Law professor. Researching and writing about innovation and access to new healthcare technologies, mostly in health law, FDA law, and patent law.
Rachel Sachs
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The 2026 Medicare Trustees Report is now out. Looking forward to reading more closely - lots of implications for prescription drug spending and policy in Parts B/D. www.cms.gov/oact/tr/2026
ICYMI, thread - key issues to look for with the release of the Medicaid work requirement IFR, expected this afternoon.
Now up at Health Affairs Forefront, @michaelannica.bsky.social and I analyze CMS's proposed rule regarding prior authorization for prescription drugs, contextualizing it as an extension of the 2024 prior auth rule and considering its broader implications. www.healthaffairs.org/content/fore...
Out now in @nejm.org, @lucamaini.bsky.social, @michaelannica.bsky.social, Pragya Kakani, and I analyze the opportunities and challenges associated with GENEROUS, the Trump Admin's most-favored-nation drug pricing model in Medicaid. www.nejm.org/doi/full/10....
For those following the drug pricing deals, the WH fact sheet about Regeneron includes a limitation not present in the fact sheets about other deals: that Medicaid will get MFN prices on "new" products. Assuming this addition is intentional, what does it mean? www.whitehouse.gov/fact-sheets/... 1/2
Great story from over the weekend on how states — red and blue — are struggling with the costs of rushing to stand up work requirements.
These concerns could get worse if the IFR (expected this afternoon) includes "surprises" that contradict implementation choices states have already made
In reading more about OMB's federal funding proposed rule, it's hard to avoid this quote, from @jtimmer.bsky.social: "If you wanted to cripple science research and were disappointed that Congress continued to fund it, this is the sort of document you would produce." arstechnica.com/science/2026...
"New" could mean products that haven't yet launched, or which have launched recently (how recently?). But it probably excludes Eylea, a blockbuster first approved in 2011. Regeneron may also want to exclude Eylea HD, approved in 2023. But like other deals, most of the key info is not public. 2/2
The number of NIH competitive awards is down 50% from 2025, and down ~70% from prior years. Even if they catch up by the end of the year, only wealthy institutions can bridge these huge funding gaps.They're killing science-and violating the constitution-by weaponizing the bureaucracy
