Trump’s ‘big, beautiful bill’ clears key Senate hurdle after high drama

By Erin Doherty - President Donald Trump’s “big, beautiful bill” cleared a key procedural hurdle in the U.S. Senate late Saturday night, pushing the massive spending package one step closer to the president’s desk. Read Full Article…

HVBA Article Summary

1. Senate Clears Procedural Hurdle on Contentious Bill: The Senate narrowly voted 51–49 to advance a massive domestic policy package to final debate, marking a key procedural step. All Democrats and two Republicans voted against the motion, but the bill advanced after several GOP holdouts, including Sens. Mike Lee, Rick Scott, and Cynthia Lummis, reversed their opposition. Sen. Ron Johnson also switched his vote to “yes,” securing a majority and avoiding the need for Vice President JD Vance to cast a tie-breaking vote.

2. Bill Faces Tight Margins and Intra-Party Tensions: The measure’s advancement came after weeks of GOP infighting over its provisions and cost, with the Congressional Budget Office estimating it could add over $3.9 trillion to the national debt. Despite support from Republican leadership, the internal disputes over fiscal impact and policy details reflect deep divisions within the party, signaling that the final vote in both the Senate and House will likely be razor-thin.

3. High Political Stakes and Urgency Ahead of July 4 Deadline: Republican leaders, including Senate Majority Leader John Thune and House Speaker Mike Johnson, are under pressure from former President Trump to pass the bill before the self-imposed July 4 deadline. While the procedural vote was a win for GOP leadership, Democrats have vowed to slow the process by forcing a full reading of the bill, and opposition from some House Republicans — particularly over Medicaid cuts — suggests a difficult path ahead before final passage.

Supreme Court rules 6-3 for Affordable Care Act 'free' preventive care selection panel

By Allison Bell - Members of the U.S. Supreme Court [Friday] ruled 6-3 that the structure of an advisory panel used to pick some of the benefits in the basic Affordable Care Act preventive benefits package is constitutional. The majority held that Robert F. Kennedy Jr. — the Senate-confirmed secretary of the U.S. Department of Health and Human Services — has enough authority over the U.S. Preventive Services Task Force to keep the work of the task force from violating the appointments clause of the U.S. Constitution. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Task Force Members Deemed Inferior Officers: The Supreme Court determined that the members of the U.S. Preventive Services Task Force qualify as “inferior officers” under the Constitution’s Appointments Clause. This means they do not need Senate confirmation, as Congress can delegate their appointment to a department head — in this case, the Secretary of Health and Human Services (HHS), who retains authority over their actions and can remove them if necessary.

2. ACA Preventive Services Remain Intact: The Court’s decision allows the U.S. Preventive Services Task Force to continue making recommendations that shape the Affordable Care Act’s (ACA) preventive services package. These services — such as cancer and diabetes screenings — must be covered by most health insurance plans without cost-sharing by patients, preserving a key benefit of the ACA.

3. Wider Implications for Federal Panels: Beyond this case, the ruling could influence how courts view the roles of other federal advisory bodies and administrative panels. It reinforces that individuals serving as inferior officers can make independent recommendations or initial decisions, as long as a superior officer has oversight authority, including the power to reverse or block those decisions.

How Healthcare Leaders Are Responding to the Supreme Court’s Preventive Care Ruling

By Marissa Plescia - The Supreme Court has issued its long-anticipated ruling in Braidwood Management v. Becerra, affirming the constitutionality of the Affordable Care Act provision that requires insurers to cover certain preventive services recommended by the U.S. Preventive Services Task Force without cost-sharing. This includes cancer screenings, pregnancy care and testing for sexually transmitted diseases. Read Full Article…

HVBA Article Summary

1. Supreme Court Upholds USPSTF Appointments: In a 6–3 decision, the U.S. Supreme Court ruled that members of the U.S. Preventive Services Task Force (USPSTF) are considered "inferior officers" and therefore do not require Senate confirmation. This means their appointments by the Secretary of Health and Human Services are constitutional under the Appointments Clause, preserving their authority to recommend preventive services covered under the Affordable Care Act (ACA).

2. Religious Objection to Preventive Care Coverage Remains Unresolved: While the Supreme Court upheld the Task Force's appointment process, it did not address the lower court’s ruling in favor of Christian-affiliated employers who objected to covering HIV prevention medication (PrEP) on religious grounds. The Court noted that the federal government chose not to appeal that part of the case, leaving the issue to continue in the lower courts and signaling potential for future religious exemptions.

3. Implications for Preventive Care and Religious Exemptions: The ruling maintains access to no-cost preventive services for over 170 million Americans, which healthcare advocates say is critical for early detection and treatment of serious conditions like cancer. However, experts caution that the decision leaves room for religious freedom challenges and political influence over the USPSTF, which could impact the future scope and consistency of preventive care coverage under federal law.

Debt collectors are coming for student loan holders. Affected employees may need HR’s help.

By Ryan Golden - Student loan debt could become a headache for employees as well as employers in the coming months with the federal government set to ramp up its collection efforts. The U.S. Department of Education announced in April that it would resume collections of defaulted loans — those on which borrowers have not made payments for a period of time determined by their loan’s type — beginning May 5. Read Full Article…

HVBA Article Summary

1. Federal Student Loan Repayment Enforcement is Resuming: After years of paused collections and 0% interest due to pandemic relief measures, the U.S. Department of Education is reinstating active enforcement of federal student loan repayments. This includes the resumption of wage garnishments for borrowers in default, starting in summer 2025. With the conclusion of the 12-month “on-ramp” grace period, borrowers who haven't resumed payments will now face real consequences, including collections and damage to credit scores.

2. Significant Financial Strain Expected for Borrowers: An estimated 25% of federal student loan debt may be in default within months, potentially doubling the number of borrowers in default to 10 million. Combined with inflation and widespread financial insecurity—evidenced by many Americans lacking emergency savings—this resurgence in repayment obligations could create serious financial hardship for millions. This strain may also affect workplace focus, mental health, and overall productivity among employees.

3. Employers Have a Role to Play in Mitigating Impact: Employers are in a position to help ease the burden through a variety of support mechanisms, including student loan repayment assistance, education-focused benefits, and partnerships with financial wellness vendors. Recent policy changes like SECURE 2.0 and IRS guidance have introduced new ways for employers to support repayment through retirement match reallocations and other benefits. As enforcement ramps up, HR teams are encouraged to proactively assess workforce needs and develop responsive strategies that align with broader organizational goals for financial well-being.

Innovative Strategies to Enhance Financial Predictability for Self-Funded Employers

By Gerardo Zampaglione - For self-funded employers, financial unpredictability can lead to a host of problems. As healthcare spend continues to rise, employers are being asked to shoulder more risk with fewer tools to manage it. Self-insured employers are likely to see even larger rate increases in the year ahead. But I believe the system can be made better. Read Full Article…

HVBA Article Summary

1. Adaptive capital solutions can improve financial stability: Middle-market self-funded employers often experience significant cash flow disruptions due to the lag in stop-loss reimbursements, which can take months for complex claims. By incorporating adaptive capital strategies that provide immediate access to funds, employers can reduce financial uncertainty, maintain liquidity, and strengthen their confidence in the self-funded model as a sustainable option.

2. Real-time data and predictive analytics enhance risk management: Many self-funded health plans operate using outdated or lagging data, which limits their ability to respond to emerging risks. By utilizing real-time insights and predictive analytics, employers can better detect high-cost claims, identify underperforming providers, and engage at-risk members early. This data-driven approach enables more accurate budgeting, optimized reserve allocation, and proactive cost containment.

3. Aligned incentives among stakeholders foster better outcomes: In traditional self-funded arrangements, different stakeholders—such as brokers, carriers, TPAs, PBMs, and providers—often work independently with misaligned financial goals. Shifting to integrated models that incentivize collaboration, efficiency, and positive health outcomes ensures all parties are working toward long-term value. This alignment improves transparency, enhances care delivery, and provides employers with a more cohesive view of their healthcare risk.

US to spend $8.6 trillion on healthcare by 2033: CMS

By Kelly Gooch - CMS projects national healthcare spending to reach $5.6 trillion this year amid continued strong healthcare utilization growth, and then climb to $8.6 trillion by 2033. The findings are from the agency’s analysis released June 25 and will also appear in the print edition of the policy journal Health Affairs next month. Read Full Article…

HVBA Article Summary

1. Health Spending Growth Expected to Remain Elevated: National health spending is estimated to have increased by 8.2% in 2024 and is projected to rise by 7.1% in 2025. Although growth is expected to moderate slightly to 5.4% in 2026 and 5.7% in 2027, overall spending remains on an upward trajectory, driven in part by shifts in insurance coverage and utilization trends.

2. Health Spending Outpacing Economic Growth: Between 2024 and 2033, national health expenditures are projected to grow at an average annual rate of 5.8%, surpassing the expected 4.3% average annual growth rate of GDP. This sustained difference is projected to increase the health sector’s share of the economy from 17.6% in 2023 to 20.3% by 2033.

3. Policy and Coverage Changes Influence Spending Trends: Spending projections reflect several influencing factors, including the end of enhanced ACA premium tax credits under the Inflation Reduction Act and changes in population health coverage. CMS notes that future legislative or regulatory actions could further impact these projections, potentially altering coverage levels, spending trends, and the overall health share of GDP.

More than 90% of GLP-1 prescriptions could be filled at lower cost, analysis finds

By Alan Goforth - The high cost of treatment has been a limiting factor in the number of consumers who enjoy the weight-loss benefits of popular GLP-1 drugs. However, more than 9 in 10 prescriptions processed by DoseSpot in the first quarter of this year could have been filled at a lower prices, saving patients more than $10 million. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. Significant Savings Potential: DoseSpot’s analysis of over 100,000 GLP-1 prescriptions revealed that $10.2 million in potential savings could have been realized in just three months. These savings came primarily from manufacturer cost-saving programs, but also from greater pricing transparency and giving patients the ability to choose their pharmacy or dispensing option. When extrapolated to the national level, the potential cost savings could reach billions of dollars.

2. Low Adherence Due to Cost: Cost remains a major obstacle to medication adherence, with one-third of Americans not filling prescriptions due to high prices. For GLP-1 users—40% of whom take the drugs for weight loss—adherence drops to just 46.3% at the 180-day mark. Making these medications more affordable through savings programs is critical for improving long-term treatment outcomes.

3. Lack of Awareness Is a Barrier: Despite the availability of cost-saving options, most patients are unaware of them, and many healthcare providers don’t proactively share pricing or dispensing alternatives. Patients are encouraged to take initiative by researching manufacturer savings programs and directly asking providers about lower-cost options to help manage ongoing medication expenses.