Legislative Weekly Update - August 25, 2025
Table of Contents
Highlights
No Surprises Act (NSA) & TiC
This five-year timeline (2020-2025), created by Becker’s, is a quick refresher on the history of the NSA and the challenges it has faced since it was signed into law.
A Fierce Healthcare article and related Managed Healthcare Executive article argue that employers need to pay attention to MRF price data which “shifts the onus... to employers to use the leverage they have” to make sure they’re providing cost-appropriate benefits to their employees.
DC and Federal Update
Congress
OBBBA (or OB3, as the cool kids write it) may indirectly cut Medicare by nearly half a billion dollars according to the Congressional Budget Office (CBO). The “Pay-As-You-Go Act of 2010” requires Congress to make across-the-board cuts if any legislation increases the deficit by $2.3T over 10 years. According to the CBO, OB3 will increase the deficit by $4.1T over the next ten years, resulting in $491B in cuts to Medicare unless Congress takes action.
Last week, we reported that Brian Blase, president of Paragon Health Institute and advocate for many of OB3’s policies, was invited by House Republicans to provide policy suggestions for future legislation. This week, Blase met with the lawmakers and argued for site-neutral payments in Medicare and against enhanced ACA subsidies, based on a recent Paragon analysis of the ACA Marketplace.
As C19-era Medicare telehealth flexibilities are set to expire Sept. 30, a group of 350 stakeholders sent a letter to Congress, coordinated by the American Telemedicine Association, asking that the flexibilities be extended.
Modern Healthcare compiled a comprehensive list of Medicare, ACA, and No Surprises Act lawsuits to watch.
White House
Pres. Trump revoked a Biden Executive Order (EO) that bolstered antitrust enforcement in many industries, including healthcare. Fierce Healthcare summarizes.
Forbes argues that Pres. Trump is transforming healthcare into a winning political issue for Republicans by promoting policies that emphasize affordability, innovation, and transparency—garnering broad public support.
Agencies
For a fleeting few hours last week, the Trump Admin.’s first schedule of upcoming regulations was briefly displayed on a public gov’t website. Called the Unified Agenda (UA), the updated list of regs (usually found here) disappeared in less than half a day and, as of this writing, has not reappeared. From the short-lived glimpse we got, it seems the administration plans to publish a number of healthcare regs, including:
CMS is sending monthly lists of individuals with unconfirmed immigration status asking states to review their Medicaid coverage.
Despite a 2018 CMS rule allowing MA plans to offer long-term services and supports (LTSS) as supplemental benefits, the percentage of plans offering these benefits has declined—from 12.9% in 2019 to 12.3% in 2025—along with a drop in member enrollment in such plans. Researchers suggest that financial viability and limited perceived value may be barriers.
The initiative to eliminate duplicate enrollments across Medicaid, CHIP, and ACA plans could save ~$14B annually, according to the gov’t. However, experts warn that implementation will be complex due to administrative burdens, data lags, and a lack of incentives for states to act, making the projected savings “overly optimistic,” according to an article in MedPage Today.
Politico obtained a draft strategy discussing how the NIH plans to use real-world data in health research and regulation, which would pull claims information from EHRs and wearables in addition to traditional claims data.
Cybersecurity, AI, & Tech
The Cybersecurity Information Sharing Act of 2015 (CISA 2015) – the “backbone of our nation’s cyber defense”- is set to expire at the end of September.
Hartford’s Bradley Int’l Airport is the first US airport to install a telehealth kiosk for common illnesses.
According to this review of a rater8 survey, patients are increasingly using generative AI tools like ChatGPT to find healthcare providers, with nearly a third relying on AI recommendations and many trusting them as much as traditional sources like Google or provider reviews.
The States
As part of its budget plan, North Carolina is cutting Medicaid reimbursement by 3% starting in October, with behavioral health, hospital care, nursing homes, and physicians expecting 8% to 10% in cuts.
Georgia’s AG announced that the state has fined 22 insurers $20M for violating the state’s mental health parity law.
The Industry
Employers expect that healthcare costs will go up by 9% in 2026; 7.6% after they make plan design changes, according to a Business Group on Health survey. Summary of survey by BenefitsPro here.
Nearly 1 in 4 people in the US are caregivers; nearly half of which are over 75, according to a study by AARP.
Eli Lilly spoke out against the proposed pharmaceutical tariffs, stating that it would increase drug costs and restrict patient access.
Providers
Medical misinformation/disinformation is rising steadily in the US according to a survey examining its impact on providers’ ability to provide care.
In reflecting on the ethical tension between patient autonomy and medical paternalism, a health policy researcher critiques the unintended consequences of instant access to medical records – arguing that while transparency empowers patients, it can also lead to confusion, anxiety, and premature conclusions.
This update is solely for informational purposes and should not be relied upon as legal advice.