The Trump administration is proposing a sharp slowdown in Medicaid spending as part of a broad reduction in the government’s investment in health care, calling for the public insurance for the poor to morph from an entitlement program to state block grants even after a Republican Congress rejected the idea.

The budget released by the White House on Monday also calls for a sizable reduction for Medicare, the federal insurance for older Americans that President Trump has consistently promised to protect. Most of the trims relate to changing payments to doctors and hospitals and renewing efforts to ferret out fraud and wasteful billing — oft-cited targets by presidents of both parties.

The Trump administration is proposing a sharp slowdown in Medicaid spending as part of a broad reduction in the government’s investment in health care, calling for the public insurance for the poor to morph from an entitlement program to state block grants even after a Republican Congress rejected the idea.

The budget released by the White House on Monday also calls for a sizable reduction for Medicare, the federal insurance for older Americans that President Trump has consistently promised to protect. Most of the trims relate to changing payments to doctors and hospitals and renewing efforts to ferret out fraud and wasteful billing — oft-cited targets by presidents of both parties.

In keeping with Trump’s promise in last month’s State of the Union address to halt the spread of HIV over the next decade, the budget includes an initial installment of $291 million next year targeted to communities where the virus is continuing to infect people not getting proper treatment — the rural parts of seven states, including Mississippi; the District of Columbia; Puerto Rico and 48 hot-spot counties scattered throughout the country….

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The sweeping health-care law created nearly a decade ago to put insurance within reach of more Americans has left significant holes in the ability of older, middle-class people to afford coverage, particularly in rural areas, according to a new analysis.

The sweeping health-care law created nearly a decade ago to put insurance within reach of more Americans has left significant holes in the ability of older, middle-class people to afford coverage, particularly in rural areas, according to a new analysis.

Sixty-year-olds with a $50,000 income must pay at least one-fifth of what they earn for the least expensive premiums for health plans in Affordable Care Act marketplaces across a broad swath of the Midwest, the analysis shows. In much of the country, those premiums require at least one-sixth of such people’s income.

The findings, issued Tuesday by the Kaiser Family Foundation, underscore why the Trump administration and other Republicans are pushing inexpensive insurance that bypasses ACA rules and protections — and why Democrats are pursuing strategies to make ACA plans more affordable….

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Walmart said Tuesday that it would no longer honor prescription drug coverage from CVS Health, leaving large numbers of Walmart customers searching for a new pharmacist and amplifying concerns about the growing market power of the CVS empire.

Walmart confirmed its exit from the CVS Health pharmacy insurance program, called CVS Caremark, after CVS refused the retail giant’s demand for larger reimbursements for the prescription drugs it dispenses.

Walmart said Tuesday that it would no longer honor prescription drug coverage from CVS Health, leaving large numbers of Walmart customers searching for a new pharmacist and amplifying concerns about the growing market power of the CVS empire.

Walmart confirmed its exit from the CVS Health pharmacy insurance program, called CVS Caremark, after CVS refused the retail giant’s demand for larger reimbursements for the prescription drugs it dispenses.

The move affects Walmart customers with CVS Caremark pharmacy coverage through employer-sponsored insurance and state Medicaid managed-care plans. It does not affect Medicare beneficiaries. It also does not affect pharmacies at Sam’s Club stores.

Walmart and CVS did not provide an estimate Tuesday of how many people will be affected….

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Executives at more than a dozen generic-drug companies had a form of shorthand to describe how they conducted business, insider lingo worked out over steak dinners, cocktail receptions and rounds of golf.

The “sandbox,” according to investigators, was the market for generic prescription drugs, where everyone was expected to play nice.

Executives at more than a dozen generic-drug companies had a form of shorthand to describe how they conducted business, insider lingo worked out over steak dinners, cocktail receptions and rounds of golf.

The “sandbox,” according to investigators, was the market for generic prescription drugs, where everyone was expected to play nice.

“Fair share” described dividing up the sales pie to ensure that each company reaped continued profits. “Trashing the market” was used when a competitor ignored these unwritten rules and sold drugs for less than agreed-upon prices….

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The Trump administration is further moving to roll back the Affordable Care Act by allowing its insurance subsidies to be used for leaner health plans that don’t cover a full range of benefits.

The result is that red and blue states are likely to see a deepening divide in how they implement the 2010 health-care law known as Obamacare, which the administration has been chipping away at since a failed effort to repeal and replace it by the Republican Congress last summer.

The Trump administration is further moving to roll back the Affordable Care Act by allowing its insurance subsidies to be used for leaner health plans that don’t cover a full range of benefits.

The result is that red and blue states are likely to see a deepening divide in how they implement the 2010 health-care law known as Obamacare, which the administration has been chipping away at since a failed effort to repeal and replace it by the Republican Congress last summer.

Under guidance issued Monday by the Centers for Medicare and Medicaid Services (CMS), states seeking federal waivers to run their insurance marketplaces will be given much more leeway. That includes the ability to apply ACA subsidies to short-term and association health plans — two types of coverage the administration has expanded as a way of making cheaper plans available to those who want them. These plans don’t include coverage of certain “essential” benefits like mental-health services and prenatal care and they can refuse to cover people with preexisting conditions…

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