This Week (March 31 - April 4)

The House and Senate are both in session this week. Republicans will continue to negotiate a unified budget resolution and discuss reconciliation strategy. The Senate may vote on its unified budget resolution as early as this week, and Senate nomination hearings and confirmation votes are expected to continue.

Senate Judiciary Committee will hold an executive business meeting to discuss prescription drug patent legislation.

• Date: April 3 at 10:15am ET
• More information available here.

House Education and Workforce Committee will hold a hearing on "A Healthy Workforce: Expanding Access and Affordability in Employer-Sponsored Health Care."

• Date: April 2 at 2pm ET
• More information available here.

House Veterans Affairs Subcommittee on Oversight and Investigations will hold a hearing on "Answering the Call: Examining VA's Mental Health Policies."

• Date: Wednesday, April 2 at 2pm ET
• More information available here.

House Energy and Commerce Subcommittee on Health hearing on "Examining the FDA's Regulation of Over-the-Counter Monograph Drugs."

• Date: Tuesday, April 1 at 10:15am ET
• More information available here.

House Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing on "Aging Technology, Emerging Threats: Examining Cybersecurity Vulnerabilities in Legacy Medical Devices."

• Date: Tuesday, April 1 at 10:30am ET
• More information available here.

House Veterans Affairs Committee will hold an oversight hearing on "Harnessing Biomedical Innovation: Modernizing VA Healthcare for the Future."

• Date: Tuesday, April 1 at 10:15am ET
• More information available here.

Last Week (March 24 - 28)

Congressional Highlights

Reconciliation discussions continue. This week, Republicans continued discussions on reconciliation strategy. Senate Majority Leader John Thune (R-SD) said on Wednesday (March 26) he wants the Senate to vote on a compromise budget resolution as soon as next week. He said a determination from the Senate parliamentarian regarding whether the use of a current policy baseline that doesn't require paying for Tax Cuts & Jobs Act (TCJA) extensions will be allowed under reconciliation will be needed before the vote. Sen. Thune also said that the Senate budget resolution will have "different instruction" than the House-passed budget resolution. Speaker Mike Johnson (R-LA) confirmed: "It's not going to align perfectly with the House's … But each side will have their own instructions, and they'll merge it all together." Health care will continue to be a key part of the discussions as the House budget resolution's directions include $880 billion cuts from the House Energy and Commerce Committee which are expected to include Medicaid.

Trump health nominees. On Tuesday (March 25), the Senate voted 56-44 to confirm Martin Makary as FDA commissioner, with three Democrats Sens. Dick Durbin (D-IL) Maggie Hassan (D-NH) and Jeanne Shaheen (D-NH) joining all Republicans in the confirmation. The Senate also voted 53-47, along party lines, to confirm Jay Bhattacharya as NIH director. On Monday (March 24), President Trump nominated acting CDC director Susan Monarez to serve as CDC director after pulling the nomination of former Rep. Dave Weldon (R-FL) in response to Senate Republican opposition. Trump on Monday also nominated Thomas March Bell, to serve as Department of Health and Human Services (HHS) Inspector General. On Tuesday, the Senate Finance Committee voted 14-13 to advance Mehmet Oz's nomination for CMS administrator.

Senate Finance Democrats release reports on drug manufacturer tax policy and MA marketing. On Tuesday (March 25) Senate Finance Democrats released a report on Medicare Advantage marketing practices. The report found that MA plans are increasingly spending on agents and brokers and third-party marketing organizations to enroll beneficiaries and includes eight recommendations to increase oversight of MA marketing practices. On Thursday (March 27), Senate Finance Committee Ranking Member Ron Wyden (D-OR) and other Democrats released a report with findings from a Democrat-led investigation into Pfizer's tax policy and use of round tripping. The report looked at 2019 tax returns and highlighted Pfizer reported $0 in US income, while recording more than $21 billion in global income.

Senate Democrats hold a forum on NIH research cuts. On Monday (March 24), Sens. Tammy Baldwin (D-WI) and Peter Welch (D-VT) hosted a forum that featured a panel of researchers, patients, and former NIH Director Monica Bertagnolli. During the forum, discussion focused on how NIH research cuts or delays of NIH research could negatively impact research into conditions, including cancer and Alzheimer's disease.

Administrative Highlights

HHS unveils layoff, restructuring plan. On Thursday (March 27), the Department of Health and Human Services (HHS) announced a restructuring plan that will reduce full-time HHS employees by about 24% and consolidate the number HHS divisions from 28 to 15 and reduce the number of regional offices from 10 to 5. Under the plan, Food and Drug Administration (FDA) will decrease its workforce by about 3,500, Centers for Disease Control and Prevention (CDC) will decrease its workforce by about 2,400, National Institutes of Health (NIH) will decrease it workforce by about 1,200, and Centers for Medicare and Medicaid Services (CMS) will decrease its workforce by about 300. As part of the restructuring, HHS said it will create a new "Administration for a Healthier America" (AHA) which will consolidate the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH). The effective date for the reorganization is May 27. Click here for a fact sheet. For more details, see attached WCEY Alert - HHS unveils layoff, restructuring plan.

DOJ proposes reorganization plans. On Thursday (March 27), the Washington Post reported that an internal memo from the Department of Justice proposes to merge the Drug Enforcement Administration with the Bureau of Alcohol, Tobacco, Firearms and Explosives. The proposal also suggests closing antitrust division field offices located outside of Washington.

FDA delays Biden-era nonprescription drug rule. On Tuesday (March 25), the FDA announced it has delayed until May 27, the effective date of the Biden Administration's final rule, "Nonprescription Drug Product With an Additional Condition for Nonprescription Use" ("ACNU") that adds new labeling and other requirements for nonprescription drug product with an ACNU.

DOJ launches task force to identify unnecessary antitrust regulations. On Thursday (March 27), the Department of Justice launched an Anticompetitive Regulations Task Force to help identify laws and regulations within the Antitrust Division that create unnecessary barriers to free market competition and harm consumers, workers, and businesses. The Task Force is seeking public comment until May 26 on unnecessary anticompetitive laws and regulations impacting key markets, including health care.

HHS pulls back COVID-19 funding. On Tuesday (March 25), HHS said it will pull back COVID-related funds for state and local public health departments, as well as other organizations. In a statement to STAT News, HHS said, "The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago."

HHS cancels and pauses research grants. Last week, the National Institutes of Health terminated more than 60 research grants to more than 40 institutions on a range of topics, including LGBTQ+ and HIV. While some of the awarded grant money, which totals nearly $40 million, has already been spent, NIH's termination will end future funding under those contracts. A tracker published by HHS shows more than 300 NIH grants have been terminated in full or part since January 21. On March 20, biotechnology company Vaxart announced that HHS' Biomedical Advanced Research and Development Authority (BARDA) had ordered a 90-day halt on a clinical trial for an oral COVID-19 vaccine. NIH said the terminations were made under "departmental authority" and are not related to President Trump's executive orders on gender identity, which are being challenged in court.

Updates on Executive Actions

Trump issues EO to limit federal unionization. On Thursday (March 27), President Trump issued an executive order that seeks to end collective bargaining with federal unions at several federal agencies and subdivisions deemed engaged in national security work, including the Department of Agriculture, Department of Defense, HHS, Department of Justice, Department of State, Veterans Affairs, and USAID.

Trump imposes new tariffs, floats pharmaceuticals tariffs. On Wednesday (March 26), President Trump announced 25% tariffs on imported automobiles, effective April 3, and auto parts no later than May 3. In his statements on the tariffs, Trump has continued to reiterate that tariffs targeting pharmaceuticals will be coming soon.

Updates on legal challenges to previous Trump executive actions. This week, dozens of court cases challenging Trump administration actions continue to progress.

• FTC Commissioner dismissals. On Thursday (March 27), Alvaro Bedoya and Rebecca Kelly Slaughter, the two Democrat FTC Commissioners fired by President Trump on March 18, filed a lawsuit challenging the dismissal. The lawsuit argues that the dismissals violate the FTC Act, which says a commissioner can only be removed by the president for inefficiency, neglect of duty, or misconduct. In a statement posted on X Thursday, FTC Chair Andrew Ferguson said that Trump had the constitutional authority to "remove commissioners from agencies that wield substantial executive power."
• Gender-affirming care. On Friday (March 21), the Department of Justice appealed two separate lower court rulings ordering the Trump Administration to pause funding freezes to health care facilities that provide gender affirming care to youth.
• Federal probationary workers. On Monday (March 24), the Trump administration filed an emergency appeal of a ruling from Judge William Alsup that ordered the rehiring of probationary workers at six Departments, including the VA, in response to a lawsuit brought by federal employees' unions. A second ruling from U.S. District Judge James Bredar that addresses probationary workers at 18 agencies, including HHS, remains in place after an appeals court on March 21 denied the government's motion for a stay pending appeal.

ICYMI: From the Week of March 17-21

Senate bipartisan 340B Working Group. On Friday (March 21), the Senate 340B Working Group announced three new members: Sens. Tim Kaine (D-VA), Markwayne Mullin (R-OK), and John Hickenlooper (D-CO). Sen. Jerry Moran (R-KS) will take over the working group for Sen. John Thune (R-SD) who has transitioned into the role of Senate Majority Leader. Other former members, Sens. Ben Cardin (D-MD) and Debbie Stabenow (D-MI) retired after last session.

Trump signs memo on federal employee dismissals. On March 20, President Trump issued a memorandum that would grant the Office of Personnel Management (OPM) broad authority to fire federal employees, including those at HHS, it deems "unsuitable." The change will need to go through the formal rulemaking process.

Trump admin delays buprenorphine, veterans' telemedicine final rules. On March 20, the Drug Enforcement Administration delayed until December 31 the effective date of two final rules related to remote buprenorphine prescribing and veterans' telemedicine.

President Trump issues EO on domestic preparedness. On March 19, President Trump signed an executive order (EO) that aims to bolster the role of states and localities in resiliency and preparedness. Among other things, the EO directs the Assistant to the President for National Security Affairs to publish a national resiliency strategy within 90 days; review and issue recommendations on critical infrastructure policies, including those related to supply chains, within 180 days; review and issue recommendations on national preparedness within 240 days; and create and national risk register within 240 days. Click here for a fact sheet.

HHS renews opioid public health emergency. On March 18, HHS Secretary Kennedy renewed for 90 days the public health emergency declaration for the nation's opioid overdose crisis.

HHS, FDA announce effort to ensure quality of infant formula. On March 18, HHS and FDA announced a new Operation Stork Speed to ensure the "quality, safety, nutritional adequacy, and resilience of the domestic infant formula supply." As part of the effort, FDA will conduct a nutrient review of infant formula and increase testing for heavy metals and other contaminants.

House Committee launches probe into medical resident hiring. On March 14, Republicans on the House Judiciary Committee's antitrust panel sent letters to hospitals inquiring about whether hiring practices related to residency training programs may be contributing to provider shortages, according to a report from Reuters. The letters have not been publicly posted.

House Democrats launch congressional docs caucus. On March 14, six Democrat members of Congress launched a Congressional Doctors Caucus, including Reps. Ami Bera (D-CA), Herb Conaway (D-NJ), Maxine Dexter (D-OR), Kelly Morrison (D-MN), Raul Ruiz (D-CA), and Kim Schrier (D-WA).

CMS enters negotiation agreements with drug manufacturers. On March 14, CMS announced that it has signed agreements with the manufacturers of the 15 drugs chosen for participation in the second round of Medicare drug negotiations.

Hearings, Markups, and Other Committee Activity

Senate Finance Committee held an "Open Executive Session to Consider Favorably the Nomination of Mehmet Oz, of Pennsylvania, to be Administrator of the Centers for Medicare and Medicaid Services." On Tuesday (March 25), the Committee voted 14-13, with all Republicans voting in favor and all Democrats voting against, to advance Mehmet Oz's nomination for CMS administrator.

• More information available here.

House Veterans Affairs Subcommittee on Health held an oversight hearing on "Breaking Down Barriers: Getting Veterans ACCESS to Lifesaving Care." On Tuesday (March 25), the Subcommittee held a hearing during which the Subcommittee heard from a panel of mental health advocates, families, and behavioral health providers, as well as a panel of representatives from the Veterans Health Administration. During the hearing, Democrats raised concern about the VA's reimbursement rate for community behavioral health providers; fraud, waste, and abuse related to community providers; and layoffs under the Trump administration, while Republicans discussed the need to leverage community providers to address VA wait times.

• More information available here.

House Ways & Means Trade Subcommittee held a hearing on "American Trade Negotiation Priorities." On Tuesday (March 25), the Subcommittee held a hearing during which they heard from witnesses representing cattle feeders, motorcycle manufacturers, service industries, and economists, and academics. The hearing focused on a range of topics with health care and prescription drugs mentioned by Ranking Member Linda Sanchez (D-CA) who said she hopes new trade agreements with partner s would help provide access to medicines and safeguard intellectual property rights and Rep. Lloyd Doggett (D-TX) who raised concerns about corporate tax policy and US taxes paid by drug manufacturers.

• More information available here.

Reports, Studies, and Journals

Congressional Budget Office: Federal Debt and the Statutory Limit, March 2025. The report projects that based on current law the US would likely reach the debt limit X-date in August or September, with the potential for the US to reach the X-date by late May or June if tax receipts are below expectations.

Congressional Budget Office: The Long-Term Budget Outlook: 2025 to 2055. The report provides projections for federal spending from 2025 to 2055, showing spending on Medicare will account for 5.2% of the gross domestic product (GDP by 2055 and spending on Medicaid, CHIP and premium tax credits will account for 2.9%.

American Journal of Preventive Medicine: The Impact of "The Real Cost" on E-cigarette Initiation among U.S. Youth. An FDA study estimated that the agency's "The Real Cost" campaign successfully prevented 450,000 youth from starting to use e-cigarettes between 2023 and 2024.