Benefits agency nominee faces Senate hearing, backs association health plans

By Allison Bell - President Donald Trump's pick to be the assistant Labor secretary in charge of the Employee Benefits Security Administration wants to help employers team up to buy health benefits. Daniel Aronowitz, the EBSA administrator nominee, said Thursday at a Senate Health, Education, Labor and Pensions Committee hearing that he hopes developing clear regulations and implementing the regulations in a fair, efficient way will unleash benefit plan designers' creativity. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Aronowitz Advocates for Innovation in Benefits: At his confirmation hearing, Aronowitz expressed strong support for modernizing employee benefits, including promoting association health plans (AHPs) and pooled employer retirement plans to expand access for independent contractors and small businesses. He emphasized wanting to work with Congress to provide health and retirement security for more workers.

2. Commitment to Regulatory Clarity and Fiduciary Support: Aronowitz criticized past EBSA practices of using vague regulatory language and pledged to end "regulation by litigation." If confirmed, he intends to provide clear and effective fiduciary guidance to help plan sponsors navigate regulations confidently, especially in areas like mental health parity, PBM oversight, and wellness program rules.

3. Experienced, Hands-On Nominee with Labor and Insurance Background: Aronowitz brings a unique combination of experience as a labor lawyer, insurance company president, and fiduciary advisor. His background includes leadership roles at Ullico and Encore Fiduciary, and personal experience with health challenges—he is a living organ donor. His regulatory knowledge and operational history position him as a well-informed candidate to lead the EBSA, which oversees 2 million health plans.

Government Relations: Legislative/Regulatory Update

By SIIA - House Passes the “One Big Beautiful Reconciliation Bill.” We told you it wasn’t going to be easy, but it ultimately got done. On May 27th, House Republicans successfully passed the “One Big Beautiful Bill” by a 215 - 214 vote count. Now, on to the Senate… Read Full Article…

HVBA Article Summary

1. SIIA’s Legislative and Advocacy Efforts: SIIA continues to oppose any changes to the tax exclusion for employer‑sponsored health coverage, and it supports provisions within the “One Big Beautiful Reconciliation Bill” that expand HSA access (e.g., covering Direct Primary Care services and on‑site clinic use without affecting HSA eligibility). These efforts include coalition-building and direct engagement with lawmakers.

2. State-Level Stop-Loss Insurance Developments:

   • In Connecticut, Senate Bill 11—which would have required stop-loss policies to cover ACA essential health benefits with minimum attachment thresholds—has been shelved for the session.

   • In Louisiana, efforts to restrict stop-loss coverage for employers with 50 or fewer employees via Senate Bill 16 were significantly scaled back, and discussions are ongoing to prevent such limitations from reappearing.

3. Key Regulatory & Legal Updates in Healthcare Oversight:

   • A 6th Circuit court ruling classified BCBS of Michigan as an ERISA fiduciary due to its discretion over plan asset use and retention of overpayment, establishing that TPAs exercising similar authority may unintentionally become fiduciaries

   • The federal government issued a Request for Information concerning prescription drug price transparency, reviving the machine-readable file initiative initially introduced during the previous administration.

Rite Aid moves toward selling and shutting down 1,245 pharmacies

By Allison Bell - Rite Aid is getting closer to selling or shutting down about 1,245 of the pharmacies it had when it filed for Chapter 11 bankrutpcy court protection in May. The company filed a new list of stores that may close down with the bankruptcy court Thursday. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Rite Aid Closures and Asset Sales: CVS Health's pharmacy unit secured court approval in May to acquire 689 Rite Aid stores, while about 496 stores are currently slated for closure across various lists. Rite Aid continues to negotiate with other potential buyers including Walgreens, Albertsons, Kroger, and Giant Eagle. However, not all sale discussions may result in finalized deals, leaving uncertainty around the fate of some locations.

2. Impact on Consumers and Employers: The wave of closures may intensify pharmacy access challenges, especially for individuals managing chronic health conditions. This development adds to employer and benefits advisor concerns that more workers could find themselves in "pharmacy deserts"—areas with limited or no pharmacy access. As of 2024, researchers estimated that 61 million Americans lived in such areas, with 30 million relying on just one pharmacy.

3. Liquidation Process Details: Court documents outline a tightly controlled liquidation process, managed by national firms like Gordon Brothers, GA Group, and Tiger Capital Group. The guidelines include specific marketing restrictions—such as banning neon signage for sign walkers—and allow Sunday sales only at stores that were already open on Sundays. These measures aim to maintain order during the large-scale closure of Rite Aid locations.

New Rec: GLP-1 Users Should Fast 24 Hours Before Anesthesia

By Lucy Hicks - Patients taking the new class of weight-loss drugs do not need to stop these medications prior to procedures requiring anesthesia, but they should adhere to longer preoperative fasting times, according to a new multidisciplinary consensus statement. Read Full Article…

HVBA Article Summary

1. Updated Perioperative Guidance for GLP-1 RA Users: A new consensus statement recommends that patients without significant gastrointestinal symptoms continue their GLP-1 receptor agonist (RA) medications before procedures requiring anesthesia, but follow a 24-hour clear liquid diet and fast from high-glucose liquids for 8 hours to reduce aspiration risk due to delayed gastric emptying. This recommendation is based on a systematic review and aims to balance safety with preserving glycemic and weight management benefits.

2. Shift from Previous Guidelines: Earlier 2023 guidance from the American Society of Anesthesiologists (ASA) advised holding GLP-1 RAs for one drug half-life. However, the latest evidence suggests that this approach does not fully resolve delayed gastric emptying, especially for long-acting medications like semaglutide or tirzepatide. Discontinuation could also disrupt glycemic control or increase GI side effects upon restarting the drugs.

3. Controversy and Caution in Risk Stratification: While the updated guidance allows for GLP-1 RA continuation in lower-risk patients, it advises extended fasting in those considered higher-risk (e.g., high-dose, weekly dosing, GI symptoms). Some experts have criticized this stratification, noting insufficient evidence to support differential treatment based on dose or treatment phase alone, and cautioning that absence of symptoms doesn't guarantee an empty stomach.

Hospital pharmacies are worried about drug shortages, staffing and federal oversight

By Ron Southwick - Hospital pharmacies are continuing to struggle with shortages of key drugs, including cancer drugs and other life-sustaining medications. Drug shortages remain the most pressing problem for hospital pharmacies, with three out of four hospital pharmacies (75%) citing it as their top concern, according to Bluesight’s recent Hospital Pharmacy Operations Report. Bluesight surveyed 258 hospital pharmacy professionals. Read Full Article…

HVBA Article Summary

1. Persistent Drug and Staffing Shortages Disrupt Hospital Pharmacy Operations: Drug shortages remain the top concern for hospital pharmacies, with 270 active shortages reported in Q1 2025—many involving life-saving medications. Contributing factors include manufacturing delays, demand spikes, and material supply issues. Additionally, 55% of hospital pharmacies report staffing shortages that affect both operations and patient safety, prompting systems to centralize pharmacy efforts for efficiency.

2. Rising Oversight and Debate Around the 340B Program: Most hospital pharmacies anticipate increased regulatory scrutiny of the 340B Prescription Drug Program. While critics argue the program has outgrown its intended scope, hospitals maintain it is vital for funding care in underserved communities. Changes to the program could financially impact hospitals that rely on it to offset rising drug costs.

3. Growing Reliance on Technology to Manage Costs and Security Risks: Hospitals are increasingly adopting digital tools to automate inventory, detect drug diversion (reported by 66% of pharmacy professionals), and optimize purchasing processes. Despite available solutions, many hospitals are just beginning to explore tech-driven efficiencies due to the complexity, cost, and lack of transparency in the current system.

Walnuts Up Insulin Response, Cut Gut Permeability in Obesity

By Marilynn Larkin - Walnut consumption modified the fecal microbiota and metabolome, improved insulin response and reduced gut permeability in adults with obesity, a small study showed. “Less than 10% of adults are meeting their fiber needs each day, and walnuts are a source of dietary fiber, which helps nourish the gut microbiota,” study coauthor Hannah Hoscher, PhD, associate professor at the University of Illinois at Urbana-Champaign, told Medscape Medical News. Read Full Article…

HVBA Article Summary

1. Walnuts Enhance Gut Microbiome and Reduce Inflammation-Related Compounds: In a controlled feeding trial involving adults with obesity, diets containing walnut halves (WH) led to higher levels of beneficial gut bacteria like Roseburia and Lachnospiraceae, both associated with gut health and short-chain fatty acid production. Participants on the WH diet also had lower levels of certain proinflammatory fecal compounds (e.g., isobutyrate, isovalerate) compared to those consuming walnut oil (WO) or corn oil (CO).

2. Walnut Halves Lower Insulin Response and Improve Gut Barrier Function: While glucose levels remained consistent across all diet groups, participants who consumed WH had a lower 2-hour insulin area under the curve (AUC) compared to those on CO, indicating improved insulin sensitivity. Additionally, WH consumption resulted in the lowest recovery of sucralose in urine — a marker of gut permeability — suggesting better gut barrier integrity.

3. Dietary Fat Source Influences Metabolites and May Affect Glycemic Outcomes: The source of dietary fat (WH, WO, or CO) significantly influenced gut microbial metabolites and circulating bile acids. WH consumption led to the highest levels of indoles — compounds potentially beneficial to gut health — and the lowest levels of glycolithocholic acid. Ongoing research aims to explore how microbial profiles may predict individual glycemic responses to diet, highlighting potential for personalized nutrition strategies.