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Politico
2 days ago
- Health
- Politico
The MAHA wave
Driving the Day IN THE STATES — Health Secretary Robert F. Kennedy Jr.'s Make America Healthy Again campaign to combat chronic disease is reshaping state legislatures, with hundreds of bills introduced this year echoing his agenda in both red and blue states, POLITICO's Amanda Chu reports. A POLITICO analysis of state legislatures found more than 130 pieces of legislation aimed at limiting access to ultraprocessed foods and improving nutrition, over 60 measures restricting the use of pesticides and other chemicals and more than 130 measures expanding vaccine exemptions or prohibiting mandates were introduced this year. Lawmakers also introduced dozens of bills to promote the use of psychedelics, authorize sales of raw milk and the antiparasitic drug ivermectin and ban the fluoridation of drinking water. The advances seen in state capitols, often considered laboratories for federal rulemaking, offer a glimpse into how a Kennedy-run Department of Health and Human Services might turn MAHA priorities into regulation. The White House is set to release a final MAHA report, which will include recommendations to fight chronic disease. Details: POLITICO tracked nearly 900 measures on MAHA-aligned subjects that were introduced in 50 states this year — a 45 percent increase from the previous year and measures introduced in 2023 among the four states that meet every two years. Measures ranged from banning the use of food dyes to limiting children's access to social media over mental health concerns to restricting the use of mRNA, the technology behind the Pfizer and Moderna Covid-19 vaccines. The surge in state activity underscores the growing political clout of the MAHA base, which cuts across party lines, and offers MAHA supporters a chance to secure policy wins outside a White House navigating competing interests. Following intense pressure from agricultural lobbyists, the Trump administration assured farm groups earlier this summer that the final MAHA report would include no new policy around pesticide use despite linking the chemical to cancer in a May draft report. Bipartisan appeal? Blue states New York and New Jersey led the country in the number of MAHA-aligned measures introduced this year, followed by Republican-led Texas. While some topics, like ending vaccine mandates, were predominantly backed by one party, a few themes had bipartisan traction: Roughly a third of measures to improve nutrition and restrict food additives were sponsored by at least one member of each party this year. 'We see so much state activity. … It's bipartisan. They're tapping into something that most Americans know intuitively. MAHA will persist when Kennedy is gone in the future,' said Joel White, a Republican health care strategist and founder of Horizon Government Affairs, a Washington lobbying firm. WELCOME TO THURSDAY PULSE. Adults in the U.S. are drinking less and worrying more about alcohol's health effects, according to new numbers from Gallup. Send your tips, scoops and feedback to khooper@ and sgardner@ and follow along @kelhoops and @sophie_gardnerj. At the White House PRASAD BACKSTORY — White House chief of staff Susie Wiles advocated to bring back the FDA's top vaccine regulator, Dr. Vinay Prasad, after he was pushed out following social media attacks from MAGA influencer Laura Loomer, POLITICO's David Lim, Dasha Burns and Tim Röhn report. Wiles' decision to advocate on Prasad's behalf, as described to POLITICO by two senior administration officials granted anonymity to discuss sensitive details, came after pleas from both Prasad's boss, FDA Commissioner Marty Makary, and Health Secretary Robert F. Kennedy Jr. They insisted that Prasad is part of Kennedy's broader Make America Healthy Again movement to combat chronic diseases and integral to the Trump coalition. Loomer did not respond immediately to a request for comment. The FDA referred questions to the White House. 'Secretary Kennedy and the entire HHS team are doing a terrific job as they deliver on President Trump's mandate to Make America Healthy Again,' White House spokesperson Kush Desai said. 'Scores of prominent restaurant chains and food brands dropping artificial ingredients from our food supply and historic reforms at the FDA to fast-track lifesaving drugs and treatments prove that the entire HHS team is delivering for the American people.' Background: President Donald Trump forced Prasad out of his FDA job less than two weeks earlier after the Cambridge, Massachusetts, pharmaceutical manufacturer Sarepta Therapeutics, joined by GOP allies and Loomer, sought his ouster. He abruptly returned last week. Read the full story here. DRUG STOCKPILE EO — President Donald Trump issued an executive order Wednesday aimed at bolstering the domestic supply of drugs by ordering his health department to fill a drug-ingredient stockpile he established during his first term, POLITICO's Lauren Gardner reports. The directive builds on the Strategic Active Pharmaceutical Ingredients Reserve that Trump established in 2020 during the Covid-19 pandemic when shortages of medical supplies and devices hampered the pandemic response. The U.S. relies largely on China, India and the European Union for APIs, particularly those that go into commonly used generic medicines like antibiotics and chemotherapies that are manufactured on low margins. Details: The order directs the Office of the Assistant Secretary for Preparedness and Response — the HHS agency that focuses on emergency readiness — to develop a list of 'approximately' 26 drugs considered critical to domestic health and security interests. It calls for an accounting of available funding that can be used to open the stockpile and to secure and maintain a six-month supply of active pharmaceutical ingredients needed to make the critical drugs. In Congress PRO MEDICAID CUTS — An influential group of Republicans has invited a key proponent of slashing Medicaid to brief congressional aides as the GOP mulls a potential second reconciliation bill, POLITICO's Benjamin Guggenheim and Meredith Lee Hill report. Brian Blase, president of the conservative think tank Paragon Health Institute, is set to address staff Thursday at a briefing on health care reform hosted by the Republican Study Committee, according to an invitation obtained by POLITICO. Blase was allied with conservative hard-liners earlier this year in pushing for significant cuts to Medicaid in the first GOP package. He was the initial author of a letter arguing for 'structural' changes to the program that Rep. Chip Roy (R-Texas) and 19 other hard-right members later sent to their House Republican colleagues. Details: An RSC spokesperson declined to comment on Thursday's briefing. But a person granted anonymity to discuss plans in advance said the meeting is set to cover enhanced tax credits for Affordable Care Act health insurance premiums, which are due to expire at the end of the year, as well as rules governing the percentage of Medicaid expenditures covered by the federal government and reimbursed to states. Not unprecedented: The RSC, composed of 189 House conservatives, has been a key force pushing for a follow-on to President Donald Trump's 'big, beautiful bill' that was signed into law last month. The group has invited several conservative experts to address staffers in recent weeks, though it has yet to endorse any specific health care policies for any forthcoming package. Those staff-level meetings continue as House GOP leaders try to plot a way forward amid skepticism over whether another sprawling domestic policy bill is even possible, given the difficulties Republicans had coming to an agreement on the first bill. Looking forward: It's still unclear what health topics a possible second package would address. Some House GOP factions are discussing further slashing Medicaid as well as possibly targeting Medicare funding. AROUND THE AGENCIES MAHA REPORT TIMELINE — The White House told several agricultural industry representatives to expect the latest Make America Healthy Again report to be publicly released in September, according to two people familiar with the conversation, POLITICO's Grace Yarrow reports. Some farm groups were recently invited to the White House and given 20 to 30 minutes to view a hard copy of a draft strategy report, said the two people, who were granted anonymity to share private details. The draft report that groups have seen is roughly 15 pages and has only 'light' mentions of pesticides, one of the two people said. But given that officials plan to wait for weeks before publishing the report, anything could change. Farm groups are crossing their fingers that the MAHA Commission won't scale up plans last minute to crack down on pesticides. 'If the ag community felt like they'd had some success in mitigating some of the worst language, or even taking some of that stuff out, an extra month may not feel like an opportunity,' said one of the people. 'It actually might feel like a bigger risk, because if they're already comfortable with where it sits now, what does an extra month mean?' 'On the other side, the MAHA folks are going to be pushing for more aggressive policy solutions across the board,' the person added. 'Maybe it would have been better for it to just pop out as it is.' Buckle up: Behind the scenes, the White House is taking extra time to review the policy recommendations to 'make sure it's not fucked up like last time,' as one person familiar with the process told our Dasha Burns, referencing the first error-riddled report from the MAHA Commission earlier this year. An HHS official told our Playbook colleagues that 'the team at the White House and HHS is ensuring that whatever is in the report is the best possible product for the American people. If they need more time, they need more time.' WHAT WE'RE READING The New York Times' Roni Caryn Rabin and Irena Hwang report on the Trump administration halting research related to racial and socio-economic disparities.
Politico
07-08-2025
- Business
- Politico
Insurers feeling the pressure
With Amanda Chu Driving the Day Q2 RESULTS ARE IN — Over the past few weeks, major health insurers reported their mid-year earnings, and the results have been largely mixed. Some have slashed their yearly guidance amid cost pressures, while others are performing in line with or exceeding their expectations. But one common theme prevailed across the insurers' reports in the second quarter: Medical costs continue to be elevated. And looming federal policy changes are leaving insurers — especially those with large Medicaid and Affordable Care Act businesses — uncertain about the future of the health insurance marketplaces they operate in. Why it matters: Insurers will adjust their pricing for 2026 to address those uncertainties — which include the expiration of enhanced Obamacare subsidies at the end of the year, unless Congress acts, and provisions in the GOP's One Big, Beautiful Bill Act that cut Medicaid spending and crack down on ACA enrollment verification. That means consumers are sure to see a jump in premiums for next year. The latest: On Wednesday, Oscar Health, which mainly offers ACA plans, was the last of the major insurers to report its earnings. The company slashed its yearly guidance a few weeks ago amid elevated Obamacare costs as more people seek out medical care. In the weeks leading up to that, competitors Centene, Elevance Health and Molina Healthcare did the same. Oscar said Wednesday its medical loss ratio — the percentage it pays out on medical claims compared to administrative costs — was 91.1 percent in the second quarter, up 12 points compared to the same time last year, largely because the enrollee population is sicker. The market will likely have 'double-digit rate increases next year' as a result, said Oscar Health CEO Mark Bertolini during an earnings call. A key takeaway: An uptick in enrollees seeking out medical care has been a common theme across major insurers in Q2. UnitedHealth Group, the largest insurer and typically an industry bellwether, has struggled with higher-than-expected medical costs this year, particularly as older adults in Medicare Advantage seek care. Executives partly attributed its cost struggle to insufficient Medicare Advantage payment rates finalized by the Biden administration. The company also saw elevated cost pressures in its Medicaid and Obamacare businesses, similar to Centene, Molina and Oscar. Bucking the trend: While all the major insurers noted that medical costs continue to be elevated, some were better positioned to weather that trend in the second quarter, likely because of adjustments to plan pricing and benefit cuts they made last year in anticipation of rising costs. Humana, a large Medicare Advantage insurer, has taken a more conservative approach to benefits in the past few years after it first noticed a rise in costs as older adults sought out care more frequently. The company's medical costs were largely in line with expectations in the second quarter of 2025. CVS Health's Aetna, which shook up its leadership last year after it struggled to control costs with more members seeking medical care, has seen continual improvements in cost savings throughout 2025, executives said during its earnings call. And Cigna recently reaffirmed its 2025 guidance, as cost trends were elevated but still in line with its expectations. WELCOME TO THURSDAY PULSE. Bestselling authors James Patterson and Vicky Ward are teaming up to write a book about the December killing of the UnitedHealthcare CEO and the hunt for the alleged shooter. Send your tips, scoops and feedback to khooper@ and sgardner@ and follow along @kelhoops and @sophie_gardnerj. In Congress DEMS PROBE UNITEDHEALTH — UnitedHealth Group is coming under the microscope of Democratic senators on the Finance Committee, adding to the mountain of congressional, legal and public scrutiny the health care giant has faced this year. Senate Finance Committee ranking member Ron Wyden (D-Ore.) and Sen. Elizabeth Warren (D-Mass.) are looking into whether the insurance company pads its revenue by encouraging nursing homes to limit the number of hospitalizations of residents enrolled in special needs plans, according to a letter the lawmakers sent today to UnitedHealth Group CEO Stephen Hemsley. Key context: The inquiry comes after The Guardian reported in May that UnitedHealth has quietly paid nursing homes thousands in bonuses to cut hospital transfers for patients, sometimes risking residents' health. UnitedHealth told The Guardian the allegations are 'verifiably false' and that the bonus payments to nursing homes help prevent unnecessary and costly hospitalizations. 'After a briefing with UHG representatives that focused on allegations outlined in recent reporting, we remain concerned about programs UHG is deploying to reduce all-cause hospitalizations and to set advance directives at its contracted nursing homes,' Wyden and Warren wrote in the letter. Why it matters: The scrutiny adds to a tumultuous year for UnitedHealth Group. It comes on the heels of leadership on the Senate Health, Education, Labor and Pensions Committee demanding answers from the company earlier this week about how it responded to a recent cyberattack and what steps it will take to prevent another breach. In December, the CEO of UnitedHealth's health insurance business was shot and killed in New York, igniting a wave of online vitriol from people sympathetic with the alleged shooter. Bipartisan lawmakers in Congress have signaled interest in cracking down on insurers, including UnitedHealth, amid allegations of excessive care denials. And the Justice Department is investigating its Medicare Advantage business, which has come under scrutiny over its billing practices. Hemsley, who recently took over as CEO after the company's former leader stepped down abruptly in May, acknowledged in June that there could be issues with how the company bills the government. Meanwhile, rising medical costs have plagued the company this year, sending its stock plunging and leading it to slash its yearly outlook. What's next: Wyden and Warren requested UnitedHealth send a full written response to dozens of questions on hospitalization policies, advance directives, marketing practices and federal oversight no later than Sept. 8. In the courts BUSINESS GROUPS' REJECTION — A federal judge on Wednesday struck down business advocates' bid to scrap the Biden administration's Medicare drug price negotiation program, ruling the groups lacked standing, POLITICO's Lauren Gardner reports. A three-judge panel of the 6th Circuit Court of Appeals agreed with a lower court's decision that the Dayton area and Ohio chambers of commerce are too 'detached' from the litigation's focus — the constitutionality of a program affecting drugmakers — to challenge the law. 'One could argue, in fact, that the overall standard of living in the Dayton area would actually improve with lower drug prices for its citizenry,' Circuit Judge Ronald Lee Gilman wrote in the opinion. Background: The U.S. Chamber of Commerce led three state and local chambers in Ohio and Michigan in suing the federal government in 2023. They focused their case on AbbVie, the company behind the cancer drug Imbruvica, which was chosen for the first round of price negotiations. The groups argued that the Inflation Reduction Act's creation in 2022 of a negotiation process between Medicare and drugmakers violates the First, Fifth and Eighth amendments. What's next: The chambers could ask the 6th Circuit for a so-called en banc rehearing, during which the court's entire bench would reconsider Wednesday's decision, or they could petition the Supreme Court to take the case. The U.S. Chamber said in a statement that it's reviewing the decision and 'considering next steps.' At the Agencies OD2A UPDATE — The Centers for Disease Control and Prevention will likely be able to fully fund its Overdose Data to Action program, NPR reports. A former CDC official, granted anonymity for fear of retribution, and Sharon Gilmartin, executive director of the Safe States Alliance, told Sophie they had confirmed the news with current CDC officials. POLITICO reported Tuesday that OD2A grant recipients had faced uncertainty about when they would receive their full obligation. Public Health MAHA MOM PUSH — Moms Across America, an activist group aligned with the Make America Healthy Again campaign, is urging Health Secretary Robert F. Kennedy Jr. to stand firm on regulating pesticides amid mounting pressure from the agriculture industry to soften his stance, Amanda reports. In a letter sent Wednesday to the MAHA Commission, which Kennedy chairs, the group urged that a moratorium be placed on the pesticide glyphosate in the final MAHA report due next week, which will include recommendations to fight chronic disease. 'Toxic chemicals that pose an unnecessary risk to human health have no place in our food system. …The EPA can, and should, stop the use of glyphosate in agriculture until there is conclusive evidence that no link exists between this chemical and serious diseases such as cancer,' said the letter, which was organized by the nonprofit Public Interest Research Group. Why it matters: The split between MAHA supporters and the agriculture industry, a key Republican constituency, highlights the tensions facing Kennedy as he vies to turn his MAHA agenda into regulation. The White House assured farm groups earlier this summer that the forthcoming report would include no new policy on pesticides after their draft report in May linked glyphosate to cancer and other health problems. Names in the News Sophia Wright is now senior adviser for Medicare programs at the Office of Management and Budget. She most recently was chief of the Medicare branch at OMB. WHAT WE'RE READING NPR's Rob Stein reports on the revived quest to create gene-edited babies. STAT's Veronica Paulus reports on growing state interest in expanding access to restorative reproductive medicine.
Politico
23-07-2025
- Business
- Politico
A health care lobbying boom
Presented by Driving the Day MONEY TALKS — U.S. health care companies are pouring unprecedented sums of money into lobbying efforts as they vie for influence with the Trump administration and the GOP congressional majority, POLITICO's Amanda Chu reports. Newly released lobbying disclosure reports show the Pharmaceutical Research and Manufacturers of America, the trade group for brand-name drugmakers, spent $7.58 million on lobbying in the second quarter, the highest amount it's spent for the period, according to a POLITICO analysis. Leading members Bristol-Myers Squibb and Merck recorded their highest spending for any quarter. Insurance companies have also boosted spending. AHIP, the industry group, spent $4.05 million in the second quarter, its highest for the period on record. The American Hospital Association, meanwhile, reported $6.15 million, its second-highest for the period. The record spending comes as the Trump administration vies to overhaul the U.S. health care sector, posing the biggest threat to industry profits in years and signaling a broader shift in the relationship between corporate America and the traditionally pro-business Republican Party. President Donald Trump has approved nearly a $1 trillion cut in federal funding for Medicaid, threatened to impose tariffs on pharmaceuticals and demanded that drugmakers lower their prices. Health Secretary Robert F. Kennedy Jr. has repeatedly questioned the safety of vaccines, rolling back Covid-19 guidance for healthy children and healthy pregnant women, and overhauling the CDC's advisory panel on vaccines. 'Historically, the business community has seen total Republican control of D.C. as a period of great opportunity for their legislative priorities,' said Jeffrey Kimbell, president of Kimbell & Associates, which represents large pharmaceutical companies. 'While that is still the case, the current administration and some Republicans in Congress also require some industries to continue their defensive posture.' Lobbying firms with ties to key lawmakers and administration officials are reaping the benefits as companies and trade groups seek inroads with Trump and Republicans in Congress. Tarplin, Downs & Young and Todd Strategy Group ranked among the top firms representing pharmaceutical companies in Washington in the second quarter, according to a POLITICO analysis of disclosures. Each firm has strong GOP connections. Linda Tarplin was HHS's liaison to Congress when George H.W. Bush was president. Dan Todd worked for then-Utah GOP Sen. Orrin Hatch on the Finance Committee. WELCOME TO WEDNESDAY PULSE. This is your friendly CMS reporter, Robert King, filling in for your regular hosts Sophie and Kelly today. I am still picking through thousands of pages of payment rules released last week. If you have any thoughts, or know something I missed, please share at rking@ or khooper@ and sgardner@ and follow along @rking_19, @kelhoops and @sophie_gardnerj. In Congress LAWMAKERS TEE OFF ON MA — After a bruising fight over Medicaid cuts in President Donald Trump's megabill, Republicans and Democrats joined together on a health issue they both agree on: reining in privately run Medicare Advantage plans. Members of the House Ways and Means Committee's oversight and health panels discussed during a hearing Tuesday the need for reforms to the popular program that enables older Americans to receive benefits like hearing and vision care outside of traditional Medicare. Lawmakers blasted the plans for high rates of care denials and overspending. 'We know of concerns about MA plans inflating a patient's level of sickness resulting in higher reimbursements for the plan at taxpayer expense,' said Chair Jason Smith (R-Mo.). 'An estimated $40 billion in 2025 alone.' Rep. Lloyd Doggett(D-Texas), ranking member of the panel's Health Subcommittee, said the plans have been overspending traditional Medicare despite the intention to do the opposite. 'Medicare Advantage was sold as a program to save taxpayer dollars and improve quality of care, but I have found that it is largely disadvantages,' he said. Why it matters: The hearing was a spark of bipartisan comity after months of acrimony surrounding the One Big Beautiful Bill Act, which Congress passed earlier this month. The legislation included more than $1 trillion in cuts to health spending over the next decade, with most cuts coming from Medicaid. Medicare Advantage reforms have long engendered bipartisan support — but not enough to get them through Congress. Lawmakers are making another run. Doggett and Rep. Greg Murphy (R-N.C.), chair of the GOP Doctors Caucus, introduced legislation Monday that would mandate MA contract rates to providers. Some MA plans and hospitals have clashed nationwide over rates, with hospitals complaining about high levels of prior authorization requests. The Prompt and Fair Pay Act would mandate MA plans to reimburse all covered items and services for at least what Medicare pays, noting that some plans pay providers below that line. AROUND THE AGENCIES THEORY LIVES ON — In a new report on Covid-19's origins, Dr. Robert Kadlec, who was a top health official in the first Trump administration, says Chinese military researchers might have played a role in developing the virus, POLITICO's Carmen Paun reports Kadlec, who led the Covid-19 vaccine development program known as Operation Warp Speed, would be well-positioned to push for greater scrutiny of China if the Senate confirms him as assistant secretary of defense for nuclear, chemical and biological defense programs. The White House and congressional Republicans have embraced the hypothesis that a lab leak, and not a natural spillover of the virus from animals to humans, triggered the pandemic that killed millions of people globally. Zooming in: The report, published Monday by the Scowcroft Institute of International Affairs at Texas A&M University's Bush School of Government and Public Service, adds to the assertion by three U.S. intelligence agencies that the pandemic started as an accidental lab leak in Wuhan, China, where the first Covid cases were reported in late 2019. The agencies haven't alleged a Chinese military role. But, but, but: There's still no scientific consensus on how the pandemic began, with many virologists continuing to argue that the virus wasn't engineered and the global outbreak had a natural origin. A spokesperson for the Chinese embassy in Washington pointed to a 2021 report by the Chinese government and World Health Organization-appointed experts that concluded that a lab leak origin was 'extremely unlikely.' The spokesperson called that conclusion 'the authoritative scientific conclusion drawn by the China-WHO joint expert group based on field visits to relevant laboratories in Wuhan and in-depth exchanges with relevant scientific researchers.' While Kadlec's report states that a natural spillover from animals to humans remains a possibility, he argues that's doubtful because the virus contains features from different coronavirus strains that don't exist in nature in close proximity. That makes it unlikely that the virus recombination would have happened naturally, he said. Kadlec's concerns about Covid's lingering effects on the brain conflict with Health Secretary Robert F. Kennedy Jr.'s push to deemphasize Covid vaccination. Given the potential for even mild Covid infections triggering long Covid in children and adults, Kadlec's report calls for efforts to screen and test children. The Trump administration suspended a program offering free tests in March. Public Safety ORGAN OVERSIGHT FAILURES — House lawmakers grilled leaders in the nation's organ procurement and donation system Tuesday after a federal report revealed that an organ procurement organization had operated on patients showing signs of life, POLITICO's Amanda Friedman reports. The House Energy and Commerce Oversight and Investigations Subcommittee's hearing followed a Health Resources and Services Administration investigation into the Kentucky-based OPO, Network for Hope. A report released in March found that the OPO had harvested organs from more than two dozen patients who might not have been definitively deceased, failed to reassess brain function and kept poor records of what happened. Subcommittee Chair John Joyce (R-Pa.) said the findings 'fractured the physician-patient relationship' and demanded accountability from the OPO and the United Network for Organ Sharing, the nonprofit that oversees the national transplant system. Dr. Raymond Lynch, who leads HRSA's Organ Transplant Branch, told lawmakers the issues aren't isolated: 'Unfortunately, it is not limited to [Network for Hope].' Other concerns: Members also raised concerns about systematic racism and whistleblower retaliation. UNOS CEO Maureen McBride faced questions about racial bias lawsuits, while Network for Hope CEO Barry Massa defended his group's procedures but acknowledged communication failures. What's next: HHS warned the OPO could be decertified on Monday. HRSA gave the group until July 28 to submit an initial remediation plan. Names in the News Vincent Bellomo is now an adviser at the Department of Health and Human Services. He most recently was a special assistant to the Secretary of HHS. WHAT WE'RE READING POLITICO's David Lim reports on the confirmation of Terry Cole to head the Drug Enforcement Administration. POLITICO's Katherine Tully-McManus reports that Sen. Elizabeth Warren (D-Mass.) will vote against the Senate's first batch of funding bills — signaling her party that she won't be cooperative in the fall funding fight. The New York Times's Nina Agrawal and Allison Jiang write about the changing face of lung cancer.
Politico
24-06-2025
- Business
- Politico
Hillsdale's lobbying pays off
With Amanda Chu, Daniel Lippman CONSERVATIVE COLLEGE CARVEOUT: President Donald Trump and Republicans in Congress are angling to use their megabill to turn the screws on elite liberal colleges that take millions in taxpayer funds while sitting on endowments worth tens of billions of dollars. But a single college that's a paragon of conservative higher education has managed to secure a carveout after finding itself in the crossfire, your host reports for Pros. — Hillsdale College, a Christian liberal arts school of fewer than 2,000 students located in southern Michigan, is one of a slew of smaller institutions that had been working to avoid being swept up in the GOP effort to raise taxes on the seemingly bottomless endowments of household names like Harvard, Princeton and Yale. — But Hillsdale stands apart from those schools: For one, it's a rare institution of higher learning that the modern Republican Party applauds. Just as uncommon, Hillsdale accepts no funding from the federal government. — That formed the crux of its argument that, on principle, Hillsdale and schools like it should not be subject to a federal tax on endowments. The university, like other schools fearful of a tax hike on their endowments, turned to K Street earlier this year for help with the endowment tax, as PI previously reported. — While the Hillsdale would still be hit by the tax under the House-passed reconciliation bill, Hillsdale's distinctive argument appeared to have broken through in the Senate, where tax writers last week included an exemption for schools that fit Hillsdale's profile in the draft text of their bill. — Despite Hillsdale's incomparable conservative credentials — or possibly in spite of them — that reprieve is by no means guaranteed, as Hillsdale found out eight years ago. And there remains one hitch that could complicate things: At least right now, there aren't believed to be any other schools besides Hillsdale that don't accept federal cash and have large enough endowments that they're at risk of being hit by the endowment tax. (Pro subscribers can read the full story here. Others can find it on the POLITICO home page tomorrow morning.) Happy Tuesday and welcome to PI. What's going on out there? Add me on Signal or email me at coprysko@ And be sure to follow me on X: @caitlinoprysko. FLYING IN: AARP will fan out across the Hill tomorrow for an 11th-hour lobbying blitz to seek changes to the reconciliation bill, including its new work requirements for recipients of Medicaid and food stamps. The advocacy group has more than 330 meetings on the books with members from both parties on both sides of the Capitol. — AARP supports certain parts of the bill, including the broadening of the bonus standard deductions for older Americans and expansions of a caregiver tax credit and the low-income housing tax credit. And AARP-opposed language in the House-passed megabill that would have expanded the orphan drug exclusion from the Inflation Reduction Act's drug pricing provisions was dropped from the Senate text. — But AARP wants to see additional changes to the Senate bill's cuts to the Supplemental Nutrition Assistance Program, including its move to foist the costs of SNAP onto states, which may end up securing approval from the Senate parliamentarian. — The Solar Energy Manufacturers for America Coalition, meanwhile, was on the Hill today in an effort to salvage an investment tax credit that is poised to sunset at the end of this year for solar projects under the reconciliation bill. SEMA is also lobbying for the removal of a restriction in the Senate version on how many products companies can claim an advanced manufacturing tax credit for. COMING ATTRACTIONS: As Republicans' war with elite colleges rages on, Wall Street is the latest industry 'trying to get out of the crosshairs of Republican states that are cracking down on companies for 'woke' policies that conservative policymakers say are illegal and discriminatory,' The Wall Street Journal's Alexander Saeedy, AnnaMaria Andriotis and Dylan Tokar write. — 'Representatives from JPMorgan Chase, Citigroup, Wells Fargo and other big banks met in recent weeks with officials in states including Texas and Oklahoma to defend against allegations that they refuse to do business with industries such as gun manufacturing and fossil-fuel extraction, people familiar with the discussions said.' — 'Banks are also worried about a bigger threat: that President Trump could turn the power of the federal government against banks, as he has with universities and big law firms. The Trump administration is considering an executive order on 'debanking,' according to people familiar with the matter.' A NEW STAMP ON BALLARD'S PASSPORT: Ballard Partners has announced another expansion to its series of strategic partnerships around the globe, teaming up with the Mexico City-based government affairs firm Global Nexus. — The latest addition to the Ballard Global Alliance means that the firm now has a foothold in every country on the continent ahead of next year's likely renegotiation of the U.S.-Mexico-Canada trade agreement, and as the Trump administration looks to squeeze America's neighbors on trade and immigration issues. — Ballard announced its partnership with Quebec-based TACT in March, and has also struck up partnerships with government affairs shops in Japan, South Korea, Latin America, the U.K. and Italy as well as a domestic alliance with Checkmate Government Relations. FIRST IN PI — GLASS HOUSE ALERT: One of the intellectual architects of the push to cut Medicaid once took a loan from the government that was never repaid, Daniel reports. Brian Blase is president of Paragon Health Institute, which has taken on a high-profile role in the effort in Congress to slash Medicaid costs through work requirements and other reforms. — He has called Medicaid America's 'most flawed' entitlement program while advocating for changes that would reduce spending on the program by hundreds of billions of dollars. — But while Blase calls for those cuts, he has benefited from government largesse in the past. His consulting firm, Blase Policy Strategies LLC, took a $20,833 Covid relief loan under the Paycheck Protection Program in May 2020, but it was not repaid and was later fully forgiven in line with many other PPP loans. Shortly after, in January 2021, he bought a house near Jacksonville for almost $700,000, according to real estate records. — Blase said he was told to apply for the PPP loan by his accountant and that he adhered to all rules as he ran his small business. 'Like millions of other Americans, I applied for a PPP loan as part of the shared national effort to keep the economy going during COVID,' he said in a statement. 'I'm proud of the work that my Paragon team and I have done to expose how government programs often fail American patients, particularly the most vulnerable, and hard-working families.' — Blase, a former congressional staffer, is testifying on Wednesday before the House Budget Committee on Medicaid reform. In a sign of Paragon's sway, a letter in early May released by fiscal hawks in Congress appeared to be written at least in part by Paragon. — Blase served on the National Economic Council in the first Trump administration. But on Jan. 6, 2021, he implicitly criticized Trump's efforts to overturn the election. In 2022, Paragon Health Institute received almost $3 million from Koch-funded outfit Stand Together. HOSPITALS HIT THE AIRWAVES: The American Hospital Association launched a seven-figure ad campaign in Washington Monday in a last-ditch effort to persuade Congress to protect hospital care in the GOP megabill, Amanda reports. — The campaign, which includes TV and digital advertising, comes a week after Senate Republicans unveiled draft provisions in the megabill to curtail a crucial Medicaid financing mechanism for hospitals, known as provider taxes, by nearly half. The ad buy comes on the heels of a fly-in of more than 250 hospital leaders last week to sway senators on Medicaid changes. SPOTTED last night at a Capitol Hull fundraiser hosted by Moran Global Strategies' Austin Durrer, HM&CO's Helen Milby, Duberstein Group's Kate Keating, Venn Strategies' Erik Olson, Thorn Run Partners' Andy Rosenberg and Stuart Chapman and DLA Piper's Jamie Gregorian for James Walkinshaw, who's running in the special election to succeed his late boss Gerry's Connolly (D-Va.), per a tipster: Rep. Don Beyer (D-Va), David Gillis of General Dynamics, Kevin Richards of SAP, Peter Brown of Deloitte, Ryan McGuire of the National Electrical Contractors Association, Tania Hanna of L3/Harris, Vanessa Ide of Demand Elections, Adam Goldberg of Elevance Health, Michelle Dorothy of Rep. Chrissy Houlahan's (D-Pa.) office, Ed An of Google, Travis Robey of the American Hospital Association, Gordon Taylor of Ogilvy, Roger West of HII, Chris Gaspar of BAE, Lee Friedman of NCTA, Karl Koch of Holland & Knight, Joe Vidulich of Capital One, Linda Auglis of the National Beer Wholesalers Association, Christopher Hartmann of Cigna, Roger Jordan of SAIC, Cindy Brown of Forbes Tate Partners and Tom McMillan of Moran Global Strategies. Jobs report — Joe Brown is joining Mehlman Consulting. He was most recently a senior professional staffer on the Senate Environment and Public Works Committee and is a John Boozman alum. — Heath Taylor is joining AxAdvocacy as director of government relations research. He most recently was a consultant at ThinkTek, and is a Booz Allen Hamilton and Rep. Chuck Fleischmann (R-Tenn.) alum. — Dow Chemical has promoted Colleen Litkenhaus to global director of public policy in addition to her current role as global director of plastics/circularity advocacy. — Elena Hernandez is now chief of staff at the Office of Science and Technology Policy. She previously worked in policy and corporate communications at YouTube and is an OSTP alum from Trump's first term. — Danielle Melfi will be the new CEO of Resolve: The National Infertility Association. She previously was the first chief people officer in the Biden White House, and is an AmeriCorps and Building Back Together alum. — Julia Trent is now director in Ervin Graves Strategy Group's defense, aerospace and cybersecurity practice group. She most recently was deputy director of member services and chief clerk for the House Veterans' Affairs Committee. — David Berrios is now vice president of organizing and campaigns for Reproductive Freedom for All. He previously was North Carolina campaign manager for the Harris campaign and is a DOE alum. — Sydney Maingot is now communications director for Rep. Glenn Grothman (R-Wis.). She most recently was a communications associate for Bullpen Strategy Group. — John Provenzano will be CEO of NENA: The 9-1-1 Association. He was previously vice president of public affairs for Publix Super Markets. — Dan Krassner is now senior vice president at Kensington Avenue Strategies and executive director of the American EV Jobs Alliance. He previously was senior director of campaigns at Unite America. New Joint Fundraisers None. New PACs Alliance 4 American Leadership (PAC) Californians For A Better Future (Hybrid PAC) La Luz (Leadership PAC: Luz Rivas) Neighbor Network (PAC) New Lobbying REGISTRATIONS Alston & Bird LLP: Remitly, Inc. Avoq, LLC: Kidde Global Solutions Ballard Partners: Manhattan Telecommunications Corporation, LLC A/K/A Mettel Ballard Partners: Rio Biopharmaceuticals, Inc. Boundary Stone Partners: Chambers For Innovation And Clean Energy Canfield Consulting, LLC: Applied Intuition Carpi & Clay, Inc: City Of Inglewood Carpi & Clay, Inc: Trifiletti Consulting Checkmate Government Relations: Digicel Holdings (Bermuda) Limited Checkmate Government Relations: Financial Industry Regulatory Authority, Inc. (Finra) Checkmate Government Relations: Summit Sd, LLC Checkmate Government Relations: Syberjet LLC Cornerstone Government Affairs, Inc.: City Of Baton Rouge And Parish Of East Baton Rouge Cornerstone Government Affairs, Inc.: Rune Technologies, Inc. Cr Federal: Umbra Lab, Inc. Dga Group Government Relations LLC: Federation Of Pharmaceutical Wholesalers, Inc. Dla Piper LLP (US): Novartis Farragut Partners LLP: Neuralace Medical, Inc. Franklin Square Group, LLC: Ai Integrators Council Franklin Square Group, LLC: Consuli Government Relations Group, LLC: Millenium Natural Systems LLC Guardian Police Solutions LLC: Phoenix Law Enforcement Association Icebreaker Strategies, LLC: The Johns Hopkins University Applied Physics Laboratory Keller Partners & Company: Manchester University K&L Gates, LLP: Fwc2026 US, Inc. K&L Gates, LLP: H.Q. Energy Services (U.S.) Inc. K&L Gates, LLP: Portland State University Maven Advocacy Partners LLC: National Wildlife Federation Michael Best Strategies LLC: Gray Media, Inc. Off Hill Strategies L.L.C.: Altria Client Services LLC Off Hill Strategies L.L.C.: American Efficient LLC Penn Avenue Partners: Eastern Shipbuilding Group, Inc. Platinum Advisors Dc, LLC: Microsoft Corp. Sandler, Travis & Rosenberg, P.A.: Aurubis Ag Saxa Innovation LLC: Rev Group, Inc. Sparacino Pllc: Sparacino Pllc Squire Patton Boggs: Moet Hennessy USa Strategies 360: Hawaii Foodbank Strategies 360: Homeaid Hawaii Thorn Run Partners: Ufa, Inc. Thorn Run Partners: Xiphos Partners Yc Consulting, LLC: Locked Brands, LLC New Lobbying Terminations Inline Policy Inc.: Skyscanner Limited Justice Action Network: Justice Action Network Mr. Mark Kopec: Motorola Solutions
