States no longer required to report on childhood vaccinations

CMS last week sent a letter to states saying they will no longer be required to report how many children and pregnant women covered by Medicaid are immunized. However, states can still voluntarily report vaccination levels to CMS so the agency can "maintain a longitudinal dataset while exploring alternative immunization measures," according to the letter.

Since 2024, states have been required to report a core set of quality measures for children enrolled in Medicaid, including their vaccination status. However, federal Medicaid payments aren't tied to vaccination reporting measures.

According to the letter, CMS will start looking into options for new vaccine measures capturing whether parents and families were informed of "vaccine choices, vaccine safety and side effects, and alternative vaccine schedules." CMS is also planning to explore how it can account for religious exemptions in its quality measures.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said immunization reporting is vital for assessing whether children are getting necessary healthcare and how taxpayer funds are being spent.

(Goldman, Axios, 1/5)

Enhanced ACA tax credits officially expire

Enhanced tax credits for Affordable Care Act  enrollees officially expired on Jan. 1, leading to higher health costs for millions of Americans at the start of the year.

In December 2025, the Senate voted down competing healthcare proposals aimed at addressing the subsidies; however, later that month, four House Republicans signed onto a discharge petition filed by House Minority Leader Hakeem Jeffries (D-N.Y.) that included a clean three-year extension of the ACA subsidies and was backed by all 214 House Democrats.

That support brought the discharge petition to 218 signatures, meaning the House will have to vote on the measure. That vote is slated to happen at some point this month.

The expired subsidies were initially given to ACA enrollees in 2021 to help Americans get through the COVID-19 pandemic but were later extended to expire at the start of 2026. With those expanded subsidies, some lower-income ACA enrollees were able to receive healthcare without premiums, and high earners paid no more than 8.5% of their income.

With the expiration of the enhanced subsidies, a KFF analysis found that more than 20 million ACA enrollees are seeing their premium costs rise by 114% on average in 2026.

Health analysts have projected the expiration of the subsidies will drive many ACA enrollees to forgo health insurance coverage entirely. One analysis from the Urban Institute and the Commonwealth Fund conducted last September estimated that higher premiums from the expiring subsidies would lead to around 4.8 million Americans dropping their insurance coverage in 2026.

(Swenson, Associated Press, 1/1)

Questions remain, however, about which healthcare providers will see the funds and how effective the rural health fund will be at improving health quality and access in rural areas.

"The hardest part of implementing the Rural Health Transformation Program isn't allocating the money to states," said Harold Miller, president and CEO of the Center for Healthcare Quality and Payment Reform. "It is ensuring the money actually preserves and improves rural healthcare services."

(Sullivan, Axios, 12/29/25; Frieden, MedPage Today, 1/2)

HHS says it will revoke funding from hospitals offering gender transition care to minors

HHS Secretary Robert F. Kennedy Jr. last month unveiled a series of regulatory proposals to ban hospitals from offering gender-affirming care to minors. Under the proposals, hospitals that provide such care to minors will be cut off from federal insurance funding.

Specifically, CMS is planning to release draft rulemaking that will bar hospitals from providing gender-affirming care to children under the age of 18 or performing surgical interventions on transgender children as a condition of participating in Medicaid and Medicare, effectively blocking all Medicaid and Medicare funding for any services at hospitals providing pediatric gender-affirming care.

"Nearly all U.S. hospitals participate in Medicare and Medicaid and this action is designed to ensure that the U.S. government will not be in business with organizations that intentionally or unintentionally inflict permanent harm on children," HHS said in a release.

"We are done with junk science driven by ideological pursuits, not the well-being of children," Kennedy said, adding that he signed a declaration saying that "sex-rejecting procedures pose medical dangers of lasting harm on children who receive these interventions."

In response, 19 states and the District of Columbia have sued Kennedy and HHS to block the proposals.

"The declaration falsely claims that certain forms of gender-affirming care are 'unsafe and ineffective,'" said Oregon Attorney General Dan Rayfield (D).

Rayfield added that HHS' decision "threatens to punish any doctors, hospitals, and clinics that continue to provide it with exclusion from the federal Medicare and Medicaid programs."

Alongside Rayfield in the lawsuit are Pennsylvania Gov. Josh Shapiro (D) as well as the Democratic attorneys general of California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Rhode Island, Vermont, Wisconsin, Washington, and Washington, D.C.

(Cunningham, Washington Post, 12/18/25; Landi, Fierce Healthcare, 12/18/25; Falconer, Axios, 12/25/25)

Trump announces pricing deals with 9 drugmakers

President Donald Trump last month announced new pricing deals with nine pharmaceutical companies to reduce the prices of some drugs. The nine companies included Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Roche's Genentech unit, Gilead, GSK, Merck, Novartis, and Sanofi.

Under the deals, drugmakers will offer some of their medications through websites where Americans can bypass health insurance and use their own money to purchase certain products. The offerings are generally more focused on drugs prescribed by primary care doctors rather than more specialized and expensive treatments like those for cancer.

The Trump administration plans to launch its TrumpRx website later this month, which will direct patients to the drugmakers' websites to help patients navigate the process of acquiring the drugs.

Some of the drugs that will be available under the deals include:

• Amgen's Repatha, for lowering cholesterol, at $239 a month
• GSK's Advair Diskus, an asthma inhaler, at $89 a month
• Merck's Januvia, a diabetes medication, at $100 a month

The drugmakers also pledged to introduce new medications in the United States at prices comparable to what they sell them for in other wealthy countries and agreed to sell most of their products to state Medicaid programs.

In exchange, the drugmakers were given three-year exemptions from any tariffs imposed by the Trump administration on imported pharmaceuticals, according to administration officials.

(Robbins/Sanger-Katz, New York Times, 12/19/25)