Happy Monday! All eyes are on the megabill as Republicans push to pass the package before the July 4th deadline. The bill includes deep Medicaid cuts, insurance market shifts, and long-term funding changes that could reshape care delivery nationwide. At the same time, federal agencies and courts are advancing major changes to vaccine policy, civil rights enforcement, and preventive care mandates—setting the stage for one of the most consequential health policy summers in recent memory.

In this week’s Nimitz Health:

• Federal News: Senate Republicans press forward with entitlement cuts, HHS cracks down on civil rights violations, and RFK Jr. remakes vaccine policy from the top down.

• State News: Colorado braces for Medicaid fallout and Louisiana warns of systemwide devastation.

• Industry News: The ACA's preventive care mandate survives while hospitals battle funding overhauls

WHO’S HAVING EVENTS THIS WEEK?

As of now, no hearings are scheduled for this week. However, the both Chambers hope to pass some version of the megabill by Friday.

NEWS DRIVING THE WEEK

Federal News

The Senate took a major step toward passing a sweeping $5 trillion domestic policy package backed by former President Trump. A 51–49 procedural vote over the weekend pushed the legislation into formal debate, though final passage remains uncertain. While the bill includes Medicaid reforms, tax provisions, and energy cuts, key Republican senators remain opposed due to fears of deep Medicaid reductions, potential rural hospital closures, and debt ceiling expansions. The legislation would also gut the 90% federal match for Medicaid expansion, sparking outcry from states and health systems alike.

In a dramatic shift from prior administrations, HHS Secretary Robert F. Kennedy Jr. has dissolved the CDC’s longstanding vaccine advisory committee (ACIP) and replaced its members with vaccine-skeptical voices. The shakeup follows his move to pull over $1 billion in U.S. support from Gavi, the global vaccine alliance, signaling a reorientation of U.S. global health leadership. Experts warn these changes prioritize ideology over evidence and could have long-term consequences for national and global health programs.

And, as of today, HHS’ Office for Civil Rights determined that Harvard University failed to respond adequately to multiple complaints of antisemitic harassment, violating Title VI of the Civil Rights Act. The university was found to have acted with "deliberate indifference" and agreed to federal oversight measures and changes to complaint protocols as part of a voluntary resolution agreement. The decision is likely to impact how civil rights complaints are handled across federally funded institutions.

State News

Colorado’s Medicaid system, which covers over 1.2 million residents and accounts for nearly half of births statewide, may face significant stress under the Senate’s proposed Medicaid work requirements. A new report shows that over 377,000 enrollees—many already working or exempt—could be affected. With a high reliance on Medicaid in rural counties, local providers fear disruptions in access and funding.

Meanwhile, Louisiana hospital leaders sent a stark warning to House Speaker Mike Johnson that proposed Medicaid cuts in the Senate megabill would cost the state over $4 billion and threaten hospital closures statewide. While a rural hospital fund is part of the bill, state leaders argue it falls short of offsetting the broader fiscal impact.

Industry News

The Supreme Court upheld the ACA’s requirement that insurers cover preventive services at no cost to patients. While many leaders celebrated the 6–3 decision as a win for evidence-based care, legal uncertainty persists around religious exemptions. More broadly, some worry that HHS Secretary Robert F. Kennedy Jr.'s influence over agencies like the U.S. Preventive Services Task Force may shift the scientific basis for what counts as “preventive” in the future.

Adding to industry unease, hospitals are raising alarms over the Senate’s megabill, which proposes capping provider taxes and limiting state-directed Medicaid payments. While lawmakers added a $25 billion rural relief fund, hospital groups say it won’t offset the financial blow, particularly for rural and safety-net providers at risk of closure.

FOR FUN

Happy (almost) 4th of July! Emily will be in North Carolina with her Husband and in-laws. But, if you are staying in DC, check out this article for info on local celebrations.

JOIN THE NIMITZ NETWORK!

Enjoying our updates? Don’t keep it to yourself — forward this email to friends or colleagues who’d love to stay informed. Please subscribe to our other publications by clicking below: