Tuesday report

David Ermer–Congress, HSA, Medical / Rx research, NIH, Obesity, OPM, SCOTUS, SDOH, U.S. Healthcare–

From Washington, DC,

  • The Wall Street Journal reports,
    • “The Senate passed President Trump’s tax-and-spending bill [(HR 1)] by a 51-50 vote, with Vice president JD Vance breaking the tie.
    • The bill extends tax cuts, reduces Medicaid spending and increases funding for defense and border enforcement.
    • The House will now vote on the bill, facing internal GOP divisions over Medicaid changes and spending cuts.
  • House of Representatives will convene for legislative business at 9 am on Wednesday morning. The House Rules Committee met about the Senate amendment to HR 1 this afternoon.
  • Reuters tells us,
    • “President Donald Trump‘s administration on Tuesday reported having 2.3 million people on federal payrolls in March, almost unchanged from prior months despite the Republican’s efforts to shrink the size of government.
    • “The Office of Personnel Management, which functions as the HR department for the federal government, published figures on Tuesday on hiring and firing across thousands of government offices, with growth in some areas of government largely canceling out cuts elsewhere.
    • “Overall, the number of federal jobs – excluding postal workers and the military – was down about 23,000 from September, the last published report on overall staffing levels.
    • “To be sure, the numbers are only through March and Trump, who took office in January, has continued efforts to shrink the federal workforce. The administration has signed deals, for example, with at least 75,000 federal workers, agreeing to pay them for several months before they resign. A spokesperson at the Office of Personnel Management said hundreds of thousands of such workers will drop off federal payrolls in October.”
  • NextGov/FCW adds,
    • “The Office of Personnel Management plans to update FedScope, the government’s portal for statistics on the federal civilian workforce, it announced on Tuesday.
    • “In the coming months, OPM will launch a newly designed platform featuring interactive visuals, detailed datasets, and tools tailored to answer the most frequently asked questions about federal employment,” OPM said in a press release, previewing a fall 2025 update to the website. 
    • “A banner on the website also hints at more regular updates, saying that “beginning this fall, Federal Workforce Data will be routinely available in an easily accessible, reimagined format.”
  • Mercer conveniently summarizes the 2026 inflation-adjusted amounts for health savings accounts (HSAs), high-deductible health plans (HDHPs) and excepted-benefit health reimbursement arrangements (HRAs) along with the 2024 and 2025 figures.
  • The Justice Department and the Federal Trade Commission held listening sessions yesterday and today about lowering drug prices for Americans through competition.

From the judicial front,

  • The Washington Examiner informs us,
    • “The Supreme Court on Monday [June 30] wiped away a series of lower court decisions that favored transgender litigants, sending the cases back to the appellate level for reconsideration in light of the court’s recent ruling upholding a Tennessee ban on puberty blockers and hormone therapy for minors.
    • “The 6-3 decision in United States v. Skrmetti, handed down June 18, marked a major victory for state-level efforts to restrict transgender procedures for minors. The ruling has now prompted the justices to vacate multiple decisions from lower courts in cases involving health benefits and birth certificate policies for people who identify as transgender.
    • “In an order list issued Monday morning, the high court overturned appellate rulings that previously blocked state-level bans or coverage restrictions for transgender-related care in North Carolina, West Virginia, Idaho, and Oklahoma. The move means each case must now be reheard under the legal standard articulated in the Skrmetti ruling, which found no violation of the Constitution’s equal protection clause in a ban on medical treatments for minors who identify as transgender.
    • “The high court also declined to take up a separate appeal from Kentucky, where families challenged the state’s similar law banning transgender procedures for minors.”
  • The Court also denied reviewing two Flower court decisions holding that the Tennessee law did not violate the 14th Amendment’s due process of law clause.
    • S. Ct. Case No. 23-466 L. W., ET AL. V. SKRMETTI, JONATHAN, ET AL.
    • S. Ct. 23-492 DOE, JANE, ET AL. V. KENTUCKY
  • Fierce Healthcare lets us know,
    • “Mass layoffs and reorganization of the Department of Health and Human Services (HHS) stalled out in federal court, as a Rhode Island federal judge sided with a coalition of 19 state attorneys general against subagencies Tuesday.
    • “Filed in early May, the Democratic attorneys general argued recent actions signed off upon by HHS leadership were unconstitutional and illegal, reported Fierce Biotech. The judge agreed, granting a preliminary injunction to halt the changes. The government must file a status report by July 11.
    • “The Executive Branch does not have the authority to order, organize, or implement wholesale changes to the structure and function of the agencies created by Congress,” said U.S. District Judge Melissa Dubose, concluding her decision.”
  • Yesterday was the effective date of the Iowa PBM reform law.  Also, yesterday, a group of employers lead by the Iowa Association of Business and Industry obtained a temporary restraining order against this law, Dropbox link to TRO order.  A preliminary injunction hearing is set for July 14. Here’s a link to an MSN article on this decision.

From the public health and medical research front,

  • Prime Therapeutic relates,
    • Only 8% of individuals (or 1 in 12) initiating a glucagon-like peptide-1 (GLP-1) agonist drug for obesity without diabetes continued to do so at three years, according to the latest real-world research from pharmacy solutions partner Prime Therapeutics LLC (Prime). Meanwhile, individuals who took a high-potency GLP-1 drug approved for obesity — such as semaglutide (Wegovy®), which is now more commonly used to treat the condition — had greater persistence at 14% three years after initiating therapy. 
    • While overall persistence continues to decrease among those taking high-potency GLP-1 products after three years, persistence among those taking the drugs over a one-year period improved throughout the span of the study. For those initiating GLP-1 therapy in 2021, 33% were persistent, while in the first quarter of 2024, 63% of new initiators were persistent. This increase is believed to be largely attributed to resolving GLP-1 drug shortages in 2024.  * * *
    • “In addition to persistence and adherence insights, the Year-3 study found 38% of individuals switched GLP-1 products during the three years of study. The mean age of individuals within the same cohort is 47 years old and nearly 80% identified as female. 
    • “For additional information and study design details, refer to Prime’s Year-3 abstract.”
  • Axios adds based on a Fair Health study that “Women approaching menopause drive GLP-1 boom.”
  • Medscape points out,
    • “A report comparing childhood obesity prevalence before the COVID pandemic and since the height of the pandemic shows a dramatic rise in the numbers for Black children and Black adolescents with obesity. Findings were published in the Annals of Internal Medicine.
    • “Researchers, led by Michael Liu, MD, MPhil, with the Center for Outcomes Research at Beth Israel Deaconess Medical Center in Boston, found that overall, the prevalence of obesity didn’t change significantly. Prevalence was 20.3% from January 2011 to March 2020, when COVID shutdowns began, and rose to 22.0% from August 2021 to August 2023. But after accounting for secular trends, “no overall increase in obesity prevalence was seen during the pandemic relative to the pre-pandemic period (adjusted difference, 0.52 percentage points; 95% CI, 2.3-3.3 percentage points).
    • “Pandemic-related increases in obesity prevalence were observed only in Black children and adolescents, the authors wrote, for whom rates were 22.4% in the decade before the pandemic and 35% in the 2 years after the height of COVID.”
  • Per Health Day,
    • “Regular exercise can ease mood disorders in children and teens, offering an alternative to medications like antidepressants, a new evidence review has concluded.
    • “Both anxiety and depression decrease when kids take part in structured exercise programs, researchers reported June 26 in Journal of the American Academy of Child & Adolescent Psychiatry.
    • “Further, the review found that anxiety and depression symptoms are relieved by different types of workout regimens.
    • “Exercise is a low-cost, widely accessible strategy that could make a real difference to children’s mental health,” lead investigator Ben Singh, a research fellow with the University of South Australia, said in a news release.
    • “Importantly, exercise could help improve kids’ moods without resorting to drugs like antidepressants, researchers added.”
  • Per Infectious Diseases Advisor,
    • “Adults aged 50 to 64 years and younger adults with chronic conditions are at increased risk for influenza-associated hospitalization and death, but this risk could be mitigated through the use of recombinant influenza vaccines (RIV). These results were published in Clinical Infectious Diseases.”
  • Healio reports,
    • “Nearly three-quarters of infants were immunized against respiratory syncytial virus through maternal vaccination or nirsevimab during the first season those products were available, according to data from 10 U.S. health systems.
    • “The overall immunization coverage for infants across these health systems was higher than expected based on the limited data available from single state studies and surveys,” Stephanie A. Irving, MHS, research associate at the Kaiser Permanente Center for Health Research in Portland, Oregon, told Healio.”
  • MedPage Today notes,
    • “In a European study, higher consumption of fruits, vegetables, legumes, and potatoes was associated with a reduced risk of Crohn’s disease.
    • “High potato consumption, meanwhile, was tied to an increased risk of ulcerative colitis.
    • “The study findings may be especially relevant for children and other first-degree relatives of people with inflammatory bowel disease, researcher says.”
  • and
    • “More than half of 95 centenarians had a low amyloid load and 9% had no amyloid, autopsy data showed.
    • “A third of centenarians had a high amyloid load comparable to Alzheimer’s disease.
    • “Five centenarians maintained high cognitive performance despite a high amyloid load.”
  • NIH Research Matters covers the following topics this week: “Home test kits for cervical cancer | Education and mortality trends | Exercise and Alzheimer’s disease.”
  • CIGNA writes in LinkedIn about why it matters to close the women’s health gap in our country.
  • MedTech Dive reports on the scientific sessions at the American Diabetes Association’s conference held last month.

From the U.S. healthcare business front,

  • STAT News reports,
    • “Centene has withdrawn its financial guidance for the rest of the year after receiving data that showed its health insurance members in Affordable Care Act plans are getting a lot more care than the company had anticipated.
    • “The company is also seeing a “step-up” in medical costs among its Medicaid enrollees. Centene’s stock plummeted 23% in after-hours trading Tuesday.”
    • “The surprise disclosure may be just the beginning of problems for Centene and other insurers that rely heavily on government health care enrollees. Centene gets a majority of its revenue from ACA and Medicaid plans. Despite Centene’s pleas to Republicans not to cut the taxpayer-funded programs, Republicans are advancing a bill that would result in the largest cut ever to Medicaid.” 
  • Healthcare Dive calls attention to “six ways employers can lower healthcare costs in 2025. ‘Employers have absorbed the majority of cost increases over the past four years, and they likely cannot continue to do so,’ one expert said” and provides an updated guide to top healthcare conferences in the second half of 2025.
  • MedCity News discusses “Innovative Strategies to Enhance Financial Predictability for Self-Funded Employers. Too often, the very systems meant to provide flexibility and control are undermined by delayed reimbursements, fragmented data, and a lack of transparency across the ecosystem. Solving this isn’t about tweaking the status quo, it requires a full redesign.”
  • Modern Healthcare tells us,
    • Ascension Health has sold four Michigan hospitals to Beacon Health System. 
    • The transaction closed Tuesday and includes four hospitals — Borgess Hospital in Kalamazoo, Borgess Allegan in Allegan, Borgess-Lee in Dowagiac and Borgess-Pipp in Plainwell — plus 35 outpatient clinics and an ambulatory surgery center, according to a Tuesday news release from Beacon. Beacon is rebranding the Ascension Southwest Michigan hospitals to Beacon Kalamazoo, Beacon Allegan, Beacon Dowagiac and Beacon Plainwell.
    • “The deal was announced in April. It brings more than 2,700 employees, including 259 providers, into the Beacon system, according to the release.
    • “South Bend, Indiana-based Beacon operates 11 hospitals, including the Ascension facilities, across northern Indiana and southwest Michigan. 
    • “Financial details of the deal were not disclosed.”
  • Per the American Journal of Managed Care,
    • “Prolonged ED stays and boarding times for older adults increased from 2017 to 2024, with academic hospitals experiencing the largest rise.
    • “The Age-Friendly Hospital Measure, effective 2025, aims to limit ED stays to under 8 hours and admissions within 3 hours.
    • “Epic Cosmos data analysis showed a significant increase in prolonged stays and boarding times, especially during the COVID-19 pandemic.
    • ‘Researchers suggest patient complexity, demand, and staffing shortages as potential drivers of increased ED stays and boarding times.”
  • Beckers Hospital Review lets us know “Physician compensation grew 4.9% in the last year, with a significant uptick for primary care physicians and specialists, according to the “AMGA 2025 Medical Group Compensation and Productivity Survey.”