A Crucial Conversation: Insights from D.C. Delegation 2025
The Nashville Healthcare Council’s Crucial Conversations series continues to tackle the most pressing topics in healthcare. In a recent session, industry leaders delved into workforce retention strategies, exploring how organizations can adapt to evolving employee expectations through purpose-driven leadership and innovative technology.
Insights from D.C. Delegation 2025
The Nashville Health Care Council’s April 23rd virtual Crucial Conversations event provided a timely briefing on the recent D.C. Delegation and offered insight into fast-evolving federal healthcare policy. Amid growing uncertainty in Washington, panelists offered clarity on how executive action, budget reconciliation, and regulatory shifts may shape the future of healthcare—particularly for Medicaid and vulnerable populations. The conversation, led by NHCC President Apryl Childs-Potter and a panel of expert delegates, featured key takeaways from leaders including Morgan Ribeiro, Tobi Adeyeye Amosun, and Jeremy Mercer. Together, they painted a picture of both disruption and opportunity for healthcare executives navigating the changing environment.
A Rapidly Evolving Policy Climate
Ribeiro highlighted the action-packed nature of the delegation, with 85 delegates attending and meetings with regulatory representatives, members of Congress, and congressional staffers. She highlighted key themes from the Delegation including a shift in culture and governance, the decline in bipartisanship and social media’s influence, and the rapid speed of change from the current administration.
Budget Reconciliation and Medicaid in the Crosshairs
Much of the Crucial Conversations panel discussion centered on Medicaid and the role of the 2025 budget reconciliation process. Ribeiro described the reconciliation process as “the focus right now in Washington,” citing its use to advance President Trump’s fiscal agenda, including a proposed $880 billion in federal spending cuts. Medicaid, a substantial part of the federal budget, is squarely in the spotlight.
Mercer urged attendees not to be distracted by political noise, instead pointing to the clear opportunities to advocate for thoughtful reform. Cuts to Medicaid “benefits” may not be happening in name, he noted, but reductions in federal matching funds are poised to force states into tough decisions about what services can remain. Mental health and substance use treatment, often funded through waivers, are particularly vulnerable.
Amosun helped clarify confusion around Tennessee’s Medicaid “block grant,” better described as a shared savings model. This model has enabled TennCare to reinvest federal savings into programs like unlimited lactation coverage and the nation’s first Medicaid-funded diaper benefit. Far from a traditional block grant, the TennCare model offers lessons in how states can drive innovation while maintaining accountability. As Mercer echoed, these models provide a framework for aligning funding with frontline needs.
Medicare, HHS Restructuring, and Executive Authority
While Medicaid dominated the discussion, Ribeiro also noted that Medicare wasn’t immune from disruption. A nearly 3% cut to Medicare physician payments quietly passed via continuing resolution, translating to more than 6% in real-dollar reductions after adjusting for inflation. These changes, while less visible than Medicaid policy debates, still deeply affect providers, particularly in outpatient and home health settings.
Amosun expressed concern about operational fallout from HHS restructuring. Staff cuts and program consolidations have created gaps in federal communication, leaving grantees without points of contact or clarity on deadlines. At the same time, some policy themes like increased focus on chronic disease prevention have broad bipartisan appeal. Yet, without operational infrastructure, even well-intentioned policies risk being ineffective.
Advocacy: Urgency and Practical Action
Throughout the panel, speakers stressed the importance of proactive and targeted advocacy. Ribeiro emphasized that industry expertise is not always present in Washington, especially among new congressional staffers, many of whom welcome data-driven input from the field.
Amosun provided a practical tip: email the Office of Management and Budget (OMB) directly to elevate concerns. Mercer encouraged organizations to clearly communicate not only the challenge but the consequence, blending both human and business impacts.
Ribeiro also noted that while industry associations remain essential, there is an increasing need for issue-specific coalitions, especially for subsectors affected differently by policy changes.
The panelists also underscored the administration’s business-minded perspective. Policymakers expect to see clear terms. Presenting data-driven stories that illustrate how a policy change increases efficiency or saves money may resonate more than abstract appeals.
Moving Forward
Despite the uncertainty, the panel closed on notes of optimism. Ribeiro highlighted three areas of emerging alignment in Washington: reducing regulatory burden, investing in value-based care, and focusing on chronic disease prevention through the "Make America Healthy Again" initiative. These shared goals, though pursued through different means, offer a foundation for bipartisan cooperation.
Mercer added that even amid policy volatility, there is broad recognition that reforms must not disproportionately harm vulnerable populations. He echoed a central message from the Delegation: At some point, healthcare always becomes local. Whether it’s community hospital funding, rural access, or Medicaid innovation, local voices and real-world data remain vital in shaping sustainable federal healthcare policy.
Amosun’s closing advice was to follow the evidence, follow the data, and bring that to action even in the midst of an evolving landscape.
As the Council’s Crucial Conversations series continues, this forum provides an invaluable platform for healthcare leaders to share insights, align on messaging, and advocate with urgency and credibility. The next session—focused on private equity in healthcare—promises to dive deeper into the structural and financial forces shaping the sector. Until then, the charge is clear: Stay nimble. Speak up. Lead with data and purpose.
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.
