Federal judge blocks shutdown layoffs

A federal judge last week blocked President Donald Trump's attempts to lay off thousands of federal employees amid the government shutdown. At a hearing, U.S. District Judge Susan Illston said she believed the plaintiffs in a case against the layoffs would succeed in demonstrating the administration's efforts are illegal and exceed its authority.

"The evidence suggests that the Office of Management and Budget, OMB, and the Office of Personnel Management, OPM, have taken advantage of the lapse in government spending, in government functioning, to assume that that all bets are off, that the laws don't apply to them anymore and that they can impose the structures that they like on a government situation that they don't like," Illston said.

However, Thomas Nagy, head of personnel for HHS, said in a court filing that the 982 HHS employees who were laid off are not represented by the unions that filed the lawsuit and therefore Illston's temporary restraining order doesn't apply to them.

Illston then on Friday held an emergency hearing where she specified that multiple federal unions were not among the plaintiffs in the case but would also be included under the temporary block. She also specified that members of the collective bargaining units the agencies had stopped recognizing were also covered by the order.

Illston issued an order Friday evening laying out the clarifications "because defendants expressed an inaccurate interpretation of the [temporary restraining order] provisions."

(Lee, The Hill, 10/15; Pifer, Healthcare Dive, 10/20; Beavins, et al., Fierce Healthcare, 10/20)

Trump administration pushes back against industry group creating AI standards in healthcare

Recent efforts by the Coalition for Health AI (CHAI), a major industry group that aims to create AI standards in healthcare, has drawn pushback from officials in the Trump administration. HHS Secretary Robert F. Kennedy Jr. said in a post on X, "We must not let the Coalition for Health AI (CHAI) build a regulatory cartel."

In an opinion piece for the Washington Examiner, Deputy HHS Secretary Jim O'Neill and FDA Commissioner Marty Makary criticized CHAI, saying the coalition's creation four years ago was an attempt by big tech companies and the Biden administration to "regulate and stifle health tech startups" and called CHAI an "unethical syndicate," adding that its influence will create poorer outcomes for patients.

"Under Secretary Robert F. Kennedy Jr., HHS will not allow CHAI — nor any other nonprofit group, think tank, or company — to operate as an implicitly government-backed regulator or policymaker," O'Neill and Makary wrote. "While we welcome the emergence of a robust consortium of voices offering suggestions for best practices, we will not force taxpayers to fund assurance labs nor any other regulatory model that we cannot hold accountable on their behalf."

CHAI CEO Brian Anderson said the criticism has taken him by surprise, noting he's had positive conversations with Sens. Ted Cruz (R-Texas), Mike Rounds (R-S.D.), and Todd Young (R-Ind.) on a variety of legislative efforts and separate collaborations with CMS and other HHS agencies.

Anderson noted that CHAI is not a regulator, nor is it looking to become one. The coalition aims to have a healthy relationship with the Trump administration, and Anderson added he's reached out to O'Neill.

"We have dozens of working groups where you have many different stakeholders, from technology companies to health systems to patient community advocates that are trying to develop consensus," Anderson said. "They're not going to agree on everything. They disagree frequently, but they are committed to building best practices."

(Perna, Modern Healthcare, 10/10; Makary/O'Neill, Washington Examiner, 10/2)

RFK Jr. to issue new dietary guidelines encouraging consumption of saturated fats

HHS Secretary Robert F. Kennedy Jr. is slated to unveil new dietary guidance that will encourage Americans to eat more foods previously considered to be unhealthy, including those high in saturated fats.

Kennedy has argued that Americans need to eat more trans and saturated fats, saying that foods like butter, cheese, milk, and red meat have been unfairly demonized for years. He has also argued that refined carbohydrates and ultra-processed foods are the main culprits of an unhealthy diet and have been ignored in conversations about obesity and inflammation.

"New dietary guidelines that are common sense, that stress the need to eat saturated fats of dairy, of good meat, of fresh meat and vegetables … when we release those, it will give everybody the rationale for driving it into our schools," Kennedy said.

Currently, U.S. dietary guidelines suggest that Americans limit saturated fats to 10% of their daily calorie intake. However, the American Heart Association has recommended limiting saturated fats to just 6%.

"Saturated fats are found in butter, cheese, red meat, other animal-based foods and tropical oils. Decades [of] science has proven that saturated fats can raise your 'bad' cholesterol and put you at higher risk for heart disease," AHA said in its guidance.

(Smith, The Hill, 10/20; Choi, The Hill, 10/20)

Higher ACA prices become public in many states

Health insurance prices under the Affordable Care Act (ACA) have become public in around a dozen states, showing sharp increases that many will pay for coverage if Congress doesn't extend subsidies to make plans more affordable.

The annual enrollment period for ACA plans is expected to start on Nov. 1, but the costs for some Americans have become publicly available in some marketplaces. The federal website healthcare.gov is slated to post prices by the end of the month.

Based on the new information, a family of four making $130,000 in Maine would see an increase of $16,100 in annual premiums next year because they would no longer qualify for subsidies, according to Gideon Lukens, a health policy researcher for the Center on Budget and Policy Priorities.

Meanwhile, in Kentucky, a 60-year-old couple making $85,000 per year could see an increase of $23,700 in annual premiums compared to an increase of $18,100 in Nevada, $15,500 in Minnesota, and $13,700 in Maryland, according to Lukens' calculations.

Lukens said that many people who look at higher premiums will likely decide they can't afford coverage and become uninsured, even if more generous subsidies are eventually extended. Some estimates say as many as 1.5 million people will drop their coverage if Congress waits until the end of the year to extend the subsidies.

"Damage is already being done, but a lot of damage can be avoided," Lukens said.

(Abelson/Sanger-Katz, New York Times, 10/17)

Chamber of Commerce sues Trump administration over H-1B visa fees

The U.S. Chamber of Commerce on Thursday sued the Trump administration for its executive order implementing a $100,000 fee for any new H-1B visa petitions. The administration has argued the fee is designed to help combat "systemic abuse" in the H-1B program and later clarified that the fee will apply only to new visa applicants outside the country, meaning employers won't need to pay the fee for anyone already living in the United States, like international doctors.

The chamber argues in the lawsuit that the order "is not only misguided policy; it is plainly unlawful."

"The President has significant authority over the entry of noncitizens into the United States, but that authority is bounded by statute and cannot directly contradict laws passed by Congress," the chamber said in a complaint filed in federal court in Washington, D.C. "The Proclamation does precisely that: It blatantly contravenes the fees Congress has set for the H-1B program and countermands Congress's judgment."

The lawsuit joins another lawsuit filed earlier this month in the Northern District of California by a coalition of labor unions, religious organizations, and others, led by healthcare-staffing firm Global Nurse Force, opposing the new fees.

According to Becker's Hospital Review, healthcare employers often use H-1B visas to sponsor medical residents and physicians. Currently, 27% of physicians and surgeons, 22% of nursing assistants, and 16% of RNs in the United States are immigrants.

(Schwartz/Radnofsky, Wall Street Journal, 10/16; Hackman, Wall Street Journal, 10/20)