In this edition of AcademyHealth’s Situation Report, we offer updates on the Senate reconciliation bill, which removed several cuts that were deemed non-compliant, including proposed cuts to the CFPB, SNAP, federal payroll reeducations, and more. Meanwhile, the Trump administration is moving forward with a new rule that will shorten ACA enrollment periods, end coverage for Dreamers, and further limit access to and funding of ACA coverage. Read on more for news we’re following including updates on HHS Secretary RFK Jr’s vaccine panel, changes to electronic prior authorization, and more.
In today’s issue:
- Senate Parliamentarian Stalls GOP on SNAP and Court Limits, Backs AI Rule Ban
- Administration Moves to Shorten ACA Enrollment Period, Ends "Dreamer" Coverage
- HHS Cuts LGBTQ+ Lifeline Services, Targets Sex Ed Standards
- Health Insurers Ease Prior Authorization Requirements
- Senator Calls for Cancellation of Vaccine Panel Meeting, Citing Member Inexperience
- Medical Groups Mobilize to Form Independent Vaccine Panel for Insurers
- ICYMI: Share Your Story with AcademyHealth
Senate Parliamentarian Stalls GOP on SNAP and Court Limits, Backs AI Rule Ban
Over the last week, the Senate Parliamentarian, Elizabeth MacDonough, dealt several blows to Republican efforts to implement their legislative priorities in the Senate reconciliation bill. Several controversial cuts were deemed non-compliant and would not be allowed in the legislation, including the proposed gutting of virtually all Consumer Financial Protection Bureau funding, Federal payroll reductions, cuts to the Office of Financial Research, and other non-essential budgetary adjustments. Proposed cuts to SNAP (food stamp) spending and restrictions on Courts’ abilities to hold officials in contempt were also removed from consideration. If Senate Republicans kept these provisions in the legislation, it would be corrosive to the bill’s ability to avoid the 60-vote Senate filibuster. However, the proposal for a 10-year moratorium on state and local AI regulations can remain in the reconciliation package. Senate leadership continues to voice optimism that the Senate bill will be ready for Trump’s signature by July 4th.
Administration Moves to Shorten ACA Enrollment Period, Ends "Dreamer" Coverage
According to the 2025 Marketplace Integrity and Affordability Rule, released Friday by CMS, the Trump Administration will shorten the time window in which individuals can enroll in individual health coverage through the Affordable Care Act marketplace. The provision also removes the ability for people with incomes below 150 percent of the federal poverty line to enroll monthly in ACA coverage and gives state exchanges the flexibility to determine their enrollment period between November and December as long as they do not exceed nine weeks.
Moreover, the rule ends coverage for ‘Dreamers,’ or people who immigrated to the United States without proper documentation as children . The Administration is also banning plans from covering “sex-trait modification” as an essential health benefit. As with Trump’s first Administration, this administration aims to limit access to and funding for ACA coverage. According to the Administration, the rule aims to limit people from applying when they are sick, encourages yearlong coverage.
HHS Cuts LGBTQ+ Lifeline Services, Targets Sex Ed Standards
This past week the HHS has made several moves that have targeted services that provide better evidence-based health outcomes for the LGBTQ+ population. The Substance Abuse and Mental Health Services Administration (SAMSHA) announced the 988 Suicide and Crisis Lifeline will no longer support the separate extension for LGBTQ+ youth to receive specializes services. Beginning July 17, the “press 3” option will no longer be available. The announcement stated the lifeline would “no longer silo LGB+ youth services”—notably dropping representation of transgender and queer populations from the abbreviation. Callers will remain on the generalized 988 line, reducing the odds a high-risk youth will be able to connect with a specialized, trained LGBTQ counselor. Critics observe that the separate extension for veterans and their families remains supported, challenging their reported mission to remove silos and “focus on serving all help seekers”.
Further, HHS on Friday notified California of a 60-day deadline to eliminate any references of “gender ideology” from federally-funded sex education programs for children. California’s Personal Responsibility Education Program (CA PREP), follows an evidence-based model to provide comprehensive sexual education to high-risk adolescents to prevent STIs and teen pregnancy. The notice cited examples of instances the curriculum refers to gender identity and asserts that by doing so, California is going beyond the scope of the authorizing statute. It is notable that these cuts are being announced during Pride Month and following the recent SCOTUS decision to uphold a ban on gender-affirming care for transgender minors.
Health Insurers Ease Prior Authorization Requirements
According to America’s Health Insurance Plans (AHIP), U.S. health insurers will voluntarily take additional measures to simplify their requirements for prior approval on medicines and medical services, as well as develop standardized data and submission requirements for electronic prior authorization by 2027. Insurers will also work on reducing the scope of claims that require prior authorization by 2026, and ensure the authorizations are valid for a 90-day period if a patient changes insurance companies during the course of treatment.
Senator Calls for Cancellation of Vaccine Panel Meeting, Citing Member Inexperience
Senate HELP Committee Chairman Bill Cassidy (R-LA), who cast the key vote to secure Kennedy’s confirmation, made a statement that this week’s Advisory Committee on Immunization Practices (ACIP) meeting should be delayed due to the eight newly appointed members inexperience and potential bias against vaccines. Cassidy specifically cited that while the appointees have scientific credentials, there is a lack of significant experience in microbiology, epidemiology, and immunology as well new technologies like mRNA vaccines. To ensure that the ACIP’s recommendations are not viewed with skepticism, the senator is calling for the meeting to be delayed until there is a larger panel with more direct and relevant experience and a Senate-confirmed CDC director is in place.
Medical Groups Mobilize to Form Independent Vaccine Panel for Insurers
Following HHS Secretary Robert F. Kennedy Jr.’s decision to disband the CDC vaccine advisory committee, outside medical organizations and independent experts are looking for alternate sources of unbiased and trustworthy information and are considering forming a group of their own. Dr. Michael Osterholm, an infectious disease expert and the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, formed the Vaccine Integrity Project following the firing of all 17 members from the CDC’s Advisory Committee on Immunization Practices, which influences the childhood vaccination schedule, which vaccines are required, what shots insurances covers, which are free, and more. CIDRAP is now taking input from medical organizations and public health groups including the AAP, the American Academy of Family Physicians, the American College of Physicians, the American Pharmacists Association, the National Foundation for Infectious Diseases, as well as insurance providers for input on vaccine recommendations. While insurance companies do rely on ACIP for guidance on which vaccines to cover, recommendations from these reputable medical and public health groups could potentially influence insurance companies on which shots to cover.
ICYMI: Share Your Story with AcademyHealth
AcademyHealth is collecting stories from across the health services research community to document the real-world impact of federal policy and funding changes. What happens when research is delayed, defunded, or derailed? What’s lost—for patients, for communities, for progress? Help us show policymakers and the public what’s truly at stake when research is sidelined. Your story can inform advocacy, spark action, and protect progress. Share your story here.
Previous Updates
This is the latest in a series of Situation Report updates from AcademyHealth. You can find prior issues here.
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