

As some states move to make COVID vaccines broadly accessible and require insurers to cover them, keep in mind one thing: States do not have authority over self-insured employers, which provide coverage to 63% of employees with employer health benefits.

One important issue here is administrative preparation/capacity and its potential to create errors that cause eligible people to lose coverage. The piece notes that CMS spent three years preparing for unwinding, while work requirements will be imposed on a much shorter timeline.

New: 14.2 million more people are expected to be uninsured due Republican Medicaid and ACA cuts, and if enhanced ACA tax credits expire at the end of this year. Here's how the coverage losses break down by state. www.kff.org/uninsured/ho...

It's important to get behind the headlines of Lilly raising the price of Mounjaro in the UK in response to President Trump's most favored nation pricing push. The UK price increase is for the list price, not what the National Health Service pays. www.reuters.com/business/hea...

This is an example of why I find most of the administration's bluster over drug prices coming down to be non-credible. The goal is not to help people who are really struggling to obtain their medications.

The net effect of the changes President Trump and Republicans in Congress are making to health care is a partial repeal of the Affordable Care Act.

Important story. Although Trump claims to want to lower drug prices, the reconciliation bill includes a provision that "delay[s] Medicare price negotiations for some of the biggest-selling drugs in the world," including Keytruda, with $17.9B in US sales alone in 2024. /1 www.wsj.com/health/pharm...

The Trump Admin's May executive order on drug pricing laid out several regulatory actions the Admin planned to take if "significant progress" toward MFN pricing was not achieved voluntarily. One (but not the only) way to read these letters is as an extension of time for such voluntary progress. /1

"What is coming is the politicization of the FDA, a regulatory body that has largely remained resolutely apolitical. But beyond that, what’s happening in the FDA ... is a descent into what happens when leaders lose any scientific compass. Simply put: This is bad." www.statnews.com/2025/07/30/v...

The Biden Admin rule aimed to "simplif[y] processes for eligible individuals to enroll" in these plans. The reconciliation text specifically bars HHS from enforcing its amendments, including 42 CFR 435.911 (streamlining eligibility determinations) and 435.952 (use of info, including attestation).

Glad to see more coverage of the part of the Republican budget bill that quite explicitly and exclusively affects Medicare enrollees, despite claims of leaving Medicare untouched. www.statnews.com/2025/07/28/m...

FDA’s cancer review team overseeing breast and gynecological products has lost about 1/3 of its medical review staff and the malignant heme group will lose about 2/3 of its medical review staff—all to voluntary resignations clustered among seasoned reviewers insights.citeline.com/pink-sheet/a...

"Kennedy plans to dismiss all 16 panel members of the U.S. Preventive Services Task Force because he views them as too 'woke.'" The USPSTF's recent recommendations include screening women for intimate partner violence and for osteoporosis to prevent fractures. www.wsj.com/health/healt...

Important piece from Sherry Glied on the destruction - and rebuilding - of govt evaluation capacity. "[These offices'] demise signals a turn away from an ideal of government that roots its actions in evidence and seeks to continually improve its programs and mission." jamanetwork.com/journals/jam...

One of FDA's Oncology Division has lost what is essentially the equivalent of a full drug review team. It's malignant hematology review teams are expected to have a staff less than half the intended size as more staff depart this August. insights.citeline.com/pink-sheet/a...

Translation for non-scientists. The major funder for cancer research in the world is now only funding proposals that score in top 4 percent. They’re funding roughly 2/3 fewer proposals than they had in recent years. I suspect the funding line has actually never been this low.

FDA's new website about the national priority review program asks for a brief 350-word description of how the company's work aligns with national priorities. In comparison, FDA envisions requests for fast-track and breakthrough designation to take 10-20 pages. www.fda.gov/industry/com... (1/2)

Many notable things about this appointment! One is that, while this FDA purports to be interested in lowering drug prices, Dr. Tidmarsh led the development of Duexis while at Horizon. Duexis, a combo of two OTC drugs with a high price tag, was subject to bipartisan concern before being discontinued.

CMS just put out a press release asserting it will no longer support waiver demonstrations for multi-year continuous eligibility — it doesn't seem to be terminating active demos, but they won't extended and new ones won't be approved. These policies have mostly been designed to benefit kids.

The companies "decided to launch the direct-sales service for Eliquis after discussions with the Trump administration about affordability." Can many uninsured patients afford $346 per month for just one medication? Medicare negotiated a price of $231 per month. www.wsj.com/health/pharm...

"Makary often seems to bring ideas to the table that seem sensical on the surface but less impressive upon closer inspection... he proposed moving Narcan, which is used to treat opioid overdoses, over the counter. That was a wonderful idea — except that the FDA had done it in 2023."

For @brookings.edu, @clinkeyoung.bsky.social, @rgfrank.bsky.social and I analyze proposals to use international reference pricing for prescription drugs, considering the different ways it can be used and operational and legal considerations that might arise. www.brookings.edu/articles/int...

Excited to welcome Sarah as Editor! Allison Hoffman and I have an article in this 50th edition special issue on the changing role of the government in American health law and its consequences for health law in light of the larger legal context. read.dukeupress.edu/jhppl/articl...

Must-read piece for FDA law & policy people. I'm writing a law review article about these issues (working title: Regulating Health Technologies in a Post-FDA World) and it's difficult to overstate the potential consequences for patients and innovation here. www.nytimes.com/2025/07/08/m...

The question is very clearly about enhanced ACA tax credits, which CBO projects will lead to an additional 4.2 million uninsured (over and above Medicaid changes), and Hassett's response ignores the question and focuses only on Medicaid provider taxes. www.cbo.gov/system/files...

The Republican megabill has many parts and was never framed for the public as a health care bill. But, it is the biggest cutback in federal support for health coverage ever.

Very helpful, candid read from Commissioner Califf on the challenges with drug importation. "Canada is understandably unwilling to risk its own pharmaceutical supply to divert medicines to the U.S. simply because the U.S. cannot get its act together to negotiate a fair price."

Clarity about the stakes from @citizencohn.bsky.social: Republicans' legislation "is probably going to kill a lot of people... When people can’t pay for medical care they frequently don’t get it. And when people don’t get medical care, they’re more likely to die early from a preventable condition."

“It is rare to see public benefits taken away from people once they’re in place, and this level of cuts to health insurance would be extraordinary.” Always read @larrylevitt.bsky.social.

We don't have updated and detailed CBO scores and the final language for the just-passed Senate reconciliation bill isn't yet available. But the devastating impact will likely be about $1 trillion/10 years in #Medicaid cuts and about 17 million more uninsured.

Senate passed billion reduces federal #Medicaid spending by $1 trillion over 10 years and will have major implications for millions of people who rely on Medicaid coverage, states and providers.

A temporary $50 billion rural health fund would make a difference, but it doesn't come close to compensating for the Medicaid and ACA cuts in the Republican budget bill, and doesn't help the millions who will lose insurance altogether.

Reminder that the median Medicaid eligibility level for pregnancy is over 2x the poverty level. Many of these people Mullin is referring to are pregnant or are children. www.kff.org/medicaid/iss...

NEWS: Trump and his GOP allies are pursuing policies that would intentionally cause millions of Americans to become uninsured. There's no precedent. kffhealthnews.org/news/article...

They could have used this gimmick to extend the enhanced tax credits at "no cost" and prevent 4.2 million people from losing coverage. This would be no more (or less) gimmicky than using it to extend tax breaks for the wealthy.

For those who haven't been closely following how many people will lose health insurance from Republican actions: CBO projects 11.8 million more uninsured from the Big Bill. An additional 5.1 million uninsured from allowing enhanced ACA tax credits to expire and administrative actions.

G.O.P. Bill Has $1.1 Trillion in Health Cuts and 11.8 Million Losing Care, C.B.O. Says www.nytimes.com/2025/06/29/u...

One accurate way of thinking about the Trump bill is that is is a massive wealth transfer from the poorest to the richest. That wealth transfer is built on administrative burdens: the savings depend on making it harder for eligible claimants to receive benefits. www.nytimes.com/2025/06/29/u...

In light of the reporting from today's ACIP meeting, highlighting this letter from Sen. Wyden calling out Sec. Kennedy's decisions and their consequences for patients. "Your actions put the vulnerable at further risk and you stand to profit from this harm." www.finance.senate.gov/ranking-memb...