Larry Levitt

President Trump didn't mention at all in his SOTU the most significant changes to health care he and Republicans in Congress have engineered: the biggest Medicaid cuts ever, expiration of enhanced ACA premium subsidies, and scaling back recommended vaccines.

I suppose he could meander his way back to health care, but no mention of Medicaid work requirements (which poll, in the abstract, more favorably than Democrats would prefer)

*taps sign*

President Trump has called for his deals with drug companies to be enacted into legislation. It's hard to know that means since the deals are not public.

TrumpRx: What's the Value for Customers? | KFF In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially th...

The details:
www.kff.org/patient-cons...

Things not mentioned by President Trump about health care:

Medicaid cuts that are the biggest rollback in federal support for health care ever.
Expiration of enhanced ACA premium subsidies, leading to a doubling of out-of-pocket premiums.
Fewer recommended vaccines.

President Trump negotiated lower prices for some drugs on TrumpRx, but discounts only apply to cash paying patients not using their insurance. Many drugs already had big discounts through manufacturers or coupons, and some have generic equivalents that are already much cheaper.

President Trump's health plan has more concepts than details. But, while shifting ACA premium tax credits to health care accounts may help healthier people, it's likely to increase costs for people who are sick.

While increasing the federal deficit by over $4 trillion

The largest tax cuts in U.S. history. Also, the largest health care cuts in U.S. history.

Quiz - How Well Do You Understand Your Health Insurance? | KFF Health insurance is often complicated, but understanding the basics helps you make better decisions about your coverage and care. This 10-question quiz touches on some terms you may encounter.

We have a new quiz on how health insurance works. But, it's really a statement about how utterly complex health insurance is in the U.S.
www.kff.org/private-insu...

The biggest challenge to Trump's drug price claims? Reality It's unclear how many patients will actually pay less under Trump's "most favored nation" deals.

"President Trump deserves credit for keeping the issue of high drug prices on the agenda, but his bark has been stronger than his bite," Levitt said.
@axios.com
www.axios.com/2026/02/24/t...

Got to love @larrylevitt.bsky.social for pointing this out. In 24 and 25 we saw more Medicare Advantage & Individual plans decommission. Are the executives chasing 2023 profits by dumping agent commissions?

New: Insurer gross margins dipped somewhat in 2024. Dollar margins per enrollee remain highest in Medicare Advantage.
www.kff.org/medicare/hea...

What Newly Released Medicaid Data Do and Don’t Tell Us | KFF On February 14, 2026, CMS released a dataset with provider-level spending data that the agency suggests could be used to identify unusual billing patterns for specific services, states, or providers. ...

I’m always for more data. But, be careful using the new Medicaid spending data released by the Trump administration. It’s missing a lot of important details and context.
www.kff.org/medicaid/wha...

Consolidation and Integration in Health Care: What It Means for Patients, Payers, and Policy | KFF Panelists discussed the motivations behind horizontal and vertical consolidation in health care, its potential to lower or raise costs, the implications for patients and payers, and how policy makers could respond.

During our latest Health Wonk Shop, Erin Fuse Brown, Cory Capps, and Elizabeth Mitchell joined @larrylevitt.bsky.social for a discussion on health care consolidation and integration.

🎬 Watch the recap: https://on.kff.org/3OqlmZl
🎧 Listen as a podcast: https://on.kff.org/4c3BYQu

KFF’s @larrylevitt.bsky.social explains that RFK Jr. has “remade healthcare in the U.S. in a way that no other HHS secretary has and has done it in a very short period of time.”

Listen to the full @economist.com episode: https://econ.st/46L9FTf

Medical debt is generally still owed by a deceased person’s estate, but not by surviving family members.

When a celebrity tragically dies with massive medical debt, I’m left with the questions. Did they have insurance? People with insurance absolutely have medical debt, but out-of-pocket costs are capped. Debt may be from out-of-network care, claims denials, or unocvered treatments.

As always, there are tradeoffs.

Catastrophic plans have lower premiums. But, a $15,600 deductible is...a lot.

It's great to have a plan where you can go to any provider. But, not if you get surprised by an extra bill because the provider charges more than your insurer pays.

Excellent summaries of the Trump administration's new proposed ACA rules from @katie-keith.bsky.social and @mattafiedler.bsky.social.

www.healthaffairs.org/content/fore...

www.healthaffairs.org/content/fore...

Because Congress won't act on it, the administration seems keen to use these catastrophic plans — which offer a fair bit of regulatory flexibility — to shoehorn in various policies that are loosely/symbolically aligned with Trump's "Great Healthcare Plan"

The Trump administration proposed two new ACA ideas this week:

1. Catastrophic plans with deductibles of $15,600 per person.

2. Qualification of non-network plans, where insurers determine how much to pay and patients shop for providers that accept it or face a balance bill.

Those are certainly factors. Plus consolidation driving higher prices generally. It’s hard to sort how much is due to each.

PhRMA pointed to hospitals in today’s E&C hearing as lead villains in rising healthcare costs. “hospital spending has continued to go up. It is the largest part of our healthcare system..we spend almost half of every dollar in healthcare on hospitals.. a lot of that is driven by.. consolidation”

Hospital Spending Accounted for 40% of the Growth in National Health Spending Between 2022 and 2024 | KFF This data note analyzes the extent to which hospital spending has contributed to the growth in national health expenditures in recent years and over the long term using data from the Centers for Medic...

Hospitals accounted for 40% of the growth in U.S. health spending from 2022 to 2024, and one-third of the increase in spending over the last two decades.
www.kff.org/health-costs...

Consolidation and Integration in Health Care: What It Means for Patients, Payers, and Policy | KFF News reports across the country trumpet major mergers and consolidation involving health insurers, physician practices, pharmacy benefits managers, hospitals and health systems, and other providers, i...

Get ready to get super wonky as we talk about consolidation and vertical integration in health care on the next KFF Health Wonk Shop on February 18. Register here.
www.kff.org/event/consol...

KFF’s @larrylevitt.bsky.social briefly shared things to consider regarding #TrumpRx on @ruralimpactpodcast.bsky.social podcast last week.

Catch up on the full episode about President Trump’s recent healthcare plan before the Trump Rx announcement tonight. https://on.kff.org/4aoFIcW

New: It's going to take months, and maybe even over a year, before we really know how many ACA enrollees have dropped their insurance because their premium payments have skyrocketed due to the expiration of enhanced premium tax credits.
www.kff.org/affordable-c...

Potential Storylines From Trump-Era Health Care Cuts This JAMA Forum discusses the ramifications of the Republican tax and spending law and presents storylines that may be used in the next season of the television show The Pitt to illustrate these healt...

This season of The Pitt hasn't exactly followed the storylines I suggested, but it has been very compelling in illustrating how health policy affects people.
jamanetwork.com/journals/jam...