Trump signs order to put 100% tariffs on drugs, countries without pharma trade deals

By Anna Brown – President Donald Trump has signed an executive order confirming that drug products that come from a subset of countries and manufacturers will face 100% tariffs within the next several months. Under the White House’s tariff plan, manufacturers with a “most favored nation” (MFN) pricing deal and that are onshoring capacity to the US won’t face the tariffs. Also exempt will be drugs from places that have struck deals with the US, including the UK, EU and South Korea, according to Thursday’s announcement. Read Full Article... ^{_{(Subscription required)}}

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1. Pharmaceutical Tariffs Introduced Under Section 232: The White House announced new pharmaceutical tariffs under Section 232 of the Trade Expansion Act following a Department of Commerce investigation that began in April of the previous year. The policy includes numerous exemptions, meaning only a limited group of pharmaceutical products will ultimately be subject to the tariffs. Implementation timelines vary, with larger drugmakers facing tariffs within 120 days and smaller companies given 180 days.

2. Country-Specific Tariff Rates and Exemptions: Tariff levels differ by country, with the United Kingdom initially assigned a 10% tariff on patented pharmaceuticals that is expected to drop to 0% if additional most-favored-nation (MFN) agreements are reached with UK-based companies such as GSK and AstraZeneca. The UK government has confirmed that its pharmaceutical exports will face 0% tariffs for at least the next three years. Drugs from the EU, Switzerland, Liechtenstein, Korea, and Japan will face a 15% tariff, while generic drugs and biosimilars are currently exempt.

3. Incentives to Expand U.S. Pharmaceutical Manufacturing: The policy encourages drugmakers to increase domestic manufacturing by offering reduced tariffs for companies that move production to the United States. Companies that onshore manufacturing may face a 20% tariff, but the rate will rise to 100% if U.S. facilities are not completed by the end of Trump’s term. To qualify as onshoring, companies must build enough production capacity in the U.S. to match the volume of drugs they sell in the American market.

The growing thirst for health insurance trustbusting

By Caitlin Owens – The idea of breaking up big health insurance companies has suddenly entered the political conversation, even if it faces long odds of ever actually happening. Why it matters: Politicians across the ideological spectrum are increasingly convinced that those owning multiple parts of the health care system have a big role in making medical costs unaffordable. State of play: Rep. Alexandria Ocasio-Cortez (D-N.Y.), several high-profile senators and entrepreneur Mark Cuban are all saying the same thing: Break them up. Read Full Article...

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1. Bipartisan Momentum for Breaking Up Insurers: Calls to break up large health insurance companies are gaining traction among both progressive and conservative lawmakers, as well as public figures like Mark Cuban. This movement is fueled by concerns that vertical integration—where insurers own pharmacy benefit managers, drug manufacturers, and provider clinics—may contribute to rising health care costs. The introduction of bipartisan legislation such as the "Break Up Big Medicine Act" signals a shift toward more aggressive antitrust approaches in health care.

2. Debate Over Vertical Integration's Impact: Proponents of breaking up insurers argue that consolidation allows companies to extract profits at multiple points in the health care system, potentially driving up costs for patients. Critics, including insurer trade groups, counter that health plans operate in competitive markets and are incentivized to lower costs, while some experts note that vertical integration could also create efficiencies. There is ongoing debate among policymakers and academics about whether the benefits of integration outweigh the risks of self-dealing and reduced competition.

3. Potential Consequences and Alternative Solutions: While legislative efforts to dismantle large insurance conglomerates are intensifying, experts caution that breaking up these companies could have unintended effects, such as disrupting care coordination or pushing more providers into higher-cost ownership models. Alternatives to trustbusting include increasing transparency about ownership structures and regulating financial relationships between insurers and providers. Some analysts argue that addressing financial practices across the industry, not just within integrated companies, is necessary for meaningful reform.

Hospital groups call on Congress to refine long-term care hospital payments

By Dave Muoio – Hospital associations have laid out their policy wish list for Congress regarding long-term care hospitals (LTCH), calling for refinements to various requirements around patient criteria and stay length that affect payments. The changes outlined by the lobbying groups, including the American Hospital Association, would relieve the “severe stress” the subsector is facing and head off facility closures that have mounted in recent years, they said. Failing to stem the loss of LTCH beds “will exacerbate growing hospital and post-acute capacity concerns in markets throughout the country,” they said. Read Full Article...

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1. Financial Strain from Medicare Payment System: The current dual-rate Medicare payment system for LTCHs, introduced in 2016, restricts full reimbursement to only certain high-acuity patients. This has led to significant financial challenges for many long-term care hospitals, as those not meeting the strict criteria receive payments that do not cover the actual costs of care. The hospital groups argue that this system has gone beyond its intended purpose and is now threatening the viability of the LTCH sector.

2. Widespread Closures and Concentration of Cases: Due to ongoing financial pressures, more than a quarter of LTCHs in the United States have closed over the past decade. The remaining facilities are seeing a concentration of cases in payment groups that do not adequately reimburse for the most complex patients. This trend is contributing to broader concerns about hospital and post-acute care capacity across the country.

3. Policy Recommendations for Reform: The hospital associations are urging Congress to expand the payment criteria to include more high-complexity patients and to revise the diagnosis-related group system specifically for LTCHs. They also recommend updating inflation adjustments, modifying the average length of stay requirement, and strengthening outlier payments to better reflect the cost of high-acuity cases. Additionally, the groups call for improved rural access to LTCHs and reforms to Medicare Advantage prior authorization practices.

Voluntary benefits litigation spotlights disclosure

By Bruce Shutan – Schlichter Bogard LLC earned a reputation 20 years ago for filing class-action ERISA litigation on behalf of plaintiffs alleging overpayments on 401(k) plan fees. Now, the St. Louis, Mo., law firm is pursuing aggressive action on the health and welfare side, filing four complaints against employers in two different U.S. district courts alleging overpayments on voluntary benefits premiums not subsidized by employers. Those lawsuits — filed just before Christmas — named several leading benefits consulting firms as defendants as well: Gallagher Benefit Services Inc., Mercer Health and Benefits Administration LLC, Lockton Companies LLC and Willis Towers Watson US LLC, claiming they engaged in self-dealing that harmed plan enrollees. Read Full Article... ^{_{(Subscription required)}}

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1. ERISA Lawsuits Increasingly Target Health and Voluntary Benefit Plans: A growing number of ERISA class-action lawsuits are scrutinizing fiduciary practices in employer-sponsored benefit plans, including voluntary benefits. Of the 155 fiduciary breach class actions filed last year, 39 were against health plans, reflecting increased legal attention in this area. Legal experts note that brokers may face ERISA liability for self-dealing or prohibited transactions even if they are not formally considered fiduciaries.

2. Questions Raised About Broker Compensation and Commission Structures: Several lawsuits allege that brokers received excessive compensation, potentially increasing costs for ERISA plans beyond what was reasonable for the services provided. Concerns include high upfront commissions and loss ratios reportedly below 50%, which some observers say could raise questions about fairness and value. Others in the industry maintain that voluntary benefits have historically generated positive employee feedback and that commission structures alone do not necessarily indicate misconduct.

3. Greater Emphasis on Transparency and Fiduciary Oversight: The lawsuits are prompting renewed focus on whether employers and advisers adequately evaluate and document compensation tied to benefit plans. ERISA Section 408(b)(2) requires disclosure and review of both direct and indirect compensation to ensure it is reasonable relative to services delivered. Experts say these cases highlight the importance of clear processes, administrative oversight, and documentation when selecting, pricing, and monitoring benefit offerings.

The tide is starting to turn in pharma's favor for the future of 340B

By Nicole DeFeudis – IPharma is gaining ground in a years-long struggle over access to federal drug discounts. Drugmakers and the federal government have historically been on opposing sides of contract pharmacy policy under 340B. But in a handful of cases against state laws, they’ve become unexpected allies. For the first time, the agency charged with overseeing the 340B program has decided to weigh in on litigation over state laws that regulate how pharma companies dispense discounted drugs. Read Full Article... ^{_{(Subscription required)}}

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1. DOJ Supports Pharma in 340B State Law Challenges: The U.S. Department of Justice, representing the Department of Health and Human Services, filed amicus briefs supporting pharmaceutical companies in lawsuits challenging state laws related to the 340B drug discount program. The government argued that states such as Colorado, Maine, and Rhode Island should not have authority to enforce rules governing the program. This position indicates the federal government believes oversight of 340B enforcement should remain primarily at the federal level.

2. Dispute Centers on Contract Pharmacies in 340B Program: The legal battle focuses on the role of contract pharmacies, which health centers use to distribute discounted drugs to low-income patients through the 340B program. Pharmaceutical companies argue that the expanded use of contract pharmacies has significantly increased the size of the program and have sought to impose limits on them. Supporters of the state laws, including health providers, contend that contract pharmacies are an important tool for ensuring access to discounted medications for underserved populations.

3. Mixed Court Rulings May Lead to Supreme Court Review: Courts have issued differing rulings on whether states can enforce laws related to the 340B program. A recent Fourth Circuit decision upheld a temporary block on West Virginia’s state law, which could strengthen the pharmaceutical industry’s position in similar cases. Because appellate courts have issued conflicting decisions, legal experts suggest the dispute may ultimately be resolved by the U.S. Supreme Court.

Catholic Nuns Are Suing UnitedHealth Group

By Wendell Potter – UnitedHealth Group — the nation’s largest health insurer and one of the most sprawling corporate empires in American history — has spent years building a health care monopoly hiding in plain sight. Now it’s trying to make sure its own shareholders can’t ask questions about it. On March 20th, a Catholic religious congregation filed a federal lawsuit in Washington to force UnitedHealth to include a shareholder proposal in its 2026 proxy materials. The proposal is modest in scope: It asks UnitedHealth’s board to publish a report on the health care impacts of the company’s decade-long acquisition spree. Read Full Article...

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1. Shareholder Proposal and Lawsuit: A Catholic religious order, as part of a coalition of faith-based investors, filed a lawsuit against UnitedHealth Group after the company refused to include a shareholder proposal in its proxy materials. The proposal requested transparency regarding the effects of UnitedHealth’s acquisitions on patient outcomes and business practices. The legal action highlights the growing tension between shareholders seeking accountability and corporations resisting such scrutiny.

2. SEC Policy Change and Corporate Accountability: The Securities and Exchange Commission recently altered its policy, now issuing “No Objection” letters instead of reviewing company requests to exclude shareholder proposals. This procedural shift has made it easier for corporations to bypass shareholder concerns without formal oversight or negotiation. Experts have warned that this change removes important checks on corporate governance and has already led to multiple lawsuits from shareholders seeking to restore accountability.

3. Broader Implications for Health Care Oversight: UnitedHealth’s consolidation and vertical integration have drawn attention from both shareholders and federal regulators, including an ongoing Department of Justice antitrust investigation. The company’s ability to route a significant portion of its claim dollars to its own subsidiaries raises questions about competition and patient care. The case underscores the challenges investors and the public face in obtaining transparency from large health care conglomerates, especially when regulatory safeguards are weakened.

AI scribe adoption linked to modest reductions in EHR, documentation time: study

By Emily Olsen – AI being used to help providers take notes on their patients’ care is one of the most common ways the technology has been adopted in healthcare. A slew of technology companies — including Microsoft, Oracle, Epic, Amazon and Abridge — have rolled out AI tools that can listen to providers’ conversations with their patients and generate documentation. The tools should help lessen clinicians’ administrative work, which has become a major challenge for providers and a source of burnout, tech companies say. Read Full Article...

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1. Modest Efficiency Gains for Clinicians: The study found that AI scribes led to small but measurable reductions in the time clinicians spent on electronic health records and documentation. While the average daily time savings were not dramatic, they represent a step toward reducing administrative burdens that contribute to clinician burnout. These findings suggest that AI scribes can help streamline some aspects of clinical workflow, though the improvements are incremental rather than transformative.

2. Variation in Impact Across Provider Groups: Certain groups of clinicians, such as primary care providers, advanced practice clinicians, female providers, and those who used AI scribes in at least half of their visits, experienced more significant time savings. For example, primary care clinicians and frequent users of the technology saw notably larger reductions in EHR and documentation time compared to the overall average. This indicates that the benefits of AI scribes may not be uniform and could depend on specialty, usage patterns, and provider demographics.

3. Financial and Workflow Implications: The adoption of AI scribes was associated with a slight increase in patient visit volume and a modest monthly revenue boost per clinician. However, the study noted that time saved on documentation did not translate into less after-hours EHR work, implying that clinicians may be reallocating saved time to other tasks such as patient messaging or reviewing records. This suggests that while AI scribes can offer some financial and workflow benefits, their overall impact on work-life balance and efficiency may be limited by other demands on clinicians’ time.

Health care reclaims top spot as Americans' leading concern

By Alan Goforth – U.S. employers and benefits advisors are bracing for another steep rise in health care spending this year. Employer-sponsored health plan costs are expected to climb as much as 10% in 2026, according to the International Foundation of Employee Benefit Plans. That marks the largest increase in nearly 20 years. Equally troubling is that higher spending is not translating into a healthier workforce. At least 75% of adults in the U.S. live with one or more chronic conditions and 40% are classified as obese, according to data from the Centers for Disease Control and Prevention (CDC). Read Full Article... ^{_{(Subscription required)}}

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1. Health Care Emerges as Americans’ Top Concern: Health care is currently the leading issue for Americans, surpassing the economy by about 10 percentage points after the two had frequently been tied for the top spot between 2002 and 2014. The shift highlights growing public attention on health care compared with other national issues. Several economic topics—including inflation, federal spending and the budget deficit, and income and wealth distribution—also rank among the highest concerns for roughly half of adults.

2. Overall Concern About National Issues Has Declined: Americans’ overall level of concern about national issues has decreased compared with last year. The average share of adults who say they worry “a great deal” about the 16 surveyed issues fell from 46% in March 2025 to 43% this year. This represents the lowest level recorded since 2020, when concern dropped to a record low at the start of the COVID-19 pandemic.

3. Partisan Divides Influence Priority Issues: Political affiliation continues to shape which issues Americans view as most concerning. Republicans most frequently cite illegal immigration, federal spending and the deficit, drug use, and crime and violence, while Democrats prioritize health care, income and wealth distribution, and the economy. Independents’ concerns overlap with both parties—especially health care, inflation, federal spending, and the economy—but tend to align somewhat more closely with Democratic priorities.