| Eric Cantor is back on top. The former House GOP leader has been named the next president and CEO of the Pharmaceutical Research and Manufacturers of America, or PhRMA, effective Nov. 9. He succeeds Steve Ubl, who has been in the role for more than 11 years — longer than any of the former chief executives for the drug industry’s most prominent trade association. Cantor has been a vice chairman and managing director at investment bank Moelis & Company since 2014 following an election loss. He’ll be staying on the bank’s board of directors while helming PhRMA, the group said in a statement. Rob Davis, the CEO of Merck who chairs PhRMA’s board, said that Cantor’s “unique combination of global business acumen coupled with policy and political experience at the highest levels of government make him an ideal person to lead PhRMA during this critical next chapter.” It’s a pivotal time for the industry, as it tries to navigate the Trump administration’s drug-pricing policies and continued scrutiny from Congress about high drug prices. The organization and its members are likely to be under the microscope if Democrats regain control of one or both chambers. Which apparently hasn’t gone unnoticed by the search committee. In the announcement, Davis emphasized what he called Cantor’s “long track record of working effectively across the political spectrum.” While he often sparred with then-President Barack Obama on policy — including health care issues — Cantor helped lead bipartisan legislation that authorized billions in funding at the National Institutes of Health to advance pediatric research, particularly research into childhood cancers and structural birth defects. Obama signed the bill into law in 2014. The program was reauthorized last year. In its announcement, PhRMA said Cantor had been “instrumental in building support for legislation that established Medicare Part D, expanding access to drug coverage for seniors and people with disabilities.” Cantor served in Congress from 2000 to 2014, including three years as the House majority leader. He lost reelection to tea party challenger Dave Brat, who has since become the Trump administration’s U.S. ambassador to Australia. → PhRMA, which represents companies including AstraZeneca, BMS and Pfizer, is also a behemoth of an organization. - Despite having just 30 members in 2024, it brought in more than $520 million in revenue, almost all of which came from member dues, according to most recently available tax forms. That’s the equivalent of nearly double what the U.S. Chamber of Commerce brings in, or more than three and a half times the revenue of the American Hospital Association. (PhRMA now has 34 members.)
- In addition to its in-house advocacy operation, the group has more than 40 lobbying shops on retainer, according to a review of lobbying filings — including firms Arnold & Porter, Capitol Counsel, Miller Strategies and Todd Strategy Group — and regularly is the top health care spender on advocacy, spending nearly $39 million on lobbying in 2025.
- The CEO gig also comes with a hefty paycheck. Ubl’s total pay package in 2024, the most recent tax filings available, was more than $7.6 million, which includes a bonus and any retirement or deferred compensation.
→ Ubl, who announced in April he would be stepping down, will be staying on as a strategic adviser to PhRMA until Jan. 15. In a statement, Davis thanked Ubl for his time at the helm of PhRMA, praising his “exceptional leadership” and calling him a “tireless advocate” for the industry, researchers and patients. “We are grateful for his leadership and the lasting impact he has made,” Davis said. The Medicare Advantage industry has a new policy wishlist for lawmakers on Capitol Hill and regulators in the Trump administration, aiming to address key concerns among policymakers about the program. The Better Medicare Alliance, an influential advocacy group, is calling for changes to prior authorization, risk adjustment, in-home health assessments and Medicare’s star ratings program that is meant to allow people to compare plans based on quality, among other proposals. The 21-page set of policy proposals, provided first to Health Brief, lands as policymakers are taking a harder look at how the privately run Medicare program pays insurers and manages care. It’s framed as a way to make the program more affordable and stable for the more than 35 million people enrolled in the program. Why it matters: Insurers are aiming to shape what the next round of Medicare Advantage reform should look like. The road map accepts more oversight in areas where there has been heavy criticism, but pairs that with demands for greater payment and regulatory predictability. “Our road map sets out a clear path to protect seniors from disruption while making Medicare Advantage more transparent, accountable and responsive to their needs,” said Mary Beth Donahue, the president and CEO of the Better Medicare Alliance. “These are actionable reforms that Congress and CMS can begin advancing now.” At a recent event held by the organization, Mehmet Oz, who leads the Centers for Medicare and Medicaid, signaled in videotaped remarks that the agency may pursue more oversight of Medicare Advantage plans. “It’s one of our top priorities to strengthen Medicare Advantage by ensuring plans deliver nothing short of exceptional care, all while responsibly stewarding taxpayer dollars,” Oz said, comparing it to managing a garden. “The fruits of our garden are the American people. We want to see them thrive into old age in a lush garden that sustains them,” he said. “Yet, in recent years, our garden has stayed vulnerable to weeds and overgrowth — and, for too long, patients have paid the price, both financially and physically.” → The proposal from the Better Medicare Alliance would speed up some prior authorization decisions, require a doctor or other licensed clinician to review AI-driven denials, and gradually change the way CMS calculates payments to plans based on patients’ health needs. It also calls for more scrutiny of health assessments conducted in patients’ homes, with plans required to follow up on diagnoses and share more information with patients’ regular doctors. Some insurers were accused by a government watchdog in 2024 of using these assessments to tack on additional diagnosis codes to get reimbursed more for those patients. Medicare Advantage plans are paid a set amount for each beneficiary, adjusted for their documented health conditions rather than the care they actually receive, which can create incentives to manage costs, but also, critics allege, capture more diagnoses. → Other recommendations target fraud and oversight, including stronger checks on providers and health plans, tighter rules for third-party Medicare marketers, and better tracking of beneficiary information. The road map also proposes accounting differently for care veterans receive through the Department of Veterans Affairs when calculating Medicare Advantage payments. What to watch: The group also is pushing for the House’s health care price-transparency package, called the Lower Costs, More Transparency Act. It could become one of the contenders in a year-end spending bill. However, the Senate has its own health price-transparency proposal, and the two bodies still need to reconcile the differences. Medicare Advantage premiums are set to drop next year, according to new data released by the Trump administration. CMS projects the average Medicare Advantage premium will decrease to $12 per month, a more than 16 percent decline. For Medicare Advantage plans with drug coverage, the average monthly premium will fall 38 percent, to $7. But the administration is also highlighting what it calls stability in stand-alone Part D plans, which solely offer prescription drug coverage. Average premiums are projected to rise by less than $1 a month, to $36, even as CMS winds down its Part D Premium Stabilization Demonstration, which provided temporary subsidies to insurers. Why it matters: CMS is using the premium numbers to argue that Medicare coverage remains affordable, even without the subsidies. The bigger question for insurers and beneficiaries is going to be what happens to benefits, networks and plan participation beneath those headline premiums. The timing element: Medicare’s open-enrollment period begins on Oct. 15, but health insurers will start to lay out specific changes to their plan and benefit offerings for the next year this Thursday. In a release Monday, CMS said that about 34 million people are projected to enroll in Medicare Advantage next year, with 97 percent of Medicare beneficiaries having access to at least 10 plans. About 8 in 10 current Medicare Advantage enrollees will be able to stay in their plan at the same or lower premium — but it’s worth keeping an eye on. “This Senate Democratic candidate is making a play for RFK Jr.’s MAHA supporters,” reports The Post’s Rachel Roubein. More details on the rift on ultra-processed foods reported by Rachel on Friday: The Wall Street Journal’s Liz Essley Whyte, Jesse Newman and Josh Dawsey write that “RFK Jr.’s Push to Revamp American Food Runs Into White House Resistance.” “CDC updates measles toll, now counts 2 deaths,” The Post’s Lena H. Sun reports. “Biosecurity Head Steps Down as Trump’s Pick Awaits Confirmation,” Rachel Cohrs Zhang and Jessica Nix report at Bloomberg. “ | 
