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How the fight over ICE could pave the way for health care reform
Republicans are considering using a special budget process known as “reconciliation” to fund Immigration and Customs Enforcement without Democratic support. That could give him room to pursue other bills on his own, including President Trump’s great health care plan.
President Trump’s plan aims to move away from the Affordable Care Act’s insurance structure and put money into individual health savings accounts. President Trump also wants to legally codify voluntary agreements with drug companies to set U.S. prices on par with their peers and prevent pharmacy benefit managers from paying large consulting firms to help employers choose benefits.
Natasha Murphy, director of health policy at the Center for American Progress, said health savings accounts are more likely to be the subject of a settlement than the drug pricing issue, despite the administration’s pressure on Republicans on drug pricing.
Earlier this year, it seemed unlikely that Republicans would use reconciliation to pass their legislative priorities. But some Republicans believe it may be the only way to sidestep Democrats’ demands for ICE reform, which Republicans oppose in the wake of the killing of two protesters in Minneapolis.
Both parties are considering a plan to fund the entire Department of Homeland Security, except for the part of ICE responsible for prosecuting and deporting illegal immigrants. In that case, Republicans would try to use budget reconciliation, which would require a simple majority to pass, to separately fund ICE and perhaps the Iran conflict.
It remains unclear whether Republicans will attempt reconciliation again. They used this process last year to pass tax legislation without Democratic support. But with a one-vote difference in the House and large tax cuts already in place, this will be difficult to achieve.
“If you look at last year, the only thing that supported everything was knowing we had to spend it on tax cuts,” said Sen. Rick Scott (R-Fla.).
This is not the first time health policy has potentially been affected by the debate over ICE. In January, the HHS funding bill became embroiled in controversy over ICE funding. The HHS spending bill was part of a larger funding package that included DHS. Republicans and Democrats broke the impasse by agreeing to fund DHS separately from other agencies, in much the same way they are currently considering splitting the DHS funding bill.
CDC all-hands meeting
As Helen Branswell reports, on the day the CDC’s permanent director was supposed to be nominated by President Trump, Acting Director Jay Bhattacharya held his first all-hands meeting with CDC staff.
Many in attendance expected Mr. Bhattacharya to announce the government’s selection to run the agency at the meeting. Instead, it said an announcement is scheduled for today. (HHS later said Mr. Bhattacharyya would continue in his part-time leadership role without providing a new schedule.)
Helen obtained the recording of the meeting. Read more about the tough questions Mr. Bhattacharya faced, his defense of Health Secretary Robert F. Kennedy Jr., and what he plans to do in the wake of the attack on CDC headquarters in Atlanta.
Representative of high drug prices
A bipartisan group of lawmakers has introduced a bill that would cap insulin copays at $35 a month for people with private insurance and lower costs for some people without insurance through a $100 million pilot program, according to Daniel Payne.
The bill builds on legislation passed as part of Democrats’ Inflation Control Act that would cap insulin prices at the same price for Medicare patients.
The Insulin Act of 2026, sponsored by Sens. Raphael Warnock (D-Ga.), Jeanne Shaheen (D.N.H.), John Kennedy (R-La.), and Susan Collins (R-Maine), aims to create new requirements for pharmacy benefit managers and increase competition for biosimilars and generics. This effort was first reported by Semafor.
A bill with the same name and a similar purpose was introduced in 2023, but it was ultimately not passed.
Although insulin is widely used and has been updated many times over the years, its core ingredient was discovered about 100 years ago, making it the epitome of high drug costs.
FTC proposes settlement over insulin pricing
The Federal Trade Commission has reached a settlement with CVS Caremark regarding allegations that the pharmacy benefit manager artificially inflated insulin prices, according to Ed Silverman.
Last month, the FTC reached a final settlement with Cigna’s Express Scripts regarding similar claims. The lawsuit stems from a complaint the FTC filed in September 2024 against CVS Caremark, Express Scripts, and UnitedHealth’s OptumRx.
read more.
Goodbye Malone
Robert Malone, an outspoken doctor and ally of RFK Jr., is leaving the federal vaccine advisory committee, Chelsea Siluzzo reports.
Malone was one of the new members of the Advisory Committee on Immunization Practices, chosen by President Kennedy after he fired all members.
A federal judge recently issued a preliminary ruling that the reorganization of ACIP and changes to the pediatric vaccination schedule made in January were likely illegal because of the way they were conducted.
CMS announces new payment pilot
CMS officials announced a pilot program aimed at improving care for children with complex medical and behavioral needs by encouraging collaboration and accountability among physicians.
CMS Administrator Mehmet Oz and Center for Medicare and Medicaid Innovation Director Abe Sutton contributed a first opinion article to STAT about a new program called ASPIRE (Accelerating State Pediatric Innovation Readiness and Effectiveness).
They explain that the pilot “will standardize a more robust value-based payment framework, which will allow pediatric providers to be more accountable and more compensated for quality care.”
what we are reading
- California considers seal of approval for ultra-unprocessed foods, STAT
- ‘We’re on the inside now’: Meet the man building the political empire behind RFK Jr., The Boston Globe
- How an outsider broke into Eli Lilly’s top ranks and plans to move the company’s business forward, STAT
- RFK Jr. Meme Wash, The Atlantic
