Save the Date!
Fostering Bold Leadership in a Fast-Changing World
Alliance 2025 Executive Seminar
April 24-25, 2025 Albany Marriott
including national expert panelists
Chuck Ingoglia, President and CEO, National Council for Mental Wellbeing
Jennifer Mathis, Deputy Director, Bazelon Center for Mental Health Law
Caren Howard, Senior Director for Policy and Advocacy, Mental Health America
See more program and registration info next week!
New Feature!
Alliance Daily Digest
February 14, 2025
RFK JR. TAKES OVER HHS Politico February 14, 2025
Robert F. Kennedy Jr. was sworn in to lead the Department of Health and Human Services on Thursday, and his plans for the agency could make Elon Musk’s budget-cutting spree look small in comparison, POLITICO’s Chelsea Cirruzzo, Daniel Payne and Adam Cancryn report.
The new HHS secretary, who won Senate confirmation Thursday, promises to take the nation’s health agencies in a radical new direction.
“We will make sure our tax dollars support healthy foods. We will scrutinize the chemical additives in our food supply. We will remove the financial conflicts of interest in our agencies,” he told the Senate Finance Committee during his confirmation hearings. “We will create an honest, unbiased, science-driven HHS, accountable to the president, to Congress and to the American people.”
Kennedy has big plans to target the health care industry and food manufacturers — representing a shift for Republicans who once largely aligned with the sectors. Focusing on attacking chronic disease by regulating food additives and chemicals in the environment will likely be at the top of his agenda, according to two people familiar with his internal discussions, who were granted anonymity to speak freely.
Asked in a Fox News interview Thursday night about rumors that 50 percent of HHS employees would be fired, Kennedy said he “would be surprised if there were 50 percent cuts.” He said most lower-level HHS employees are “good American patriots and hardworking people,” and he’s more interested in firing people who “have made really bad decisions,” such as on nutrition guidelines.
“I’m not going to let the food industry and the pharmaceutical industry run health policy anymore,” Kennedy added. “We’re going to turn health policy over to people who are actually concerned with public health.”
It’s not clear how quickly Kennedy might move to put his stamp on the administration’s health agenda, but he laid out an aggressive plan even before Trump named him to lead HHS, including vowing an overhaul of HHS’ Food and Drug Administration, calling it “corrupt.”
Even so: Kennedy’s lack of managerial experience and unfamiliarity with the intricacies of HHS’ various programs could limit his reach. A former senior Trump HHS official, granted anonymity to speak freely, told POLITICO that Kennedy’s influence would come down to his circle.
“Personnel is policy. That’s incredibly true of the Trump administration,” the official said. Kennedy, the person said, will need to rely on people with institutional knowledge to make the changes he wants to make — within the applicable constructs to avoid judicial challenges….
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Republicans Put Health Care Cuts Front and Center to Advance Agenda
by Tobias Burns and Nathaniel Weixel – The Hill February 14, 2025
House Republicans are putting cuts to Medicaid at the top of their list of budget cuts to help pay for their wide-ranging agenda that spans tax cuts, energy production and border security.
Republicans are eyeing changes to how much the federal government, as opposed to states, will contribute to Medicaid expenditures, a number called the federal medical assistance percentage (FMAP).
Republicans see Medicaid as a program rife with fraud and abuse and have long sought to rein in its spending.
The joint federal-state program provides health coverage for more than 70 million people, with the federal government covering anywhere from 50 percent to about 75 percent of the costs for traditional Medicaid but 90 percent for states that expanded coverage under the Affordable Care Act (ACA).
The House Budget Committee considered a plan Thursday that would instruct the Energy and Commerce Committee — which has jurisdiction over Medicaid — to find $880 billion in savings over the next 10 years.
Possible changes Republicans are floating include capping Medicaid spending on a per capita basis at a potential savings of $900 billion per year; rolling back the enhanced federal matching rate for ACA expansion states to save $561 billion; and lowering the 50 percent floor for the traditional Medicaid population, for a savings of up to $387 billion.
The latter change would primarily affect wealthier states such as California and New York, but every state would bear the brunt of reduced federal spending, forcing difficult trade-offs.
Rep. Russ Fulcher (R-Idaho) told The Hill that Republicans have to go after Medicaid for cuts because “that’s where the money is.”
….Rep. Chip Roy (R-Texas) said his conference was considering how Medicaid “formulas are applied in terms of state-by-state.”
…Republicans are also considering establishing work requirements for Medicaid. An expansion of the Child Tax Credit failed to pass last year because it didn’t include work requirements, among other reasons.
Certain groups of people in the Republican proposal wouldn’t have to work in order to get health coverage through Medicaid, including pregnant women, primary caregivers, people with disabilities, and full-time students.
….Republicans have only a slim majority in the House and will need every vote to pass the budget resolution on the floor.
They will also face a formidable obstacle in hospitals and health providers, who will lobby heavily against any cuts to Medicaid.
“While some have suggested dramatic reductions in the Medicaid program as part of a reconciliation vehicle, we would urge Congress to reject that approach. Medicaid provides health care to many of our most vulnerable populations, including pregnant women, children, the elderly, disabled and many of our working class,” Rick Pollack, president and CEO of the American Hospital Association, said in a statement….
https://thehill.com/policy/healthcare/5144053-republicans-put-healthcare-cuts-front-and-center-to-advance-agenda
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As States Mull Medicaid Work Requirements, Two Scale Back (excerpts)
KFF Health News February 14, 2025
President Donald Trump’s return to the White House sent a clear signal about Medicaid to Republicans across the country: Requiring enrollees to prove they are working, volunteering, or going to school is back on the table.
The day after Trump’s inauguration, South Carolina GOP Gov. Henry McMaster asked federal officials to approve a work requirement plan. Ohio Republican Gov. Mike DeWine plans to soon follow suit. Republicans in Congress are eyeing Medicaid work requirements as they seek to slash billions from the federal budget.
But, just as a second Trump administration reignites interest in work requirements, Georgia is proposing to scale back key parts of the nation’s only active program. And Arkansas announced an effort to revive — with fundamental changes — a program that ended after a legal judgment in 2019.
The Georgia and Arkansas proposals, from the only two states to have implemented Medicaid work requirements, reveal the disconnect between rhetoric behind such programs and the realities of running them, said consumer advocates and health policy researchers….
https://kffhealthnews.org/news/article/medicaid-work-requirements-states-revamp-trump-administration/
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CMS May Evade Trump’s Sweeping Deregulation Order
Modern Healthcare February 14, 2025
President Donald Trump’s government-wide directive to slash regulations doesn’t appear likely to hamstring day-to-day operations for companies that do business with programs such as Medicare and Medicaid.
Trump’s executive order requires federal agencies to cut 10 regulations for each new one proposed. But its impact seems poised to be minimal at the Centers for Medicare and Medicaid Services, largely because most of the rules it issues are mandatory under statute…..
https://www.modernhealthcare.com/policy/trump-deregulation-executive-order-cms