This week (June 16-20)

This week, the House will be in recess and the Senate is scheduled to be in session Monday through Wednesday, with work continuing on the reconciliation bill.

Last week (June 9-13)

Congressional Highlights

Reconciliation update. This week, the Senate continued work on the House-passed One Big, Beautiful Bill Act (OBBBA, H.R. 1) to extend Tax Cuts & Jobs Act (TCJA) provisions expiring at the end of 2025 and cut mandatory spending. On Tuesday (June 10), the Senate Health, Education, Labor, and Pensions (HELP) Committee released its portion of the reconciliation legislation that includes a provision in the House bill to fund cost-sharing reduction payments for Affordable Care Act plans, as well as changes limiting funds for federal student aid programs, including those for medical education. The Senate Finance Committee, which has jurisdiction over Medicaid, taxes, and the Affordable Care Act, could release its language as soon as today. The legislation may undergo further revisions as the Senate parliamentarian reviews whether all provisions meet the requirements, known as Byrd rules, of the budget reconciliation process. Negotiations will continue into this week before the bill is considered on the Senate floor.

President Trump and Republican congressional leaders are still working toward the goal of enacting the bill by July 4. Senate Majority Leader Thune (R-SD) is working toward Senate consideration the week of June 23, which would leave time for the House to vote on the Senate's version of the bill before the holiday. However, any hiccup in the process could delay those target dates.

House passes recissions package. On Thursday (June 12), the House voted 214-212 to pass a $9.4 billion recissions package that rescinds $8.3 billion for foreign aid, including funding for health programs within US Department of State and US Agency for International Development (USAID) and the President's Emergency Plan for AIDS Relief (PEPFAR) funding. The Senate has until July 12 to pass the package or the funding remains on the federal books.

Senators release bipartisan report on organ donation. On Tuesday (June 10), Senate Finance Committee Ranking Member Ron Wyden (D-OR) and Sen. Chuck Grassley (R-IA) published a bipartisan report, detailing the findings of their investigation into organ procurement organizations and policy recommendations.

Administrative Highlights

HHS replaces all ACIP members. On Monday (June 9), HHS Secretary Robert F. Kennedy Jr. published an op-ed in the Wall Street Journal announcing the immediate removal of all 17 members of the Advisory Committee for Immunization Practices (ACIP), an independent advisory committee that makes vaccine recommendations for the Centers for Disease Control and Prevention (CDC) to consider. On Wednesday (June 11), the HHS Secretary announced eight new members of ACIP, including prominent vaccine critics. The new members are scheduled to attend the upcoming June 25-27 meeting where they will consider recommendations for several vaccines, including COVID-19 vaccines, HPV vaccine, influenza vaccines, meningococcal vaccine, RSV vaccines for adults, and RSV vaccine for maternal and pediatric populations. ACIP recommendations adopted by CDC and listed on Immunization Schedules generally are required to be covered by group health plans and health insurance issuers offering group or individual health coverage without imposing any cost-sharing requirements.

Trump admin to hold joint listening sessions on drug competition. On Wednesday (June 11), the Federal Trade Commission and the Justice Department's Antitrust Division, along with the Department of Commerce and the HHS, announced three joint listening sessions to discuss ways to make prescription drugs more affordable for Americans by promoting competition and address anti-competitive practices.

FDA leaders outline future vision. On Tuesday (June 10), FDA Commissioner Marty Makary and Center for Biologics Evaluation and Research Director Vinay Prasad published a JAMA article that outlines the FDA's priorities on accelerating cures, advancing AI, improving the US food supply for children, harnessing big data, lowering drug costs. The article also describes a new pilot pathway to frontload much of the paperwork at the beginning of the application process.

White House issues memo on Medicaid waste, fraud, and abuse. On Friday (June 6) the White House issued a memorandum that directs the HHS Secretary to eliminate waste, fraud, and abuse in Medicaid including by ensuring Medicaid state directed payments do not exceed Medicare rates. The Office of Management and Budget (OMB) is currently reviewing a CMS rule on Medicaid Managed Care-State Directed Payments. Under the current rules, the payments can reach the average commercial rate. Under a provision in HR 1, state directed payments would be similarly capped for Medicaid expansion states, while non-expansion states would be capped at 110%.

Court Highlights

Equity and DEO: On Monday (June 9), the US District Court for the Northern District of California issued a partial injunction that prevents the Trump administration from enforcing certain provisions of EOs on gender ideology, DEI, and merit-based opportunity against the parties who brought the suit. The parties include health centers and other organizations that work with the LGBTQ community. The injunction applies to the equity termination provision, which directs agencies to terminate federal funding for all equity-related grants or contracts and the gender termination and gender promotion provisions, which direct agencies to terminate funding for any programs that promote gender ideology.

Hearings, Markups, and Other Committee Activity

Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing on "A Review of the President's Fiscal Year 2026 Budget Request for the National Institutes of Health." On Tuesday (June 10), the Subcommittee heard testimony from NIH Director Jay Bhattacharya on President Trump's proposed fiscal year (FY) 2026 budget request for the agency. During the hearing, both Republicans and Democrats raised concerns with the administration's proposal to reduce the NIH budget by approximately 40%, with full committee Chair Susan Collins (R-ME) calling the proposal "disturbing." Chair Collins also spoke critically of the NIH's proposed 15% cap on indirect costs, though Republicans generally emphasized the need to ensure NIH funding is spent on research as opposed to indirect costs to universities. Several Democrats also raised concerns about grant funding delays and terminations. During the hearing, NIH Director Bhattacharya spoke about the need to reform the agency to "restore our reputation among the American people and address the chronic disease crisis" and affirmed his commitment to working with Congress.

• More information available here.

House Energy and Commerce Committee held a hearing on "Strengthening Domestic Manufacturing and the Health Care Supply Chain." On Wednesday (June 11), the Subcommittee held a hearing on US health care supply chain resiliency. During the hearing, both Republicans and Democrats agreed that US reliance on "adversarial" nations for its drug supply chain presents national security risks and risks to patients, with Republicans applauding the Trump administration's actions to bring manufacturing back to the US and Democrats criticizing its cuts to research entities and tariff policies. Lawmakers and witnesses discussed a range of ways to ensure a resilient supply chain through onshoring and near-shoring, geographic diversification, and US manufacturing investment. During the hearing, lawmakers and witnesses also discussed drug shortages impacting critical generic drugs with witnesses saying the US needs to address incentives for purchasing generic drugs and transition to long-term federal purchasing contracts for essential medicines

• More information available here.

House Appropriations Committee held a markup of the FY 2026 Military Construction, Veterans Affairs (VA), and Related Agencies appropriations bill. On Tuesday (June 10), the Committee approved along party lines the FY 2026 Military Construction, Veterans Affairs (VA), and Related Agencies appropriations bill, which provides funding for the VA. The bill would provide $59 billion in medical services, a $15 billion decrease over FY 2025 enacted levels, and $38.7 billion in medical community care, a $4.7 billion increase compared to FY 2025 levels. The Committee also voted to approve amendments related to VA suicide prevention programs and additional resources for the Veterans Crisis Line.

• More information available here.

House Appropriations Committee held a markup of "FY 2026 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Bill." On Wednesday (June 11), the Committee concluded its markup without voting on the FY 2026 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Bill after Republican and Democratic members debated the proposal to cut funding for FDA and several proposed amendments.

• More information available here.

Treasury Secretary Scott Bessent testified before both the House Ways and Means Committee and Senate Finance Committee. During both hearings, Treasury Secretary Bessent spoke optimistically about tariff discussions with China and during the Senate Finance Committee hearing said the EU has been "intractable in negotiations." But ultimately, he expressed optimism about reaching agreements likening the current disputes to sibling fighting. While health care was rarely mentioned, the topic of pharmaceutical manufacturing was raised briefly in each hearing. During the Senate Finance Committee hearing, Treasury Secretary Bessent spoke about using tariffs to bring pharmaceutical manufacturing back to the US. During the Ways and Means Committee hearing Treasury Secretary Bessent again said we need to bring pharmaceutical manufacturing back to the US and noted that the US drug supply chain's reliance on China gives China "negotiating leverage."

• More information available here.

Reports, Studies, and Journals

• Congressional Budget Office: Monthly Budget Review: May 2025. CBO said "the government's ability to borrow using extraordinary measures would probably be exhausted between mid-August and the end of September 2025," or about two weeks later than the agency had estimated in March.

• MACPAC: June 2025 Report to Congress on Medicaid and CHIP. The annual report includes chapters on transitions from pediatric to adult care, residential behavioral health treatment services for children, access to medications for opioid use disorder in Medicaid, the Program of All-Inclusive Care for the Elderly, and Medicaid home- and community-based services.
• MedPAC: June 2025 Report to Congress: Medicare and the Health Care Delivery System. The annual report includes chapters on physician fee schedule payment reform, supplemental benefits and home healthcare use in Medicare Advantage, Medicare Part D prescription drug plans, Medicare beneficiaries in nursing homes, Medicare rural provider quality measurements, and cost sharing for outpatient services at critical access hospitals.