Key Healthcare Policy Shifts: Visa Fees, Drug Pricing, and Vaccine Updates with Paige Twenter

This episode features Paige Twenter, Assistant Editor at Becker's Hospital Review. Twenter highlights three major healthcare stories shaping the industry today, including new H-1B visa fees and their impact on the workforce, Most Favored Nation drug pricing deals, and evolving vaccine mandates and access across the U.S.

Episode Transcript

(00:00):
Welcome to the Becker's Healthcare podcast. And today,
I'm your host, Snell Bunker. And right now,
I am speaking with Paige Twinter, the assistant
editor at Becker's Hospital Review, who keeps us
updated regularly on health care trends she's keeping
an eye on. Paige, thank you as always
for joining me today. Why don't you take
it away and tell us about some of
the things that you're seeing out there?
K. Thank you so much for having me

(00:21):
as always.
There's three topics I'd love to chat about
today,
including
new visa fees, the most favored nation deals
the Trump administration has entered into with Pfizer
and AstraZeneca,
and then also just national vaccine access and
updates.
So these are the three stories I'm most

(00:41):
closely watching and reporting on.
Let's start off with the visa fees. In
September, The US enacted a new $100,000
application fee for h one b visas.
These visas are work visas for special multi
occupations including health care.
In 2024, about 4% of h one b

(01:01):
visas were for health care and hospital roles.
Becker has spoken to a few health system
leaders and hospital executives across The US, and
many of them,
have said this fee could exacerbate
health care shortages.
The executive order said the fee is intended
to clamp down on what it calls, like,
abuse,

(01:23):
including suppressed wages over the past few years
while health care leaders told Becker's
that this fee could cause, quote, a brain
drain in innovation primarily in the health IT
space,
and it could also disrupt clinical workforce
pipeline. So
foreign born employees account for, about about 27%
of physicians

(01:44):
working in The US.
Same with about 16%
of registered nurses and nearly one third of
janitorial and maintenance workers in hospitals.
So if any health execs are listening and
would like to chime in on the topic,
my colleague Mariah Taylor and I
are working on an article
about how h one visa fees are changing

(02:07):
or could affect
hospital recruitment plans.
And so,
another topic I'm closely following is the most
favored nation
deal. So
a few weeks ago, Pfizer, which is based
in New York City, and AstraZeneca,
which is based in The United Kingdom, they
have both struck most favored nation pricing deals

(02:27):
with the federal government.
These deals,
are really the both drug makers they've pledged
to offer
most of their drugs to Medicaid at this,
quote, most favored nation price, which
is really what they say is gonna be
the lowest price that's offered in other
nations to American consumers. So the White House

(02:49):
is also planning to launch launch a direct
to consumer website
dubbed the trumprx.gov
in 2026.
One thing to note right now is that
while these deals,
are pretty interesting and newsworthy,
Medicaid beneficiaries
already pay next to nothing for prescriptions.
Federally, I believe the cap is $8

(03:12):
for new medications.
And in some states, some Medicaid beneficiaries, they
have no out of pocket cost.
And go back to those $8
cap, that's for people with the lowest incomes
federally.
So,
we're expecting more of these deals to come
through soon, but,
really, for these to have the biggest impact

(03:32):
on the average American consumer, you know, the
average person walking up to the pharmacy counter
for medicine
for their family. These kind of most favored
nation deals would need to be expanded
to more than just Medicaid.
For example,
if the initiative grew to more therapies,
those savings could go to employers, private payers,

(03:53):
Medicare,
the average American.
Last thing I would note is
national changes to
vaccination
availability.
So,
few different things to watch. In OneNote is
in Florida.
In early September,
border surgeon general
said that the state health health department was

(04:13):
moving to scrap all school based vaccine mandates,
and then the department later said it was
looking into lifting mandates on school based vaccines
for specific diseases including chickenpox and hepatitis b.
Meanwhile, the I spoke with the president and
vice president of the Florida chapter of the
AAP or the American Academy of Pediatrics.

(04:34):
Recently, they said they're being flooded with calls
from parents and pediatricians,
many of whom are concerned and confused about
the potential
change.
And the AAP leaders told me that a
reduction in school based vaccine requirements
will not only endanger children,
but adults as well. It'll likely

(04:55):
also result in avoidable emergency department visits, severe
illnesses, and deaths if the vaccination if the
state vaccination rate decreases
in results.
One other thing to keep an eye out
for as it comes to vaccines is MMR
or measles, mumps, and rubella.
It indicated
or kind of hinted or teased that the

(05:17):
advisory committee on immunization
practices,
which is an independent CDC panel of advisers
who provide vaccine guidance to the CDC.
This committee,
has shared plans to review several aspects of
the childhood vaccination schedule as recommended by the
CDC. So in a document posted earlier in

(05:37):
October,
they're looking at the timing and order of
vaccines,
the safety of vaccine ingredients,
and then the immunization
schedules in other countries.
They did specify
which vaccines they're looking at, which vaccine ingredients
they're gonna be investigating.
But one note is that
the

(05:58):
administrator
of, the CDC,
the acting director,
has indicated
the MMR vaccine would be split into three
shots.
So, a potential three way breakup might be
on the horizon, and that's what I would
note as the top three news in the
past few weeks.
Perfect. Thank you as always, Paige, for keeping

(06:19):
us updated on all these important trends
and for joining me once again on the
Becker's Healthcare Podcast. Always a pleasure. Thank you.
Thank you, Snow.