Happy Monday! As Congress barrels toward year-end, Washington’s health policy arena is anything but quiet. Here is what you need to know going into the week:

In this week’s Nimitz Health:

• Federal News: ACA subsidy deals, US/UK drug pricing agreement, vaccine politics, Medicaid data-sharing with ICE

• State News: Idaho mental healthcare lawsuits, Virginia health AI regulations, smartphone health risks among teens

• Industry News: WHO endorses GLP-1s, medical debt surges, and hospitals lean on AI

WHO’S HAVING EVENTS THIS WEEK?

Tuesday, December 2nd

• *House Ways and Means: “Lives at Stake: Holding Tax-Exempt Organ Procurement Organizations Accountable” at 10am. Watch here.

Wednesday, December 3rd

• *Senate HELP: “Making Health Care Affordable Again: Healing a Broken System” 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

The future of Affordable Care Act (ACA) premium subsidies is hanging in the balance as lawmakers race to avoid a policy cliff before the end of the year. Although a leaked White House proposal signaled potential support for extending cost-sharing reduction payments, former President Donald Trump has not committed publicly. Lawmakers across the aisle are pushing for clarity as insurers warn of sharp 2026 premium hikes if subsidies expire. The delay in Trump’s position is frustrating moderates who see a narrow path to bipartisan agreement before January.

Senators Bill Cassidy (R-LA) and Jeanne Shaheen (D-NH) continue to push a bipartisan plan that would stabilize the ACA marketplace and bolster reinsurance. In the House, Representatives Brian Fitzpatrick (R-PA) and Scott Peters (D-CA) have aligned on similar terms. Yet these efforts are meeting resistance from hardline conservatives who want stricter conditions and lower spending. With time running out, centrists are trying to position their framework as the last viable compromise.

In global drug policy, the Trump administration announced a pharmaceutical pricing agreement with the United Kingdom. Under the deal, the UK has agreed to increase what its National Health Service pays for innovative drugs by 25% and scale back aggressive clawbacks under its VPAG rebate framework. In return, the U.S. will exempt UK pharmaceutical imports from tariffs and suspend any Section 301 trade probes through the end of Trump's term. The deal is being touted by USTR and HHS as a major win for domestic drug developers.

The Trump administration has also announced plans to restart the sharing of Medicaid data with ICE. The policy was suspended under Biden and its return has sparked immediate backlash from immigrant advocacy groups. Supporters argue the move is necessary to detect fraud but health experts warn it could suppress enrollment in vulnerable communities, especially among mixed-status families.

CMS is touting $12 billion in projected savings through Medicare drug price negotiations under the Inflation Reduction Act. CMS removed three drugs from the list after generic competition became available, prompting Republicans to argue that the private market alone can drive cost reductions. Still, administration officials claim these savings validate the negotiation model and plan to expand it further in the coming years.

Vaccines remain politically volatile as RFK Jr.’s campaign-linked health team proposes expanding the Vaccine Injury Compensation Program to include autism-related claims. Critics argue this could unravel the program by overwhelming it financially and driving manufacturers to exit. HHS is reviewing the proposal but public health leaders are warning of long-term damage to vaccine confidence. Senator Cassidy (R-LA), a vocal vaccine proponent, has declined to directly address the matter.

CDC is also seeing a leadership shift with former Louisiana Surgeon General Ralph Abraham (R-LA) appointed as Deputy Director. Abraham previously promoted ivermectin as a COVID treatment and his elevation is drawing scrutiny from medical professionals who fear a politicization of the agency during a crucial transition period.

State News

Idaho’s Medicaid program is under legal fire after a second lawsuit was filed to block deep cuts to its mobile mental health treatment services. The program, which supports patients with severe illness who do not respond to traditional care, is set to be dismantled due to projected budget shortfalls. Plaintiffs argue the cuts will result in higher rates of homelessness, hospitalization, and incarceration for hundreds of vulnerable residents.

In Virginia, legislators are preparing to introduce AI-focused health care bills for the 2026 session. The proposals aim to set guardrails without stifling innovation and include requirements for transparency, patient data protections, and oversight officers within hospital systems. Lawmakers on both sides say they want to avoid rushed regulation while acknowledging AI’s growing role in diagnostics and clinical workflows.

Smartphone use among preteens is drawing renewed concern after new research from the University of Pennsylvania showed that kids who owned phones by age 12 had significantly higher risks of depression, obesity, and insufficient sleep. The findings could add momentum to state-level screen time bills already in play, particularly in states considering youth digital safety laws. Pediatric experts say public health guidelines are overdue as tech adoption accelerates among younger children.

Industry News

Semaglutide-based GLP-1 drugs like Ozempic and Wegovy are making headlines again after the World Health Organization recommended their use for adults with obesity. The endorsement further validates the growing clinical use of these medications but adds pressure on state Medicaid programs. Costs are already forcing rationing and, in some cases, providers are advising patients on how to qualify through extreme weight thresholds. Officials worry about the long-term sustainability of coverage for these drugs.

Medical debt is once again front and center after a new poll showed nearly half of Americans struggle with affording care. Even insured patients are reporting difficulties due to high deductibles and co-pays. Nonprofit aid organizations are overwhelmed with requests as inflation and policy uncertainty compound the affordability crisis. With federal subsidies at risk and Medicaid redeterminations ongoing, health economists warn the situation could deteriorate further in early 2026.

The health care sector is leaning further into artificial intelligence as a response to chronic staffing shortages and documentation burdens. Hospitals are rapidly adopting generative AI transcription tools to convert clinician-patient conversations into notes. Advocates say this could reduce burnout and improve accuracy. However, legal and privacy experts are pressing for clearer standards around how patient data is handled and whether AI tools meet clinical safety thresholds.

FOR FUN

HillVets’ Holiday Party is on Friday, December 5th at 6pm ET. All are welcome. It’s on Capitol Hill and it’s free! Email me ([email protected]) or [email protected] to RSVP.

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