It’s been another momentous week in healthcare, particularly from the world of policy. Here’s the news I found most interesting.
Congress passes the ‘Big, Beautiful Bill’ and millions will lose health coverage in the process
What’s been reported: The Bill will now be sent to President Trump’s desk for signature, and it includes massive spending cuts, including to Medicaid. Millions of people will lose health coverage, and hospitals will see significant cuts to their Medicaid funding – as high as 18%. It goes without saying that those who will be hit the hardest are the underserved, rural populations that already struggle with access to care.
What the GOP said: Only 2 Republicans voted against the bill in the House. Reports from the Hill claim that the final vote was hard-fought, with some holdouts fearing the impact to their constituents that value their access to Medicaid coverage.
What the Congressional Budget Office estimates: The CBO estimates that the bill would increase the deficit by $3.4 trillion and that more than 12 million people in America would lose their health insurance by 2034.
Expert POV: We may think that we won’t see much direct impact outside of Medicaid. But I spoke with Dickon Waterfield from Lantern a few days ago on the Second Opinion podcast, who made the excellent point that health systems will likely react to cuts in Medicaid by driving up prices with its commercial population. Employers are already facing huge pressures related to rising medical costs, given cell and gene therapies, complex cancer and surgical cases, GLP-1s and more. This could create an environment where employers increasingly say no, and we continue to see demand for Point Solutions and other vendors to prove ROI in the form of cost savings.
Special thanks to our friends at Ambience Healthcare, who have made this post free to all users as part of sponsoring Second Opinion.
Ambience Healthcare is the leading AI platform for clinical documentation and coding—trusted by top health systems like Cleveland Clinic, UCSF Health, St. Luke’s Health System, and Houston Methodist.
In partnership with KLAS Research and St. Luke’s Health System, Ambience also just published a breakthrough impact report, detailing how St. Luke’s is leveraging Ambience’s AI platform to reduce documentation time and clinician burnout, while improving documentation accuracy and revenue integrity (generating more than $13K annually per clinician).
CMS tries to get WISeR about Medicare spending
The news: The Centers for Medicare & Medicaid Services (CMS) launched a request for applications for a new initiative called the Wasteful and Inapprate Service Reduction (WISeR) Model, to be implemented in Texas, Arizona, Oklahoma, Ohio, New Jersey, and Washington. The six-year project aims to test whether AI enabled technology can reduce unnecessary spending for Medicare services.