Centers for Medicare & Medicaid Services

Rule Changes

Source of baseline spending projections and historical data

For decades, American health care spending grew faster than the economy, seemingly without limit. Government actuaries projected in 2010 that health care would consume 21.2 percent of gross domestic product (GDP) by 2024—roughly $6.3 trillion. The actual figure: 18 percent, about $977 billion less than expected. A new analysis presented at the Brookings Institution on March 27, 2026, concludes that the United States has genuinely bent its health care cost curve for the first time in the modern era.

Updated 2 days ago

Rule Changes

Administering BALANCE model to expand GLP-1 access

Medicare has been banned from covering weight loss drugs since 2003. CMS launched the BALANCE voluntary model in December 2025 to work around the law—negotiating $50-per-month access to Ozempic, Wegovy, and similar blockbusters for 10% of Medicare enrollees starting July 2026. The workaround: don't call it weight loss coverage, call it treatment for chronic disease with specific comorbidities. Manufacturer applications closed January 8, 2026, with negotiations continuing through February 28.

Updated Jan 14

New Capabilities

Determining reimbursement rates for blood tests

For decades, diagnosing Alzheimer's meant either a $5,000 brain scan with radiation exposure or a painful spinal tap. In October 2025, the FDA cleared Roche's blood test for use in primary care—a simple blood draw that rules out Alzheimer's 97.9% of the time. It's the second blood test approved in five months, transforming a diagnosis that once required specialists and imaging centers into something your family doctor can order.

Updated Jan 9

Rule Changes

Linked to a new CBD access pilot described alongside the executive order

Trump’s executive order instructing DOJ to fast-track marijuana’s move to Schedule III immediately triggered a familiar split-screen: public health and industry groups cheered the potential research and tax impacts, while House Republicans organized opposition, urging Trump to keep marijuana in Schedule I.

Updated Dec 18, 2025