Happy Monday! This week, the Trump administration’s recently passed megabill is forcing major decisions on Medicaid, FDA funding, and drug manufacturing, while state leaders scramble to retain access to core services. Whether you're tracking federal investigations or local coverage cliffs, this week’s headlines point to intensifying pressure across the board.

In this week’s Nimitz Health:

• Federal News: FDA funding clash heats up, Medicaid faces deep cuts, and gender-affirming care providers are under federal scrutiny.

• State News: Connecticut moves to shield access to care and states continue banning fluoride.

• Industry News: Hospitals brace for Medicaid fallout, CVS hit with massive fraud judgment, and Humana expands in Florida’s senior care market.

WHO’S HAVING EVENTS THIS WEEK?

Tuesday, July 15th

• *Senate Homeland Security & Government Affairs: “Voices of the Vaccine Injured” at 3pm. Watch here.

Wednesday, July 16th

• *House Energy & Commerce: “Legislative Proposals to Maintain and Improve the Public Health Workforce, Rural Health, and Over-the-Counter Medicines” at 10am. Watch here.

• Senate HELP Committee: “Hearings to examine the nominations of Brian Christine to be an Assistant Secretary of Health and Human Services” and others at 10am. Watch here.

*Will be covered by Nimitz Health. Please email [email protected] if you would like a readout of any other hearings.

NEWS DRIVING THE WEEK

Federal News

There was lots of movement on the FDA front last week. The agency released more than 200 redacted complete response letters from 2020 to 2024, marking a new era of transparency intended to help developers better anticipate approval challenges. In tandem, the agency launched two cross-agency AI councils—one focused on internal use and another on policy—to accelerate innovation in drug and device review. Commissioner Makary also floated a controversial idea: rewarding companies with expedited reviews if they commit to aligning U.S. drug prices with those in other high-income countries.

The Senate Appropriations Committee unanimously advanced a $7 billion FDA funding bill for FY2026, with $3.6 billion in taxpayer dollars and $3.4 billion from user fees. In contrast, the House version—passed along party lines—offers only $3.2 billion in taxpayer funding, drawing criticism from Democrats for shortchanging the agency amid growing responsibilities. Without a broader budget agreement, a continuing resolution looms as the September 30 deadline nears.

President Trump issued an executive order to onshore prescription drug manufacturing, directing federal agencies to speed approvals for new domestic facilities and increase inspections of foreign plants. While regulatory hurdles and higher costs have long delayed the shift, new models like continuous manufacturing and public-private partnerships are gaining traction.

Closing out our federal news, the Justice Department issued subpoenas to at least 20 providers and pharmaceutical companies involved in gender-affirming care for minors, marking an aggressive escalation in the administration’s efforts to limit access. Concurrently, FTC Republican commissioners heard testimony suggesting providers have misled families about care outcomes. Legal observers note the administration is increasingly using consumer protection and fraud statutes in these crackdowns.

State News

With healthcare policy shifting rapidly under Trump, Connecticut passed a budget that proactively protects public health. The $55.8 billion package includes emergency public health funding, EMTALA codification for abortion-related emergencies, and a safe harbor fund for out-of-state patients seeking reproductive or gender-affirming care. A new advisory panel will also review vaccine recommendations independently from federal bodies reshaped under HHS Secretary Robert F. Kennedy Jr.

Several states, including Florida and Utah, have moved to ban fluoride from public water systems, reflecting a growing state-level backlash against longstanding federal public health guidance. The shift follows HHS Secretary RFK Jr.’s claim that fluoride’s benefits are only topical and may carry ingestion risks. In response, the FDA is preparing to ban ingestible fluoride products for children, prompting concern from dentists and health officials who warn the changes could worsen oral health disparities, especially in low-income communities.

Industry News

Trump’s “One Big Beautiful Bill” slashes $340 billion from Medicaid over the next decade, but the cuts are delayed until 2028. Hospital lobbyists are mobilizing for a multiyear effort to reverse the provisions, citing parallels to past repeals of unpopular ACA taxes.

CVS’s Omnicare division was hit with a $949 million judgment in a False Claims Act case for dispensing medications without valid prescriptions. The judge emphasized the systemic nature of the fraud, though CVS is appealing. Meanwhile, Humana’s CenterWell unit has bid $50 million to acquire bankrupt Florida provider The Villages Health, a network saddled with $361 million in Medicare overpayments

UNAIDS warns that 6 million new HIV infections and 4 million AIDS-related deaths could occur between 2025 and 2029 following the collapse of U.S. funding through the President’s Emergency Plan for AIDS Relief (PEPFAR). Programs in Nigeria, Mozambique, and Eswatini have seen staffing cuts, clinic closures, and plummeting access to PrEP and pediatric care.

FOR FUN

Did you know that some health insurance companies reimburse or discount gym memberships? Check out this article to see if it applies to you!

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