By Megan R. Wilson

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In today’s issue:

• Manufacturers’ restrictions on repairing medical devices are slowing fixes and delaying patient care, technicians say. An advocacy group says it helps fuel momentum behind legislative proposals meant to loosen repair rules.
• A new KFF poll finds broad bipartisan support for more regulation to rein in the cost of medicine as the Trump administration leans into affordability messaging.
• Insurers promised to streamline the prior authorization process this year, but doctors aren’t seeing big changes.

Good afternoon, and welcome to the Health Brief newsletter. Today’s must-read is a profile of Chris Klomp, the head of Medicare who has taken on an expanded role at the Department of Health and Human Services. WaPo’s Dan Diamond writes about how President Donald Trump has leaned on Klomp, who now runs day-to-day operations at HHS, as the administration simultaneously leans into affordability messaging.

In one meeting last year, Trump asked “Where’s my Mormon?” as he searched for Klomp, Dan writes in the piece. (Klomp is a member of the Church of Jesus Christ of Latter-day Saints.)

It’s Feedback Friday. What’s on your mind? What’s on your policy agenda? Send me a note — and any other tips or intel — at megan.wilson@washpost.com. If you prefer to message me securely, I’m also on Signal at megan.434.

This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from the Washington Post newsroom. Learn more about WP Intelligence.

Barriers to allowing third-party repairs of complex medical equipment, such as MRI machines, can lead to patient delays, according to a new report. (Rosem Morton/For The Washington Post)

	The Lead Brief

Many biomedical equipment technicians say manufacturer restrictions are making it harder to repair medical devices, according to a survey from the U.S. PIRG Education Fund that found the issues can lead to longer equipment downtime and even potential delays in patient care.

The group surveyed 107 technicians and health care technology management experts on barriers to fixing hospital equipment.

About 83 percent of respondents said repair barriers — such as manufacturer-imposed software locks or passwords, and limited access to parts or service manuals — increase equipment downtime at least somewhat frequently.

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Almost half said it had gotten worse since the pandemic, when some companies temporarily eased repair limits to help hospitals keep devices such as ventilators running.

→ Meanwhile, medical device manufacturers argue that limiting access helps protect patient safety by ensuring that devices are properly maintained.

Why it matters: When complex health tech devices, such as imaging machines and ventilators, stop operating properly, it can delay procedures or testing for patients — or require them to go elsewhere.

The debate over medical device repair has been simmering for years, but the findings suggest it could gain new urgency as hospitals grapple with aging equipment and federal health funding cuts.

The report also highlights how common it is for hospitals to keep older equipment running. More than three-quarters of technicians said they “often” service devices that manufacturers have declared “end of life,” a notification that device-makers issue when they stop making a product. Sometimes the manufacturer will also stop servicing devices after this point.

The legislative push: Some states have floated “right to repair” laws that enable providers to repair devices themselves or hire third-party servicers.

Nathan Proctor, who leads the U.S. PIRG’s Right to Repair campaign, said the organization will use the report to urge state lawmakers to pass legislation that would loosen rules about who can repair medical equipment.

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“There is significant momentum around the topic generally in the states,” he tells me.

Hospital groups have supported these efforts, while health tech industry groups and some patient groups have pushed back on the proposals.

AdvaMed, an industry group for medical device makers, claims that manufacturers are often called to fix a machine when third-party repairs fail. However, many right-to-repair laws focus on other products — such as cars, farm equipment and electronics — and specifically exempt medical devices.

In Congress, there was a right-to-repair provision tucked into the defense authorization bill last year, which would have covered all devices and equipment used by the military. However, it was stripped from the final bill following industry pushback.

	Numbers Game

72 percent

That’s how many respondents to a newly released KFF poll said the government isn’t doing enough to control drug prices.

Specifically, the respondents said there isn’t as much government regulation limiting the price of prescription medications as there should be.

• More Democrats believe the government should be doing more (77 percent), but it’s a view also held by 72 percent of independent voters and 68 percent of Republicans — a surprising statistic as the party generally favors a more hands-off approach to industry.
• Nearly 60 percent said they worry about affording prescription drugs for themselves and their families. That’s the largest share since KFF began asking the question in 2018.
• More than 40 percent of adults say they have not taken medication as prescribed over the last year due to the cost — including 27 percent who said they have decided not to fill a prescription and 19 percent who’ve cut pills in half or skipped doses.

Ahead of the midterms, the Trump administration has sought to capitalize on its drug pricing efforts, including negotiating agreements with some of the largest drugmakers to compel them to align the cost of U.S. medicines with peer nations abroad, known as most-favored nation pricing. However, 59 percent of Americans surveyed by KFF said it is “not too likely” or “not at all likely” that the policies will lower drug costs.

	WP Intel File

Although health insurers got some attention last summer when they pledged to streamline prior authorization for medical care, providers are saying there hasn’t yet been enough progress.

WP Intelligence’s Rebecca Adams unpacks the promises — and how the changes were supposed to materialize earlier this year — in her latest report. It also delves into the practice of prior authorization, which is one of the most unpopular parts of the U.S. health system.

• Insurers said that, by January, they would cut back on the scope of treatments that require advance approval from a doctor before they’re approved and impose other changes to smooth coverage.
• Two months after those goals were to take effect, the insurance trade groups AHIP and Blue Cross Blue Shield Association say that they will release updates later this spring showing their progress. Insurers are the ones setting their own goals and deciding whether they’ve been met.
• Insurers also highlight improvements under some plans, including a policy implemented by Aetna that allows medical staff to get pre-authorization for several related services at once. UnitedHealthcare also said last year it was reducing the volume of services that need approval by 10 percent as part of an ongoing companywide effort. In January, the company stopped requiring preapproval for certain imaging procedures.
• Insurers and federal officials say that next year will bring consumers more important changes. By Jan. 1, 2027, insurers say they’ll give providers real-time responses for 80 percent of electronic submissions and more standardized electronic prior authorization. Some insurers already automatically respond to some requests.

→ Rebecca spoke to several providers, who said they haven’t seen much improvement from insurers. “For cancer patients, it’s just become a nightmare,” David Eagle, an oncology doctor in New York, told her. “It’s only getting worse.” Another provider in New Jersey said the number of prior authorizations has actually increased since the beginning of the year. Another just said “hell no” when she asked if things had gotten better.

“Patients and physicians remain skeptical,” American Medical Association President Bobby Mukkamala said. “Insurers have made similar promises before and failed to deliver meaningful change.”

But, insurance officials also note that if prior authorization didn’t exist, health care costs — another major concern for Americans and employers — would be even higher than they already are. Insurance companies also say medical providers often don’t provide all the documentation needed for approval.

What to watch: Separate from the voluntary pledges, insurers have to meet Biden administration rules targeting insurers that operate government-financed health plans, such as Medicare Advantage and Affordable Care Act plans. Those went into effect at the beginning of this year.

Federal officials say they’re keeping an eye on the issue.

“We’re not sitting idly by,” Chris Klomp, a top Trump administration health official, told Rebecca earlier this month. Prior authorization reform is a “passion project” for him, he said.

Klomp added that federal officials are talking to insurers and keeping them on track for the commitments for real-time authorization next year. “We expect them to do that,” he said.

	What We’re Reading

“Bipartisan coalition drops new bill to supercharge AI-powered research,” Politico’s Gabby Miller writes.

“White House says it’s ‘done’ with vaccines. MAHA begs to differ,” Daniel Payne and Chelsea Cirruzzo report at STAT.

“FDA panel OKs strains for fall’s flu shot,” Lauren Gardner writes at Politico.