WHITE HOUSE

This week, the White House focused on relieving pressure from the tariffs on domestic automobile manufacturing, establishing a new US-Ukraine reconstruction investment fund, establishing a “Religious Liberty Commission”, and posted their 100-day recap (the 100-day mark of a Presidential Administration is typically seen as an early benchmark (political wonk alert) of success). One item of indirect interest:

• • On Friday, the White House released the President’s 2026 “skinny” budget proposal. The full release page is here. It’s important to note that Presidential budgets never pass as initially proposed. They mainly act as a blueprint for Presidential priorities to guide Congress in actually appropriating funds. While there will be a lot of noise, from all ends of the political spectrum, on what the skinny budget does, ultimately it’s up to Congress to actually pass a budget, and to not read too much into the Presidential proposal.

CONGRESS:

Speaking of budget, the House continues to struggle with Reconciliation and how to move forward. The Energy & Commerce Committee delayed their hearing on the $880 billion in cuts as they continue to have major internal pushback on the right path forward. Following last week’s letter from GOP moderates that they will not support Medicaid cuts, and the President’s support of Medicaid, a group of conservative hardliners sent a letter this week that urges for even greater cuts to the program. The Agriculture committee, which is the other committee responsible for significant cuts, also delayed their hearing. It’s a sign of the deep divisions within the GOP as they struggle with cuts that are extremely unpopular. With July 4^th the new target date for passage, there’s still plenty more drama to come. Elsewhere in the political world:

• • A good read on what work requirements would look like, should they make their way into the final Reconciliation bill.

• • An excellent primer on the two most important Republicans in terms of the tax provisions of Reconciliation: Senator Mike Crapo and Congressman Jason Smith.

• • Europe continues to move forward on AI regulation, despite US pushback.

• • The CRS updated their guide for Congress on Medicaid this week. As Congressional offices rely on the CRS for guidance on the program, it’s a good insight into how they are viewing the program.

AGENCIES:

As Federal agencies continue to remain quiet on the healthcare regulation front, the DOJ filed a lawsuit against three MA companies and three brokers alleging serious violations of anti-kickback statutes. Here are a few good summaries on the lawsuit from the Wall Street Journal and Fierce Healthcare.

Nothing official, but there are reports that federal supplemental payments to hospitals are being delayed.

The Supreme Court ruled against hospitals on how to calculate reimbursements for a program that serves low-income patients.

FROM THE NOTEBOOK:

• • Once again, the Kaiser Family Foundation found that cuts to Medicaid and health agencies are extremely unpopular with the public.

• • A good read on the devastating impacts that the Medicaid cuts under discussion would have on SNF’s, featuring AHCA’s Clif Porter. He also sat down with Skilled Nursing News to discuss the ongoing debate in Washington.

• • Montana is investing $124 million into the state’s behavioral health system. This is part of a greater trend by states to invest in their behavioral health budgets.

• • Florida wrapped up their legislative session without a budget, which must be passed by July 1^st. It’s unclear when the next steps will be taken.

• • Add Michigan to the list of states that are taking a long look at PBM’s.

• • A lawsuit in Maryland, seeking to force the state to eliminate their backlog of surveys, was allowed to move forward as a class-action suit.