Hello from the Common Health Coalition! The 2-4-2 Digest is a weekly snapshot for health leaders - 4 key insights in 2 minutes or with 2 swipes on your phone.

Weekly Health Insights

Medicaid Financing: CMS finalized a rule tightening limits on state provider taxes used to finance Medicaid, prohibiting higher rates and new taxes and phasing out existing arrangements over three years. The policy affects a financing mechanism that generates about $24 billion annually for states and is projected to reduce federal Medicaid spending by $78 billion over a decade.

Substance Use Policy: The White House has launched the Great American Recovery Initiative through executive order, directing HHS, DOJ, and other agencies to coordinate addiction prevention, treatment, and recovery efforts under a centralized federal framework. The initiative consolidates existing programs and reporting structures but does not introduce new funding.

Drug Price Negotiations: On January 27th, CMS named 15 high-cost drugs for the 2028 Medicare drug price negotiation cycle, marking the first time Part B drugs administered in hospitals—such as Xolair, an injectable biologic used to treat severe allergic asthma and chronic hives—will be subject to negotiation. 

PrEP: Several major insurers and pharmacy benefit managers have expanded coverage of the twice-yearly HIV PrEP injection Yeztugo (lenacapavir) in the months following its FDA approval. The shift signals growing payer acceptance of long-acting PrEP, as insurers weigh adherence benefits against lower cost oral alternatives.

Colleague Corner

In a JAMA Health Forum Viewpoint, Dr. Marc Gourevitch argues that U.S. life expectancy has failed to motivate meaningful policy action and proposes shifting public health’s “North Star” toward measuring whether people’s basic needs are being met to better drive political and public engagement.

"These 2 realities—that life expectancy fails as a catalyst for change and that public sentiment about material hardship has real-world, narrative traction—point to an essential path forward for public health. To improve life expectancy, we need to stop focusing attention on it. Rather, in this complicated moment, as policymakers seeking to advance health struggle to connect with public sentiment, our field must engage to better enable households across the country to meet their basic needs. Twin goals will thus be served: lessening pervasive material hardship and bending the curve of the population’s health back in a positive direction."

– Dr. Marc N. Gourevitch, MD, MPH, Muriel G. and George W. Singer Professor of Population Health, NYU Grossman School of Medicine

Data Watch

An npj Digital Public Health analysis of 190,698 Medicaid-covered pregnancies across 26 states and DC finds that integrating clinical data with social needs data enabled identification of high-risk pregnancies a median of 55 days earlier than traditional clinical indicators.

Fig. 3: Model performance comparison incorporating social determinants of health

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