Our final post here at z-Intel! Starting next week, the Digest will have a new home at Park Place Live, a new site co-founded by Marc Zimmet and Mark Parkinson that’s launching this week at the Zimmet Conference. If you’re in Connecticut, come find us.

WHITE HOUSE:

The White House focused this week on creating more transparency in higher education admissions, new oversight in the federal grantmaking process, and addressing Russian threats via increased tariffs. Two items of indirect interest for us:

• • The President also issued an Executive Order that “democratizes” access to alternative assets in 401(k) plans. Included in the order’s definition of alternative assets are non-traditional assets like private equity, real estate, and digital assets (i.e. cryptocurrency and the like). While the details will need to be worked out, expanding access to these assets can have a significant impact on retirement planning, as well as how holders of these assets can market them. The practical impact won’t be felt for quite some time, but this is something to discuss with your tax folks. The full text of the EO is here.

• • The President issued an Executive Order to target “debanking”, the perception that banks are targeting customers for their political beliefs. As with any executive order, there may be unintended consequences for legitimate clients based on how the rules are implemented by the agencies tasked with carrying out the EO. Given the extensive relationships that exist between facilities and their lenders, it’s something to be aware of. The full text of the EO is here.

CONGRESS:

The Senate headed out of town earlier this week to officially begin the Congressional summer recess, while leaving a lot of unfinished business. The biggest item on the agenda for September is figuring out how to fund the government. With the usual competing priorities of those who think the government is spending too much versus those who think they don’t spend enough, as well as the razor-thin margins in the House & Senate, it’s going to be a race to the finish. Still, with some early work by the Senate, and Democrats making outreach to their Republican counterparts, maybe we’ll get to avoid the usual shutdown drama this year. Elsewhere in the political arena:

• • Senators Ron Wyden (D – OR) & Elizabeth Warren (D – MA) sent a letter to United Healthcare asking for more information on their I-SNP practices. The full letter can be found here (PDF).

• • We mentioned CMS’s plan to introduce AI & prior authorizations to several services traditionally covered by Medicare. 41 Congressional Democrats, primarily from the progressive wing of the party, sent a letter to CMS urging them to rethink the program. The full letter is here (PDF).

• • The Texas redistricting wars are really heating up. While the GOP hopes to pick up 5 seats in Texas, the ripple effects for other states and districts remain to be seen. It’s also causing angst among blue-state Republicans as Democrats look to go on the offensive with their own redistricting efforts.

• • Congressional members, particular from the Senate, continue to head out for state races, including the gubernatorial races in Tennessee and South Carolina. Rumors are also swirling that Chip Roy, a noted member of the House Freedom Caucus, is exploring a run for Texas’ Attorney General.

• • A good look at one of the Senate’s new Democratic centrists who’s hoping to bring the party back to the middle.

• • Another behind-the-scenes look at what goes into advocating for changes at an agency.

AGENCIES:

HHS announced that they’re winding down the Biomedical Advanced Research and Development Authority (BARDA)’s mRNA research that led to the Covid vaccines. The move was met by criticism by Senator Bill Cassidy (R – LA).

Although DOGE efforts to contain costs continues to phase out, at least one project remains active: the push to modernize the federal government’s retirement system.

Nothing official yet, but the Wall Street Journal is reporting that the President is exploring privatizing Fannie Mae & Freddie Mac.

FROM THE NOTEBOOK:

• • The Kaiser Family Foundation did a deep dive on the use of prior authorization in state Medicaid managed care programs.

• • With Medicare Advantage programs struggling financially, many of them are trimming benefits and other incentives.

• • Following the passage of a state law that regulated how manufacturers that utilize the federal government’s 340B are allowed to sell their drugs in Oregon, five pharma companies are suing the state.

• • In a shock to no one, a study revealed that more than half of the increase in direct care workers in HCBS are immigrants. With the TPS program coming to an end, it’s a needed reminder that immigration is a needed piece of solving the workforce shortage.

• • A new study found that private equity can also offers positive outcomes for SNF’s, with firms often providing needed capital investments and operational experience. McKnight’s has a good summary.

• • There’s a surprising new population that both Republican & Democractic states actually want to increase Medicaid coverage for: folks in jail within the last 90 days of their their sentence.

• • With the details of the Rural Health Transformation Fund currently being worked upon by CMS, a new study in Health Affairs found that many hospitals are double dipping and are dual certified as rural/urban.