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Washington Update | Trump Officials Rush Reform Package

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Trump officials are still aiming for final passage of the “big, beautiful bill” by the week of July 4, despite Congressional skepticism.

  • Sen. John Thune (R-SD) says his team is working closely with House Speaker Mike Johnson (R-LA-04), but Johnson said there are still “a lot of question marks” over the bill.

  • To meet the deadline, Trump officials want to skip conferencing, pushing the Senate to send a bill the House can pass without changes.

  • Meanwhile, House Freedom Caucus members are demanding major revisions, including:

    • Barring ACA expansion states from using provider tax arrangements.

    • Cutting Medicaid FMAP for those states’ expansion populations.

  • (Read in Politico-White House), Politico-Congress, AP News, Punchbowl News, and Inside Health Policy)

Advocates are backing off efforts to include Medicare site-neutral reforms, while others continue to push changes to state directed payments (SDPs).

  • Inside Health Policy reports left-leaning groups are retreating, after GOP signals that site-neutral would be added to, not replace, Medicaid reforms.

  • The Paragon Health Institute continues to support:

    • Site-neutral reforms.

    • Capping SDPs to Medicare rates and lowering provider tax thresholds in expansion states.

  • (Read at Inside Health Policy)