President-elect Trump to Enter Office with GOP Sweep: Made official on Wednesday evening, Republicans will enjoy a full majority sweep in 2025 and will be ready to address their intended reforms to the health system. Republicans have traditionally wanted to add risk pools to ACA markets to cut rates for healthy, young people; VP-elect JD Vance supported this view on the campaign. The new administration will also pursue rulemaking to add work requirements to Medicaid and potentially rollback the CMS direct drug negotiation program. In Congress, insiders have indicated incoming Senate HELP Committee Chair Cassidy plans to put things in “hyperdrive” next term, addressing doctor reimbursement, hospital pay, ACA subsidies, and potential 340B program reforms.

Trump Announces Robert F. Kennedy Jr. as HHS Secretary Pick: President-elect Donald Trump has picked Robert F. Kennedy Jr. to be his next secretary of the Department of Health and Human Services. Kennedy, who ran an independent campaign for president early this year, reportedly accepted the offer Trump’s offer on Thursday. Kennedy, a COVID vaccine skeptic, proposed numerous policies aimed to overhaul food safety, promote holistic medicines, and restructure public funding for vaccine research. He floated replacing 600 officials at the National Institutes of Health with hand-picked staff at a November event, as well. In 2025, the Trump administration will be charged with writing the next iteration of the Dietary Guidelines for Americans, and Kennedy has stated aims to strip processed food out of school lunch and limit food dyes in American diets.  

Crapo and Cassidy to Lead Senate Health Committees, House Leadership yet Undetermined: On Thursday, Sen. Bill Cassidy (R-LA) announced he will take the gavel of  the Senate HELP Committee in the 119th Congress. Sen. Cassidy will join Sen. Mike Crapo (R-ID) leading health policy priorities in the Republican majority. On the House side, the race to lead the Energy & Commerce Committee is yet between current Health Subcommittee Chair Brett Guthrie (R-KY) and Subcommittee on Communications and Technology Chair Bob Latta (R-OH).  

Sens. Cassidy and Hassan Reveal Site-Neutral Payment Framework: On November 1, Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH) released a framework for site-neutral payment reforms in Medicare. The legislation, which is expected to help lay the groundwork for bipartisan efforts to enact site-neutral reform next Congress, also included reinvestment in rural hospitals.  

Healthcare Groups Turning to Congress after CMS Finalizes Payment Rules: On November 1, CMS finalized a 2.83% cut to 2025 physician fee schedule payments and 0.5% bump for Medicare home health reimbursements, with hospital and home health advocates immediately calling on Congress to address these shortfalls in an end-of-year package. A bipartisan group introduced the Medicare Patient Access and Practice Stabilization Act which proposes a 4.73% payment increase for physicians, though we are yet unsure what exact figure Congress will decide for 2025 relief.  

Johnson & Johnson and Eli Lilly Sue HRSA Over 340B Rebate Program: On Tuesday, Johnson & Johnson filed a lawsuit against HHS for prohibiting the drugmaker from charging certain hospitals full price for two drugs the company previously sold at the 340B discount rate. This summer, the drugmaker told hospitals they would need to pay full price up front for Stelara and Xarelto and then apply for 340B discounts. On Thursday, Eli Lilly announced it is also suing HRSA, saying its program is designed to pay cash directly to 340B covered entities every week.

Interest Groups Press for PBM Reform in Lame Duck: On Monday, PhRMA purchased a seven-figure suite of ads urging Congress to pass PBM reform legislation before the year’s end. The National Association of Manufacturers also announced the launch of a video and digital advertising campaign on the issue. Both the House and Senate have passed differing policies, and 100 health organizations also signed a letter calling for “reforms that enhance transparency.”  

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