May 14, 2025
Good afternoon,
Hope to see you tomorrow morning for the following NYS Council Member Support Webinar:
Navigating Change: Communications Considerations for Today’s Shifting Policy Landscape
Facilitators: Amanda Maynord, CEO, Dana Coleman, Vice President, Lovell Communications (an HMA Company)
May 15, 9:15 – 10:15
Health care organizations today are facing unprecedented changes as a result of federal policy shifts that impact everything from how you communicate to your ability to remain viable as funding sources are threatened. Join us for a conversation with crisis and change management communications experts from HMA Lovell Communications to understand what you need to consider in these turbulent times, how to approach decision-making about your communications and the impact on key stakeholders.
Lauri Cole is inviting you to a scheduled Zoom meeting.
Time: May 15, 2025 9:15 AM-10:15 Eastern Time (US and Canada)
Join Zoom Meeting
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Meeting ID: 862 7094 1266
Passcode: 619723
One tap mobile
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Yesterday, the Department of Health and Human Services (HHS) ordered the recission of 4 documents, effective immediately, including (but not limited to) “Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder”.
Here’s the Notice in the Register with brief discussion of the 4 documents that are rescinded: https://www.federalregister.gov/documents/2025/05/14/2025-08393/notification-of-hhs-documents-identified-for-rescission
And here is an excerpt from the Federal Register Notice (below). Stand by for further information. I am working to get clarity on how this directly impacts our members in their day-to-day work with care recipients:
“…I have determined that the documents identified below have been superseded, are unduly burdensome, no longer represent the considered legal judgment of HHS, and/or are otherwise appropriate for rescission. To the extent one of these documents should have been promulgated with notice and comment, but was not, that provides another basis for rescission. Accordingly, all documents identified below are hereby rescinded, effective immediately.
Because HHS promulgated these documents without notice and comment, HHS may rescind them in the same manner. Perez v. Mortg. Bankers Ass’n, 575 U.S. 92, 101 (2015). Any effect on reliance interests could only be positive since these guidance documents have already largely been superseded. Thus, formal rescission will reduce the burdens on regulated parties. To the extent there are negative effects on reliance interests, those interests are unreasonable or unwarranted. The American public knew that these informal documents could be rescinded at any time, especially following a change of administration now that they are defunct.
This is the beginning of a new era for HHS and American health more broadly. In this new era, patient choice and individual freedom will predominate over burdensome federal regulations. In this document, we are taking the first step towards making that a reality.”
I hereby order that the following documents be rescinded, effective immediately:
* Extension of Designation of Scarce Materials or Threatened Materials Subject to COVID-19 Hoarding Prevention Measures; Extension of Effective Date With Modifications, 86 FR 35810 (July 7, 2021).
* Opioid Drugs in Maintenance and Detoxification Treatment of Opiate Addiction; Repeal of Current Regulations and Issuance of New Regulations: Delay of Effective Date and Resultant Amendments to the Final Rule, 66 FR 15347(Mar. 19, 2001).
* Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder, 86 FR 22439 (Apr. 28, 2021).
* Notification of Interpretation and Enforcement of Section 1557 of the Affordable Care Act and Title IX of the Education Amendments of 1972, 86 FR 27984 (May 25, 2021).
Robert F. Kennedy, Jr.,
Secretary, Department of Health and Human Services.
[FR Doc. 2025-08393 Filed 5-13-25; 8:45 am]————————
Yesterday, HHS issued a Request for Information focused on deregulating all areas under the Department, entitled “Ensuring Lawful Regulation and Unleashing Innovation To Make America Healthy Again”. The National Council is highly likely to prepare formal comments in response to the RFI. I will get with them by the end of the week to make sure our voices are heard when they submit comments for the record.
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The House Energy and Commerce Committee apparently worked through the night debating the impacts of its current assignment to save $880B over 10 years. There is no update (yet) in the form of a new document from the Committee although I am keeping my eyes peeled. Here’s more on what happened yesterday and what to expect once the Senate gets the completed bill from the House:
(Politico, 5/14) LONG DAY’S JOURNEY — The Energy and Commerce Committee pulled an all-nighter debating the potential impacts of Republican proposals to change Medicaid, part of the GOP’s domestic policy megabill, Ben and Robert report.
Republicans defended their efforts as needed reforms to eliminate waste, fraud and abuse in a bloated program.
Democrats said the proposals, which include work requirements, new limits on provider taxes and penalties for states that use the program to insure undocumented immigrants, would throw millions of vulnerable Americans off the rolls.
The $625 billion in savings from most of the Medicaid provisions helps pay for the $4 trillion spending package that will extend President Donald Trump’s tax cuts and fund other domestic policy priorities.
But the bill’s passage remains an open question as several conservative hardliners have complained it doesn’t go far enough to cut government spending.
The day got off to a raucous start.
As E&C Chair Brett Guthrie (R-Ky.) finished his opening statement, protests erupted throughout the room, with Capitol Police arresting 25 people and escorting out more as protesters chanted, “No cuts to Medicaid.”
Here’s some of the committee debate:
— Democrats cited a preliminary estimate they requested from the Congressional Budget Office that found more than 8.6 million people could lose insurance if the bill becomes law.
“Let me be clear — this is not a moderate bill, and it is not focused on cutting ‘waste, fraud, and abuse.’” said ranking member Frank Pallone (D-N.J.). “Instead, Republicans are intentionally taking health care away from millions of Americans so they can give giant tax breaks to the ultrarich who don’t need them.”
— Republicans countered that the changes are necessary to preserve Medicaid for those who need it, which includes people who are elderly or disabled. “Medicaid was created to protect health care for Americans who otherwise could not support themselves, but Democrats expanded the program far beyond this core mission,” Guthrie said. “That’s why we are establishing common-sense work requirements for capable, but not working, adults in the expansion population.”
— The bill is generating fierce pushback from hospital groups worried about losing Medicaid funding. However, more moderate Republicans are happy that Guthrie didn’t include more drastic reforms, such as a cap on federal funding for Medicaid’s expansion.
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May 14, 2025
Yes. The Senate will change the GOP reconciliation bill
Here’s something Speaker Mike Johnson should be worried about: Senate Republicans are gearing up to change the House’s reconciliation package.
The big questions are by how much, and can House Republicans live with those changes?
Johnson hopes to have the House GOP reconciliation package on the floor next week. If Johnson and his leadership team can pass it, then Senate Republicans will have several weeks to debate and revise the package to pass it before the debt limit needs to be raised in mid-July.
This is a hugely complex legislative vehicle that will directly impact nearly every American – plus the political outlook for President Donald Trump and the GOP-controlled Congress.
There’s widespread agreement that changes on issues ranging from tax credits to health care provisions will be necessary to satisfy different factions within the Senate GOP Conference, as well as the Byrd Rule.
But you should expect changes.
“We are, both the House and the Senate, trying to stay as close as we can on policies,” Senate Finance Committee Chair Mike Crapo (R-Idaho) said. “That being said, the House is going to have a different work product than we end up with here.”
That’s an unappealing prospect for many House Republican moderates wary of voting for controversial provisions that may be dramatically different once the Senate has its say.
Conservatives won’t like it either, especially if Senate Republicans balk at the hundreds of billions of dollars in spending cuts to Medicaid and other social safety net programs House Republicans are proposing.
“The goal is to make sure we do the best job possible so the things they might want to deal with are as limited as possible,” said House Majority Whip Tom Emmer, who huddled with Senate Republican whips on Tuesday.
Emmer added: “We’re gonna pass this bill and send it to them. When it gets to them, it’s their job to do what they need to do to that bill and get it back to us as soon as possible.”
Tax: GOP tax writers worked closely to tweak the 2017 tax cuts in an attempt to make the current policy baseline work in the Senate.
Republicans plan to use the accounting tactic to make the tax provisions permanent without needing big offsets down the line under reconciliation rules. Those adjustments — many of which grant some extra tax cuts — are in the Ways and Means Committee bill.
But beyond that, the Senate will still have a lot to work through, including revenue raisers in the package. There are GOP senators uneasy about the net $515 billion of clean energy tax credit repeals included in the House package.
“We’re gonna have a little bit of a different view, so we’ll wait to see what they come out with,” Sen. Shelley Moore Capito (R-W.Va.) said about the House’s clean energy provisions.
Senate Republicans also aren’t thrilled with a SALT cap above $10,000, which has to be included for Johnson to push this bill through the House.
GOP senators will push to make key business tax breaks for R&D, interest expenses and buying short-term assets like machinery permanent. House Republican tax writers would love permanence, but that’ll raise the bill’s cost. Ways and Means had to stick to an under $4 trillion price tag to please House deficit hawks, but the Senate could blow past it.
Ag: Senate Agriculture Committee Chair John Boozman (R-Ark.) said he’s coordinated with his House counterparts to include risk management tools in the farm bill section of the reconciliation package.
But there are larger problems ahead, as Boozman has raised concerns that some of the other House provisions won’t survive the Byrd Rule, including a partial rewrite of the farm bill.
“We’re going to wait and see what they mark up,” Boozman said.
House Agriculture Committee Chair GT Thompson (R-Pa.) told reporters on Tuesday that he’s held discussions with Boozman over this issue.
“We’ve worked with him, we’ve worked with the parliamentarians. Ultimately, the Senate will have the final say. But we’ve really done our due diligence to try to avoid any type of conflict with that Senate rule,” Thompson said.
Medicaid: Some of the most controversial House GOP policy moves – especially Medicaid cuts – are winning Senate converts, although Republican senators aren’t committing to backing the reconciliation package yet.
“I think it’s getting better,” said Sen. Jim Justice (R-W.Va.). Justice and Capito were among several red-state Republican senators concerned about House GOP proposals to alter how the federal government reimburses states for Medicaid recipients or impose per capita caps. These senators have lots of Medicaid recipients among their constituents too.
As it is, House Republicans are making less-sweeping FMAP revisions while imposing new work requirements and eligibility checks. But health care changes in the reconciliation bill will still result in 8.6 million Americans losing health insurance.
Sen. Mike Rounds (R-S.D.) summed up the fluid nature of the final package by noting that making the Trump tax cuts permanent and extending the debt limit are the only two must-pass provisions.
“Other than that, everything else is up for discussion for the most part,” Rounds said.
Also: Johnson met with the SALT Caucus Tuesday evening. They’re inching closer to finding a deal but it hasn’t happened yet. The group discussed different expiration dates for a higher cap – an earlier expiration date would lower the cost. The two sides broke up last night with the understanding that they would run numbers to figure out the costs and reconvene and hopefully notch a deal today.
One of the options under consideration was a $40,000 cap for individuals and an $80,000 cap for couples. This would be very pricey and would be a big win for SALTers.
– John Bresnahan, Max Cohen, Andrew Desiderio, Laura Weiss, Jake Sherman, Brendan Pedersen, Punchbowl News, 5/14/25