Happy Monday! This week, policymakers are trying to cut costs, states are scrambling to preserve coverage, and industry is bracing for tougher fights over pricing, regulation, and cyber risk. The result is a health agenda that feels more fragmented, but also more urgent, with real consequences for patients, providers, and companies alike. Here’s what we are tracking.

In this week’s Nimitz Health:

• Federal News: Medicaid home care crackdown, Title X funding uncertainty, and FDA Flu Vaccine approval

• State News: ICHRA expansion in red and blue states, Los Angeles clinic tax proposal, and North Carolina rebids Aetna and CVS contracts

• Industry News: Biotech pushback on most favored nation pricing, obesity drug competition, and cyberattacks and data access battles

WHO’S HAVING EVENTS THIS WEEK?

Tuesday, March 17th

• House Appropriations Labor-HHS-Education Subcommittee: “Oversight Hearing – National Institutes of Health” at 10:30am. Watch here.

• House Energy & Commerce: “Protecting Patients and Safeguarding Taxpayer Dollars: The Role of CMS in Combatting Medicare and Medicaid Fraud” at 2pm. Watch here.

Wednesday, March 18th

• House Select Committee on the Strategic Competition Between the United States and the Chinese Communist Party: “From the Science Lab to the Medicine Cabinet: How China is Cornering the Market on Our Medicines” at 10am. Watch here.

• *House Energy & Commerce: “Lowering Health Care Costs for All Americans: An Examination of the U.S. Provider Landscape” at 10:15am. Watch here.

• House Ways & Means: “Improving Kidney Health Through Better Prevention and Innovative Treatment” at 2pm. Watch here.

Thursday, March 19th

• Senate HELP: “Member Day” at 10am. Watch here.

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

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NEWS DRIVING THE WEEK

Federal News

Washington is still focused on cost, oversight, and regulatory control. Republicans are keeping pressure on the safety net, with House Budget Chair Jodey Arrington signaling interest in another reconciliation push built around fraud prevention and renewed Medicaid cuts. At the same time, the administration is tightening scrutiny of Medicaid spending, especially in home and community based services, which is putting states and providers on notice that enforcement will remain a major theme.

Title X became one of the clearest examples this week of administrative delay shaping policy. Clinics spent days warning that millions of low income patients could face disruptions in birth control, STI testing, cancer screenings, and other care if new guidance did not arrive before funding runs out on April 1. HHS finally released the guidance late Friday, but with a compressed application window and revised language that removed several earlier references to equity and more detailed nondiscrimination standards, leaving providers worried that service gaps are still possible.

The FDA is also trying to hold the line on process and evidence. Vaccine advisers voted to align next season’s flu shot with the WHO strain recommendation after this year’s mismatch contributed to a difficult season. More broadly, the agency is facing pressure across multiple fronts as officials defend scientific standards while navigating a far more political environment.

State News

After enhanced ACA subsidies expired and enrollment began to fall, more states are looking at tax credits that would encourage small employers to help workers buy marketplace coverage. Connecticut and Ohio are among the states moving first, and insurers are backing the policy as both parties look for ways to stabilize coverage and reduce pressure on Medicaid. Read more here.

States and localities are also searching for ways to backfill safety net losses. In Los Angeles County, clinic leaders are backing a half cent sales tax on the June 2 ballot that could generate about $1 billion a year for community clinics, hospitals, and schools as providers brace for the combined effects of federal Medicaid cuts and state fiscal tightening.

North Carolina is a notable procurement story to watch. The State Health Plan will rebid both its administrator and PBM contracts for 2028 rather than extend current arrangements with Aetna and CVS Caremark, a sign that large public purchasers are using contract cycles to reset expectations around cost, alignment, and member experience.

Industry News

Mid sized biotech companies are now more openly warning Republicans against codifying Trump’s most favored nation pricing plan, arguing that it would function like price setting, chill investment, and hit smaller innovators hardest. The significance is not just the policy fight itself. It is that a part of the industry that often stays quieter than large pharma is now trying to shape the Republican message in public.

The obesity market is also entering a more complicated phase. Demand remains strong, but the policy and regulatory fight around GLP 1s is intensifying. Eli Lilly is raising alarms about compounded tirzepatide mixed with vitamin B12, while FDA has also cited Novo Nordisk over adverse event reporting practices. Together, those developments show that blockbuster growth in the category is now being matched by tougher scrutiny.

FOR FUN

HBO’s “The Pitt,” MAHA, and Harry Styles collide in this week’s SNL skit. Watch here.

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