Trump Administration Puts New Chokehold on Billions in Health-Research Funding
The pause came in the form of a footnote from the Office of Management and Budget Director Russell Vought's office, in a document that doles out federal funds to the National Institutes of Health. The footnote stipulated that the agency's funding for the remainder of the fiscal year could only go to staff salaries and expenses, not to new grants or certain grants that are up for renewal. Most NIH-funded research is done by outside scientists at labs across the country.
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CNBC
18 minutes ago
- CNBC
Healthy Returns: Medicare, Medicaid will reportedly pilot covering obesity drugs – a potential win for drugmakers
For once, the Trump administration may be giving some drugmakers a reason to celebrate. The Trump administration is planning to experiment with covering costly weight loss drugs under Medicare and Medicaid, the Washington Post reported on Friday. That plan could expand access to millions of Americans with obesity who can't currently afford Novo Nordisk's Wegovy and Eli Lilly's Zepbound, blockbuster GLP-1 drugs that cost around $1,000 per month before insurance. In a statement to CNBC about the plan, the Department of Health and Human Services said all drug coverages undergo a "cost-benefit review." The Centers for Medicare and Medicaid Services "does not comment on potential models or coverage," the department added. The reported plan – if it ultimately takes effect – would be a huge win for Eli Lilly, Novo Nordisk and many Americans. Spotty insurance coverage of obesity drugs remains the biggest barrier to access for patients – and it's choking broader uptake and revenue growth for the two pharmaceutical giants. Many health plans, including Medicare, cover GLP-1s for treatment of diabetes, but not obesity. Medicaid coverage of obesity drugs is limited and varies by state, according to health policy research organization KFF. But it's important to remember that this plan isn't exactly new. In November, the Biden administration proposed having Medicare and Medicaid cover obesity treatments, which would have extended access to roughly 3.4 million Medicare beneficiaries and about 4 million Medicaid recipients. The proposal was controversial at the time, as it would cost taxpayers as much as $35 billion over the next decade, a congressional analysis found. The Trump administration dropped that proposal in April, but said it could reconsider coverage of those drugs in the future. Let's get into what the newest reported iteration of the plan looks like. Under the Trump administration's reported pilot plan, state Medicaid programs and Medicare Part D plans would be able to voluntarily choose to cover Ozempic, Wegovy, Mounjaro and Zepbound for patients for "weight management" purposes. That's according to several Centers for Medicare and Medicaid Services documents obtained by the Post. The plan is expected to start in April 2026 for Medicaid and January 2027 for Medicare plans, the Post reported. It's unclear how exactly the plan will play out, Jared Holz, Mizuho health care equity strategist, said in a note to clients on Friday. Holz said he expects the government to put some coverage parameters in place related to factors like age, body weight, body mass index and other comorbidities, or coexisting chronic health conditions. He also said the pricing of the drugs will be a "major consideration." Holz said he expects the government to pay less than the current list prices of drugs. But having that coverage would expand access and could help drive higher sales volumes, he noted. Another factor to consider is how much the government is willing to crack down on so-called compounding pharmacies, which are allowed in rare cases to sell cheaper, unapproved versions of GLP-1s. The pharmaceutical industry fiercely opposes those knock-off GLP-1s, as their safety and efficacy aren't vetted by regulators and they are, in some cases, illegally sold at scale. Holz said the industry's complaints to the government about compounded GLP-1s have so far "not been met with a widespread shut-down." But overall, Holz said the Trump administration's reported willingness to consider covering obesity drugs is "a slight positive as far as industry sentiment." It's definitely a breath of fresh air for Eli Lilly, Novo Nordisk and other drugmakers – including Amgen, Roche, AstraZeneca and Pfizer – that are hoping to bring their own obesity drugs to market. The last six months have been anything but smooth for the broader industry: The Trump administration has ratcheted up calls for drugmakers to lower U.S. drug prices, overhauled federal health agencies and could impose sweeping tariffs on pharmaceuticals imported into the country any day now. We'll keep watching to see whether this plan gets implemented, so stay tuned for our coverage! Feel free to send any tips, suggestions, story ideas and data to Annika at After reporting its second straight earnings miss and guidance cut, UnitedHealth Group completed its executive sweep by replacing CFO John Rex. Executives on the earnings call admitted to mis-execution in Medicare Advantage and pledged to get back to profitability and win back investor trust. Nearly two years ago it was CVS Health under pressure, after profits in the company's Aetna health insurance division were torpedoed by low Medicare Advantage Star quality ratings. This week, CVS beat and raised its outlook on the strength of its MA program. CEO David Joyner, now one year into the job, told me he feels good about the turnaround at Aetna and its Medicare business. On top of that, the company saw market share gains in its stores, thanks in part to winning over Rite Aid customers. Humana, similarly, has seen progress on its turnaround, but CFO Celeste Mellet told me that all insurers are grappling with pricing plans for next year amid high medical costs. One big cost driver right now, Mellet told CNBC, is oncology drugs, as some expensive therapies are now being used in combination. The next moment of truth for the Medicare Advantage players will come over the next six weeks – when they'll learn the fate of their Star ratings for 2026 plans. Long-time health-care executive Dr. Marc Harrison has stepped down as CEO of General Catalyst's Health Assurance Transformation Company, or HATCo, and has moved into a strategic advisor role, CNBC has confirmed. The venture capital firm brought in Harrison and announced the formation of HATCo in 2023. In a release at the time, General Catalyst said the company would work closely with health system partners, and that it would eventually acquire and operate its own health system. Months later, HATCo announced its plans to buy Summa Health, a nonprofit integrated health system in northeast Ohio. Under its new structure, Summa would become a for-profit organization, and General Catalyst said it would introduce new tech-enabled solutions that aim to make care more accessible and affordable. Buying a health system is an unprecedented move in the venture industry, and the deal wasn't well received by some members of the Ohio community. Hundreds signed a petition urging Summa to remain a nonprofit and to halt negotiations with HATCo. Ohio Attorney General Dave Yost conditionally approved the deal in June, though he outlined a number of "enforceable commitments" as part of the agreement. HATCo will have to notify the Attorney General of transactions that could trigger antitrust concerns for 10 years after the deal closes, for instance. Harrison went to medical school in the late 1980s and has spent most of his career within health systems, most recently as CEO of Intermountain Healthcare. General Catalyst told CNBC that Harrison will continue to provide the firm's CEO, Hemant Taneja, with clinical insights and will remain connected to its ecosystem in his new role. "It became increasingly clear to both Marc and to us that Marc's role would best be accomplished as a strategic advisor to Hemant Taneja as we bring that ambition and vision to life," a General Catalyst spokesperson said. Daryl Tol, the head of General Catalyst's Health Assurance Ecosystem, was promoted to president of HATCo, the spokesperson said. He will spearhead the firm's day-to-day- work with Summa Health leadership. General Catalyst has also appointed Kate Walsh, the former Massachusetts Secretary of Health and Human Services, to HATCo's board. In addition, she will serve as the chair of the board at Summa Health once the transaction closes. "We are grateful for Marc's leadership and collaboration as co-founder and CEO to help get us to this point in the evolution of HATCo, and we look forward to leveraging his invaluable perspective as we continue to progress," the spokesperson said.
Yahoo
an hour ago
- Yahoo
Hey Jane expands to Michigan, offering telehealth medication abortions, other online care
New York-based Hey Jane has expanded its telehealth business to Michigan, offering abortion pills and emergency contraception, also known as the morning-after pill or Plan B, as well as birth control and treatment for sexually transmitted diseases, yeast infections, urinary tract infections and more. "We really do view it as an important step to increase access for reproductive and sexual health care in the states, and in particular, in states that have taken really significant action to protect (abortion) care," said Kiki Freedman, co-founder and CEO of Hey Jane, which now operates in 22 states and the District of Columbia. "We ... want to be sure Michiganders have as many options as possible." The expansion of Hey Jane into Michigan comes as access to in-person abortion and other reproductive health care shrinks in the state — despite a 2022 ballot initiative that amended the Michigan constitution to protect the right to legal abortion. Why is it difficult to find in-person abortion clinics in Michigan? That's partly because of a physician shortage. About one-third of Michigan's counties have no obstetrician-gynecologists at all, the office of Gov. Gretchen Whitmer reported in January, when she signed a bill into law that allows pharmacists to prescribe and dispense hormonal contraceptives, including birth control pills, vaginal rings, patches and emergency contraceptives. And 73 of Michigan's 83 counties have no in-person abortion provider, according to Planned Parenthood of Michigan has 10 remaining health centers in the state. It closed three Michigan clinics in April — including its only site in the Upper Peninsula — and consolidated two Ann Arbor locations to one. At the time, its leaders said the closures would help it remain financially sustainable amid efforts by the Trump administration to freeze federal funding for family planning services. Then in July, Congress passed the sweeping "One Big Beautiful Bill Act," and President Donald Trump swiftly signed the legislation into law. Among the provisions: a one-year ban on federal Medicaid payments to any large, nonprofit health center that also provides abortions. That meant that Planned Parenthood affiliates would be unable to get Medicaid reimbursements even for such services as cancer screenings, family planning visits, counseling, and testing for sexually transmitted infections. Federal law already prohibited the use of Medicaid dollars to pay for abortions, except in very limited circumstances. Alexis McGill Johnson, president and CEO of Planned Parenthood Action Fund, called it "a backdoor abortion ban" that would force the closure of as many as 200 more of its health centers. Did Medicaid funding stop for Planned Parenthood affiliates? Yes, for a little while. Planned Parenthood Federation of America, Planned Parenthood League of Massachusetts, and Planned Parenthood Association of Utah sued the Trump administration on July 7, saying the law violated their First Amendment and equal protection rights. The same day, U.S. District Judge Indira Talwani issued a temporary halt to the funding freeze, but the order expired after 14 days. Planned Parenthood said some of its health centers had to stop billing Medicaid, Reuters reported, when the temporary injunction expired. Michigan Attorney General Dana Nessel and the attorneys general of more than 20 other states, the District of Columbia and New Jersey Gov. Josh Shapiro, also sued. 'The Trump Administration's push to strip funding from these providers is an unlawful political tactic aimed at undermining care, even in states like Michigan, where the right to reproductive freedom is protected by our constitution," Nessel said in a statement. National Right to Life President Carol Tobias, however, said the Planned Parenthood affiliates' federal lawsuit was a "desperate attempt" to take public dollars. 'Planned Parenthood's priority is abortion — not women's health, not compassion, and certainly not life,' Tobias said in a statement. On July 28, Talwani issued another ruling, finding in favor of the Planned Parenthood affiliates. She said the federal government "shall take all steps necessary to ensure that Medicaid funding continues to be disbursed." White House spokesperson Harrison Fields called her decision "not only absurd but illogical and incorrect," Reuters reported, noting that the Trump administration had appealed an earlier decision in the same case. "It is orders like these that underscore the audacity of the lower courts as well as the chaos within the judicial branch," Fields said in a statement. "We look forward to ultimate victory on the issue." Hey Jane's Freedman called the efforts to strip federal Medicaid funding from Planned Parenthood "appalling." "We think people should be able to choose the type of care they get, whether that is in-person, whether that is through telehealth," Freedman said. "We do think telemedicine has a big potential to fill some of that gap. It can be more convenient for folks. They don't have to travel. They don't have to take off work or find child care. It can be more affordable. It can be more private and we are also able to offer full wraparound support. "But at the end of the day, we need in-person clinics, too. It has been devastating to see these closures." Medication abortion can be used only for a limited term during the pregnancy. Hey Jane prescribes the two-drug combination of mifepristone and misoprostol up until the 11th week, Freedman said. To have an abortion after that requires an in-clinic surgical procedure, she said. "People do need care beyond that ... and they absolutely should be able to get it." What is the cost of medication abortion? Cost can be a barrier for many seeking abortion. The Kaiser Family Foundation reported that among all abortion-providers in 2023, the median out-of-pocket cost for a medication abortion in the first trimester was $563. It was $650 for an in-clinic surgical abortion. The foundation found it's cheaper to get the medication from a telehealth provider. The median cost of medication abortion from virtual clinics in 2023 was $150. "We know financial accessibility is absolutely critical to our mission," Freedman said of Hey Jane. "And so we are the only fully digital provider to accept private insurance plans as well as Medicaid in some states. We do everything we can to offer pricing that's as low as possible. ... We do offer a sliding scale for our cash-pay patients and partner with local abortion funds for those who need financial assistance." The out-of-pocket cost for a medication abortion through Hey Jane can range from free to $299, Freedman said, depending on insurance coverage and whether a person gets assistance from an independent abortion fund. "Abortion funds are doing some of the bravest and most important work in this care space right now," Freedman said. "We know that financial accessibility and logistical support are both critical for folks being able to get care." Can people in states with abortion bans come to Michigan for treatment? Yes. People living in states other than Michigan, where there are restrictive abortion laws or outright bans, can obtain medication abortion from Hey Jane if the patient can travel across state lines and take the medicine while they are in Michigan. "We know that patients need care across the country, regardless of where they live, and telemedicine for many can make that a bit easier if you do need to travel for care," Freedman said. "In all states, it remains fully legal to travel to a state where the care is legal to receive treatment. "Hey Jane can absolutely help you out with that. We are able to provide logistical support," and mail prescriptions to a post office for pick up. "You don't even need a P.O. Box," Freedman said. "You can pick it up at the counter with an ID," she said. "It is a good option for folks who may need to travel for support." The Guttmacher Institute reported that in 2024, more than 1,600 people traveled from other states to Michigan for abortions in 2024. Contact Kristen Shamus: kshamus@ Subscribe to the Detroit Free Press. This article originally appeared on Detroit Free Press: Hey Jane expands to Michigan, offers telehealth medication abortions Solve the daily Crossword
The Hill
2 hours ago
- The Hill
NIH broke law by withholding funding: GAO
A congressional watchdog determined Tuesday that the Trump administration broke the law when it directed the National Institutes of Health to cancel hundreds of research grants earlier this year. The Government Accountability Office (GAO) found that the NIH violated the Impoundment Control Act when it canceled 1,800 grants in an effort to follow a series of executive orders aimed at cutting federal funding for diversity, equity, and inclusion initiatives, according to a report from the agency. The 1974 law regulates how the president can cancel or delay federal funds that Congress has already appropriated. The GAO also found that the NIH violated the law when it awarded $8 billion less in grants between January and June of this year compared to the same time in 2024 because of following the Trump administration's executive orders. President Trump issued several executive orders shortly after taking office in January targeting diversity, equity and inclusion initiatives. One of those orders instructed federal agencies to cancel all 'equity-related' grants and contracts within 60 days. A week later, the Trump administration directed the Department of Health and Human Services (HHS) in late January to order the NIH to stop posting notices of grant review meetings in the Federal Register and to remove any documents in the process of being posted to the publication. This move prevented the agency from reviewing and awarding grants for roughly two months, according to the GAO report. 'NIH's actions to carry out these executive directives, coupled with publicly available data showing a decline in NIH's obligations and expenditures, establishes that the NIH intended to withhold budget authority from obligation and expenditure without regard to the process provided by the Impoundment Control Act,' the report reads. In the report, the GAO notes that HHS did issue notices lifting the pause related to Federal Register notices and that they are aware of the White House directing NIH officials in July to pause 'grants, research contracts, and training,' which have since been reversed. But the agency could still not confirm that more money towards grant appropriations has returned. GAO's report findings are not legally binding in any way but have the power to influence Congressional opinion. A federal court ruled in June that the grant cancellations were illegal. Some Democratic lawmakers have called for the White House to stop pausing the flow of money to the NIH medical research, which could halt future medical advances. 'It is critical President Trump reverse course, stop decimating the NIH, and get every last bit of this funding out,' said Senator Patty Murray (D-Wash), in a statement. Murray serves as vice chair of the Senate Appropriations Committee. 'The longer this goes on, the more clinical trials that will be cut short, labs that will shutter, and lifesaving research that will never see the light of day.' A spokesperson for the White House and NIH could not be immediately reached for comment. A spokesperson for the HHS sent its response to the GAO report to The Hill, noting that the submissions pause to the Federal Register has been lifted and peer-review scheduling has resumed.
