Health Equity & Access Weekly Roundup: May 19, 2025

Proposed GOP Medicaid Cuts Threaten Loss of Coverage for Millions

The House Committee on Energy and Commerce’s proposed fiscal year 2025 budget resolution outlines $912 billion in Medicaid and health care cuts through 2034, with major reductions targeting fraud, eligibility enforcement, and individual accountability measures. While Republican leadership frames the cuts as necessary to reduce waste and strengthen the program, critics—including moderate Republicans and Democrats—warn of devastating consequences, such as 8.6 million more uninsured individuals and reduced access to care. Contentious provisions include work requirements, citizenship checks, and bans on Medicaid funding for gender-affirming care for minors. The proposal has sparked intra-party divisions, especially among GOP lawmakers from Medicaid-reliant districts, and clashes with President Trump’s stance to protect Medicaid.

Trump Administration Walks Back Mental Health Parity in Insurance Coverage

The Trump administration has suspended enforcement of a Biden-era rule that strengthened the Mental Health Parity and Addiction Equity Act, a 2008 law requiring insurers to cover mental health and addiction treatment on par with physical health care. The Biden administration’s 2024 updates aimed to clarify compliance expectations and improve enforcement after years of inconsistent insurer practices. However, a lawsuit from the ERISA Industry Committee challenged the new rule, arguing it exceeded federal authority and would increase costs while reducing care quality. In response, the Trump administration paused enforcement while reconsidering the rule’s future, raising concerns from experts and former officials that access to mental health care could be seriously diminished. This move aligns with other recent actions by the administration that critics say undermine mental health treatment access, including budget cuts and program rollbacks.

Access to Minimally Invasive Surgery for Advanced Ovarian Cancer Varies Widely by Facility

Significant facility-level disparities were identified in the adoption of minimally invasive interval debulking surgery (MI-IDS) for patients with advanced epithelial ovarian cancer, with concerns that these gaps may widen as the procedure becomes more common. Using data from the National Cancer Database, researchers observed that hospitals serving higher proportions of Black and uninsured patients were less likely to adopt MI-IDS, while academic and high-volume centers were more likely to use the approach. Although MI-IDS offers benefits like reduced morbidity and shorter hospital stays, its uneven implementation raises equity concerns. The authors urged immediate action to ensure that access to this less invasive surgical option is determined by patient needs rather than facility characteristics.

Diabetes Health Gains Outpace Economic Progress, Study Finds

Despite major advances in diabetes care that have improved clinical outcomes for middle-aged adults, a new study reveals that economic outcomes, such as employment rates and reliance on disability income, have remained stagnant for Americans 40 to 64 years old with diabetes. Analyzing data from 1998 to 2018, researchers found that individuals with diabetes were consistently less likely to be employed and more likely to rely on disability benefits than those without the condition, with no meaningful improvement over time. These findings highlight a persistent disconnect between health and financial well-being and underscore the need to address broader social and economic factors that contribute to the labor market disadvantages experienced by people with diabetes.

Racial Disparities in Ovarian Cancer Could Increase as Trends Point to Access Barriers: CK Wang, MD

Black women are disproportionately diagnosed with advanced-stage ovarian and breast cancers, largely due to systemic barriers in access to care and a lack of effective screening tools, particularly for ovarian cancer. The report findings from COTA show disparities are worsened in states with abortion restrictions, which also have the highest mortality rates for breast and cervical cancers. CK Wang, MD, COTA’s chief medical officer, warns that a shortage of gynecologic oncologists and a decline in obstetrics-gynecology residency applications—especially post–Roe v Wade and in rural areas—threaten to widen these care gaps. As access to specialists declines, cancer detection and treatment may increasingly fall to generalists, raising concerns about delayed or suboptimal care for underserved women.