Budget Reconciliation Process Continues with Senate Consideration of Revised House Resolution

April 9, 2025

medicaid

On April 5, the Senate voted 51-48 to pass a modified version of the House-passed budget resolution with reduced deficit reduction targets for Senate committees as compared to the House. Specific to health care, the revised Senate resolution instructs the Senate Finance Committee (SFC), which has jurisdiction over Medicaid, to propose changes that will increase the deficit by no more than $1.5 trillion, but does not provide a target number for potential cuts.

The revised resolution maintains the cuts for House committees, including instructions to the Energy and Commerce Committee (E&C), which also has jurisdiction over Medicaid, to find at least $880 billion in savings over the next 10 years. In effect, if this version of the resolution passes both chambers, this gives Senate committees much more flexibility to roll back potential cuts that may be considered by the House, including potential Medicaid cuts. House Speaker Mike Johnson (R-LA) has stated large Medicaid program cuts, such as per capita caps and changes to the Federal Medical Assistance Percentage (FMAP), are no longer under consideration.

While there is no clarity into proposals being considered for cuts, a partial or full repeal of regulations promulgated by the Biden Administration including the nursing home staffing rule, the Medicaid/CHIP ACCESS rule, and the Medicaid Eligibility rule, could be on the table. The next step in the process is for the House to pass the revised resolution, which may be difficult given conservatives’ skepticism of the lack of certainty around budget cuts.

legislation

CMS Releases Final 2026 MA Policy and Technical Rule; Declines to Finalize Coverage of GLP-1s

On April 4, the Centers for Medicare & Medicaid Services (CMS) finalized the 2026 MA Policy and Technical Changes rule. Of note, CMS is not finalizing certain provisions from the proposed rule, most importantly the proposal requiring coverage of anti-obesity medications (AOMs) in both Medicare and Medicaid. CMS said that it may address these proposals […]
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April 9, 2025

EGWP marketplace medicaid Medicare

legislation

2026 Final Rate Announcement for MA and Final Part D Program Instructions

On April 7, CMS released the Calendar Year (CY) 2026 MA and Part D Final Rate Announcement and the Final CY 2026 Medicare Part D Program Instructions. The Administration strongly defended its focus on fraud, waste, and abuse, while protecting beneficiaries. The final rate notice increases average payments to MA plans by 5.06% up from […]
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April 9, 2025

EGWP medicaid Medicare

legislation

Senate Finance Committee Advances Dr. Oz’s Nomination for CMS Administrator

On March 25, the Senate Finance Committee voted 14-13 along party lines to advance the nomination of Dr. Mehmet Oz as CMS Administrator. During the confirmation hearing, Chair Mike Crapo (R-ID) and other Republicans expressed strong support for Dr. Oz, citing his prior experience as a physician and health advocate. Democrats however scrutinized the nomination. […]
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April 9, 2025

EGWP marketplace medicaid Medicare

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