Eighty-five delegates from the Nashville Health Care Council convened in Washington, D.C. last week to engage with top policymakers, strategists, and journalists to understand the forces reshaping the business of healthcare. The two-day event offered participants an unfiltered look into the current political climate and its implications for the industry. Get an inside look at the D.C. Delegation with the following session recaps. Read the pre-D.C. Delegation reference materials here.
The Political Landscape in Washington: Policy and Priorities Under the Current Administration
Moderator: Mark Tipps, Operating Partner and Counsel, Frist Cressey Ventures
Panelists: Sheila Burke, Former Secretary of the Senate and Strategic Advisor and Chair, Government Relations and Public Policy Group, Baker Donelson, Liz Fowler, Former Director, CMS Innovation Center
The first day of the Nashville Health Care Council's D.C. Delegation started with a timely overview of the current administration's policies and priorities. Mark Tipps skillfully moderated a panel of seasoned political insiders who offered deep insights into the complex Washington landscape.
Burke and Fowler emphasized the stark shift in Washington's culture and governance compared to previous decades. A decline in bipartisanship, the influence of social media, and extreme redistricting have created an environment where members of Congress rarely encounter dissenting views—either at home or in Washington. With control of both chambers of Congress, they noted, the White House is testing the limits of executive power, often bypassing traditional processes and relying on an aggressive use of executive orders to implement sweeping policy changes.
The conversation painted a picture of a government operating at breakneck speed with uncertain consequences, a political climate defined by urgency, control, and disruption. The implications for health care policy, federal institutions, and democratic norms are bound to be significant yet still unfolding.
Inside Capitol Hill: A Candid Panel with Key Congressional Staffers
Moderator: Dr. Larry Bucshon, Senior Policy Advisory, Holland & Knight
Panelists: Nolan Ahern, Senior Policy Advisor, Office of the House Majority Whip, Sarah Levin, Deputy Staff Director, Subcommittee on Health of House Ways & Means Committee
The impacts and complexities of the reconciliation process emerged as a key theme from the panel. Medicaid was a central focus, with proposed cuts generating concern among healthcare stakeholders and political leaders. While pressure to reduce federal spending is intensifying, both Ahern and Levin acknowledged bipartisan reluctance to make sweeping changes to Medicaid, which remains complex both in politics and practice.
The panel underscored the importance of data-backed advocacy and storytelling in informing policy decisions, particularly when those stories reflect the local impact of federal programs. They encouraged health leaders to remain engaged with policymakers, noting that well-timed insights from constituents, especially those linking policy to patient care or economic impact, can shift conversations.
The discussion highlighted the increasing influence of congressional staff and committee leadership in a political environment where narrow margins in both chambers heighten the stakes of every vote. Despite the gridlock, the panelists affirmed that healthcare policy is still very much in motion, driven by behind-the-scenes negotiations, evolving budget dynamics, and sustained pressure from both internal and external stakeholders.
Medicaid at a Crossroads: Policy Challenges and Opportunities in a Changing Landscape
Moderator: Matt Salo, CEO, Salo Health Strategies and former Executive Director of the National Association of Medicaid Directors
Panelists: Marielle Kress, Senior Health Advisor, Committee on Finance (Minority), Charlotte Rock, Senior Health Policy Advisor, Senate Finance Committee
In a candid deep dive into the heightened political and fiscal uncertainty facing Medicaid in 2025, Kress and Rock provided differing viewpoints amid looming budget reconciliation battles. Salo facilitated the discussion by highlighting the scale and complexity of Medicaid, an $880 billion program that now plays a critical role in long-term care, mental health, and economic security.
Rock emphasized that the GOP is committed to the value of Medicaid and focused on examining program sustainability, regulatory burdens, and perceived loopholes that may be driving federal costs. Kress cautioned against framing the conversation solely around cost-cutting, warning that even targeted reductions would have tangible human impacts and reduce access to care.
The panel revealed a stark policy divide, which healthcare leaders and Americans alike are feeling. Rock outlined Senate Republicans’ intent to use the reconciliation process to scrutinize state practices like provider taxes and managed care arrangements while preserving flexibility for non-expansion states. Kress underscored Democratic priorities: protecting coverage, opposing work requirements, and ensuring reforms enhance rather than hinder access to care.
Both panelists agreed that the Medicaid program is complex and in need of thoughtful improvement based on input from a wide range of stakeholders
Shaping Health Policy Breakout Session: Healthcare Systems' Viewpoint on Regulations and Landscape facilitated by the Federation of American Hospitals
Speakers: Chip Kahn, President and CEO, Federation of American Hospitals and Charlene MacDonald, Executive Vice President, Public Affairs, Federation of American Hospitals
The session led by Kahn and MacDonald from the Federation of American Hospitals (FAH) centered on the critical issues facing health systems in the upcoming year. FAH’s most urgent policy priority is ensuring patients have health insurance coverage. To this end, its two top objectives are extending premium tax credits for healthcare exchanges and preventing potential Medicaid cuts. The organization is notably concerned with maintaining healthcare coverage for lower-income individuals, especially in states that did not expand Medicaid, where the FAH membership is concentrated.
Kahn also emphasized the administrative challenges its members face in managed care (e.g., Medicare Advantage and Medicaid managed care), such as prior authorizations, denials, and delays in reimbursement. Finally, he highlighted challenges in the current political landscape, noting the potential impact of administrative disruptions on healthcare policy.
MacDonald outlined a multi-pronged strategy to address these priorities. One key approach is helping voters and legislators see that premium increases are driven by Congress allowing tax credits on the exchanges to expire. Other aspects include building cross-sector coalitions, targeted lobbying, and public education campaigns focused on the human impact of potential Medicaid cuts.
Keynote Dinner with Mike Allen at Riggs D.C. Hotel
Speaker: Mike Allen, Co-founder and Executive Editor of Axios, Former POLITICO Chief White House Correspondent
Axios Co-founder and Executive Director Mike Allen provided an engaging and informative keynote to close the Delegation. His presentation unpacked the psyche of the Trump administration, the remarkable influence of Elon Musk, and what it means for the healthcare industry and broader business community.
Allen opened with levity, sharing stories from inside the White House. He detailed what he calls the “psychic White House,” which is a political culture driven by personal loyalty, rapid decision making, and showmanship over traditional governance in pursuit of “radical change.”
For healthcare leaders, Allen’s commentary provided a sobering perspective on what is at stake with the rapid attempt to re-wire the American government. This includes cuts to veterans’ programs, opioid prevention, and pharmaceutical oversight in an effort to create a more efficient government, but Allen cautioned that these could cause collateral damage and consequences for many in the country.
Many traditional industries and business leaders are staying quiet amidst the sweeping changes, noted Allen. He believes leaders are hoping to have future negotiating leverage by seeing how the chips fall.
Allen wrapped with reflections on how Trump’s ecosystem, especially the “MAGA media and podcast network”, is built to last well beyond the man himself. Even as Democrats struggle to formulate an effective response, Allen argued, Trumpism is already embedded deeply in American political infrastructure.
Allen’s keynote was more than just political commentary—it was a call to understand the new operating rules in Washington and what they mean for the future of policy, healthcare, and leadership in America.
About the Nashville Health Care Council
The Nashville Health Care Council strengthens and elevates Nashville as The Healthcare City. With a $68 billion economic impact and 333,000 jobs locally, Nashville’s healthcare ecosystem is a world-class healthcare hub. Founded in 1995, the Council serves as the common ground for the city’s vibrant healthcare cluster. The Council offers engagement opportunities where the industry’s most influential executives come together to exchange ideas, share solutions, build businesses and grow leaders.