Senate GOP goes hard on Medicaid cuts

Senate Finance Committee Chair Mike Crapo (R-Idaho) unveiled a bill that would dig even deeper into Medicaid than House-passed legislation for savings to pay for President Trump’s tax cuts.

The legislation, which represents the Finance Committee’s part of the One Big Beautiful Bill, is already facing some resistance from Republicans, such as Sen. Josh Hawley (Mo.), who want to safeguard Medicaid pay rates to rural hospitals and other providers.

The Senate bill would place stricter limits on tactics that states use to boost federal funding of Medicaid programs and increase payment rates to providers. The bill also would make parents with children over age 14 work in order to receive Medicaid, while the House bill exempted all parents with dependents from that requirement.

states

Money grab

As Republicans target those funding mechanisms, 15 states rushed to lock in higher rates in state-directed payment programs, Bob Herman reports.

The tax bill that House Republicans passed would freeze provider tax rates for all states and cap them at the current 6% limit. The Senate bill would lower the limit to 3.5% over time in states that have expanded Medicaid, though nursing homes and intermediate care facilities would be exempted.

States use provider taxes to boost federal funding, which they then use to fund higher provider pay rates with state-directed payments.

Bob sifted through more than three dozen state-directed payment arrangements that were approved by CMS in late April and May. Together, the programs account for more than $9 billion in new Medicaid funding for 2025 alone.

hospitals

Hospitals would be hit hardest

Hospitals would bear the brunt of federal health care funding cuts in Republicans’ tax bill, and they’d be hurt in both Democratic- and Republican-led states, according to an analysis by the Urban Institute and the Robert Wood Johnson Foundation.

Medicaid provisions in the House version of the One Big Beautiful Bill would, over 10 years, reduce Medicaid payments to hospitals by $321 billion, and hospitals would face a $63 billion increase in uncompensated care when the uninsured don’t pay their bills, according to the Urban report.

Politico reports that hospital associations in 13 states are urging Senate Republican leaders to maintain the measures on provider taxes and state-directed payments in the House bill.

Read on for details of how other providers would be impacted.

vaccines

What’s in a conflict of interest?

HHS Secretary Robert F. Kennedy Jr. chose new vaccine advisers after dismissing the previous group and accusing them of having too many drug industry ties, Chelsea Cirruzzo reports. But Kennedy’s picks have their own entanglements, some with groups that question the value or safety of vaccines. That raises the question: What does Kennedy consider a conflict of interest?

HHS has not explained how new members were vetted or what constitutes a conflict of interest.

Some public health experts were skeptical of Kennedy’s claims that the prior committee was rife with conflicts, given the robust process members undergo to be able to serve and the requirement that they don’t have ties with the pharmaceutical industry during their tenure. There’s also uncertainty about what standards his new committee is being held to. Read on to learn more about the conflicts of interest among the new panel members.

research funding

Universities propose alternatives to Trump funding cuts

Universities face billions of dollars in proposed cuts to research overhead payments from the Trump administration. A coalition of academic groups has devised two proposals it says would be a more measured way to revamp how the federal government pays for scientific research, Jonathan Wosen reports.

Jonathan obtained the proposals for paying institutions for facility and administrative expenses connected with research. Both strategies differ markedly from the current system, in which institutions receive overhead payments based on rates they negotiate with the federal government.

the courts

A victory for researchers

Researchers were handed a victory Monday when a federal judge in Boston deemed that a set of grant terminations by the National Institutes of Health were “void and illegal,” Anil Oza reports. The decision from Judge William J. Young came after two hours of arguments in U.S. District Court in Boston in a hearing for two separate cases against the administration.

Since Trump took office, he has overseen sweeping changes to the massive biomedical research funder and the work it finances. One study estimated the administration terminated $1.8 billion in just over a month, while another estimate of the total terminations was much higher. The court’s decision will only apply to grants listed by the plaintiffs, which they said numbered in the hundreds.

“We are absolutely thrilled with the judge's decision. This is a huge victory for public health and really vindicates the bravery of our clients who chose to come forward and stand up for science,” Olga Akselrod, a senior counsel at the American Civil Liberties Union, which represented one group of plaintiffs, said outside the courtroom.

What we’re reading

HHS plans ‘bold, edgy’ campaign on ultra-processed foods and diabetes, STAT
Trump administration gives personal data of immigrant Medicaid enrollees to deportation officials, AP
To boost Medicare Advantage profitability, Humana turns to old tactic: the annual wellness visit, STAT
Trump’s big bill would be more regressive than any major law in decades, The New York Times
CDC workers fired from prominent STI, hepatitis labs are rehired,