Thoughts
Thought Leadership Posts
Five Reasons Republicans Won’t Cut Medicaid (Much)

It is starting to feel like 2017 all over again, and not in a good way.
When the House last month passed a budget resolution that calls for $880 billion in savings from the Energy & Commerce Committee, it sent a strong signal that Republicans plan to pursue deep cuts to the Medicaid program. As a letter from the Congressional Budget Office confirms, Medicaid accounts for 93 percent of the spending under that committee’s jurisdiction (if you exclude Medicare, which Trump and party leaders claim they will protect).
For many, there is clearly cause for great concern emanating from Washington these days. The Department of Government Efficiency’s mass layoffs pose considerable risks to millions of impacted working families and the economy as a whole. Small businesses across the country are already reeling from the imposition of tariffs and the threat of more. Many immigrant communities are living in fear, which also has profound ripple effects on the economy as a whole.
As I recently pointed out, the absence of moderate Republicans who helped stop these cuts in 2017 means that the party could implement them this time if it chooses.
I believe it is highly unlikely that they will, however, and if they do proceed, they are likely to fail. Here are five reasons why....
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Improving Access to School-Based Behavioral Health Services Through Medicaid

Currently, many young people are experiencing considerable mental health challenges; Medicaid school-based behavioral health services can play a crucial role in their health and wellness. Federal policymakers have an opportunity to optimize federal resources and new Medicaid flexibilities for states to increase access to mental health services in schools. Collaborative models, such as the Centers for Disease Control and Prevention’s Whole School, Whole Community, Whole Child (WSCC) model, demonstrate how the education, school health, and public health sectors can work together to improve children’s health and well-being....
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Bipartisan Congressional Support for PBM Reform Grows

Following the enactment of the sweeping drug pricing provisions included in the Inflation Reduction Act (IRA), lawmakers are again attempting to address high drug prices, this time by focusing on pharmacy benefit managers (PBMs) in a bipartisan fashion. PBMs are third-party intermediaries responsible for negotiating prescription drug price discounts with drug manufacturers and managing prescription drug benefits on behalf of payers. They have come under scrutiny in recent years for their role in high drug prices.
Congress has crafted several legislative packages that include reforms to increase transparency regarding the role of PBMs in the distribution chain for prescription drugs, overhaul how PBMs are compensated, and curb potentially anticompetitive behavior. In this blog post, we describe these legislative proposals....
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Lawmakers Eye Lame-Duck Session for Unfinished Health Care Business

Congress has until the end of the year to extend several expiring health care provisions, including COVID-19 telehealth flexibilities and funding for community health centers. But the parties will have to agree to policies that could help pay for these “must-do” items, perhaps by advancing bipartisan health policy priorities to help offset the extensions. The potential lame-duck health package could move with government funding due December 20. In this blog post, we highlight health policies that are primed for consideration this year....
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Access to Medicaid and Behavioral Health Care Provisions in Congress’s Recent Funding Package

More than 78 million Americans — nearly one of four — are insured by Medicaid. In 2020, an estimated 40 percent of the nonelderly adult Medicaid population experienced a substance use or mental health disorder. Consequently, expanding Medicaid coverage can improve health outcomes for people with behavioral health care needs. The Affordable Care Act’s Medicaid expansion, for instance, improved access to care for people with depression and other psychological distress.
In the recent “minibus” appropriations package for 2024 (H.R. 4366), Congress included several behavioral health reforms, largely for Medicaid beneficiaries and individuals who receive care in community-based settings, with hopes that these reforms can increase the availability of behavioral health services for Medicaid beneficiaries and improve health outcomes....
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What The Election Means for Federal Health Care Legislation

With a clean sweep of the White House and Congress likely, and a favorably disposed federal judiciary, Republicans are poised to effectuate their health care policy priorities over the next two years. This article takes a closer look at their likely congressional leadership and the policies they are likely to pursue....
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Here Are Key Mental Health Provisions in the Bipartisan Safer Communities Act

While advocates are pleased to see new funds authorized for mental health services, they worry that including it in this package reinforces the misconception that most gun violence is perpetrated by people burdened with mental health problems. The reality is that people with mental illnesses are more likely than other people to be victims of firearm violence rather than perpetrators. Only 3% to 5% of violent acts are committed by people with serious mental illnesses, such as schizophrenia, bipolar disorder, or major depression. Here we discuss key investments and policies contained in the gun safety law....
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Biden Administration Outlines Comprehensive Equity Action Initiatives

Several hours after taking the oath of office, President Joe Biden signed an executive order directing the federal government to advance racial equity and support for people of color and others who have been historically underserved, marginalized, and harmed by persistent poverty and inequality. The order affected more than 90 federal agencies, including the Department of Health and Human Services (HHS) and the Department of Housing and Urban Development (HUD). Each agency then assessed whether its programs and policies perpetuate systemic barriers to opportunities and benefits for people of color and other underserved groups, and whether new policies, regulations, or guidance documents will be needed to advance equity. These assessments informed the development of Equity Action Plans, released by the White House last month, that outline concrete strategies and commitments to address systemic barriers across the federal government....
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Biden Lays Out His Health Policy Agenda

When President Joe Biden delivered his first State of the Union (SOTU) address to the nation recently, it was intended to tout legislative accomplishments and present his policy priorities and solutions. With Biden’s approval rating currently around 42%, the SOTU provided the president an opportunity to build public confidence in the administration’s ability to govern and address ongoing challenges — primarily the COVID-19 pandemic, the Russian invasion of Ukraine, and rising inflation. Throughout the March 1 speech, the president highlighted an array of health-related priorities, including proposals in the Build Back Better Act (BBBA) (H.R. 5376) currently stalled in the narrowly divided Senate. He discussed the administration’s updated COVID-19 response, measures to lower the cost of prescription drug prices and Affordable Care Act (ACA) coverage, strategies to address the mental health crisis, plans to improve the quality of care at nursing homes, and his renewed Cancer Moonshot initiative....
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What Are the Biden Administration’s Health Policy Priorities?

When it comes to health policy, the fledgling administration of President Joe Biden and Vice President Kamala Harris hit the ground running. The White House has issued more than 20 health-related executive orders so far. While the administration’s top priority is to address COVID-19, there are many other key health policy areas in which significant changes might occur. These include stabilizing and building upon the Affordable Care Act (ACA), removing obstacles to health equity, and limiting drug prices....
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