This week (December 15-19)

The House and Senate are both scheduled to be in session this week, with the Senate expected to hold a vote on the House-passed NDAA and the House expected to vote on a health care bill.

House Energy and Commerce Oversight and Investigations Subcommittee will hold a hearing on "Examining Biosecurity at the Intersection of AI and Biology."

• Date: Wednesday, December 17 at 10:15AM ET
• More information available here.

House Veterans' Affairs Subcommittee on Technology Modernization Oversight Hearing will hold a hearing on "Ready, Set, Go-Live: Assessing VA's EHR Modernization Deployment Readiness."

• Date: Monday, December 15 at 3PM ET
• More information available here.

Joint Economic Committee will hold a hearing on "Stop Paying More for Less: Realigning Healthcare Incentives to Improve Outcomes and Reduce Costs."

• Date: Wednesday, December 17 at 2:30PM ET
• More information available here.

Last week (December 8-12)

Congressional Highlights

ACA enhanced premium tax credit expiration looms. On Thursday (December 11), the Senate failed to pass a Democratic bill (S. 3385 ) to provide a three-year extension of the enhanced Affordable Care Act (ACA) premium tax credits (PTCs) expiring at the end of this month, as well as a Health Savings Account (HSA)-based Republican alternative (S. 3386 ) crafted by Senate Finance Committee Chair Mike Crapo (R-ID) and HELP Committee Chair Bill Cassidy (R-LA). The vote tally for both bills was 51-48, falling short of the 60 votes required for passage. Republican Sens. Susan Collins (R-ME), Josh Hawley (R-MO), Lisa Murkowski (R-AK), and Dan Sullivan (R-AK) voted in favor of the Democratic bill (S. 3385). Sen. Rand Paul (R-KY) joined Democrats in opposing the GOP alternative (S. 3386).

With the Senate stalled, bipartisan negotiations could see an uptick, though Congress is set to depart for the holidays at the end of next week and any potential deal may need to wait until January. The House is expected to vote next week on a GOP health package that would allow employers to offer workers tax-advantaged funds to pay for individual health insurance through custom health option and individual care expense (CHOICE) arrangements, fund cost-sharing reduction payments, enable small employers to form association health plans to offer coverage, and increase transparency for pharmacy benefit managers.

House passes National Defense Authorization Act. On Wednesday (December 10), the House voted 312-112 to pass the conference agreement for the FY 2026 National Defense Authorization Act (S. 1071 ). While the bill primarily authorizes appropriations and sets policies for the Department of Defense (DOD), it also includes several health-related policies, including the BIOSECURE Act, expiring and new health care programs for DOD employees and their dependents and other updates related to biotech, Tricare benefits, and AI and more. The Senate is expected to take up the bill next week.

Administrative Highlights

Trump signs AI executive order. On Thursday (December 11), President Trump signed an executive order that seeks to limit the ability of states to regulate artificial intelligence (AI) while taking aim at existing state AI laws. The order directs Attorney General Pam Bondi to create a "Litigation Task Force" within 30 days whose purpose is to challenge State AI laws that the administration deems excessive. The order also instructs Commerce Secretary Howard Lutnick to identify existing state laws that "require AI models to alter their truthful outputs." States that have such laws on the books may have to enter into agreements not to enforce them in order to receive discretionary federal funding. The order tasks senior White House officials like AI/crypto "czar" David Sacks with drafting recommendations for congressional legislation that would preempt state laws regulating AI.

HHS announces new fitness standards for federal public health workers. On Friday (December 12), HHS launched the PHS Mission Fit, an initiative that will set expectations for physical fitness standards and impose two annual physical fitness test for U.S. Public Health Service (USPHS) Commissioned Corps members.

CMS unveils new lifestyle model. On Thursday (December 11), CMS announced the "Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence," or MAHA Elevate, model. The voluntary model will test interventions like physical activity, nutrition and other wellness-focused strategies that are not covered by Medicare currently and gather cost and quality data to inform future policy. The model will provide approximately $100 million to fund 3-year cooperative agreements for up to 30 pilot projects that promote health and chronic disease prevention for traditional Medicare beneficiaries.

CMS proposes updates to IOTA model. On Thursday (December 11), CMS published a proposed rule with updates to the Increasing Organ Transplant Access (IOTA) Model for performance year two, which will begin on July 1, 2026. The updates include new transparency requirements, the removal of the voluntary health equity plan requirement and all health-equity-related provisions, changes to the timing of downside payments, and more. The rule also includes requests for information (RFIs) on a "future access to waitlist quality process measure," policies to address allocation out-of-sequence concerns, and the inclusion of MA beneficiaries in the model. Comments are due February 9, 2026.

FDA issues RFI on TRT for men. On Thursday (December 11), the FDA issued an RFI on testosterone replacement therapy (TRT) for men, seeking public input on indications, dosing, route of administration, duration of treatment, and goals of treatment. Comments are due on February 9, 2026.

Trump Admin announced new efforts to improve food. Wednesday (December 10), Secretary of Agriculture Brooke Rollins, HHS Secretary Robert F. Kennedy Jr., and the CMS Administrator Mehmet Oz announced a regenerative pilot program to improve U.S. farmers' soil health and the approval of six state waivers to remove unhealthy foods from the Supplemental Nutrition Assistance Program, or SNAP. Both efforts are aligned with HHS' MAHA initiative.

CMS publishes guidance on OBBBA provisions. On Monday (December 8), CMS published an information bulletin to provide states with information on the One Big Beautiful Bill Act's (OBBBA) Medicaid work requirements ahead of future rulemaking, including applicable individuals, exclusions and exceptions, outreach, and more.

On December 9, the Department of the Treasury and the Internal Revenue Service issued guidance on provisions that extend HSA eligibility to individuals with bronze and catastrophic plans and direct primary care service arrangements and expand HSA benefits to include telehealth before the deductible.

CMS publishes ACA enrollment report. On Friday (December 5), CMS released an update on ACA open enrollment that showed nearly 950,000 consumers who do not currently have individual market Marketplace coverage have signed up for coverage since the start of open enrollment on November 1.

Hearings, Markups, and Other Committee Activity

Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on "Examining the Future of the U.S. Organ Procurement and Transplantation Network." On Thursday (December 11), the Committee held a hearing to discuss ways to improve the organ procurement system, with Republicans speaking in favor of policies to increase transparency, increase competition, and improve accountability. Democrats, meanwhile, spoke about addressing disparities in access impacting minorities and vulnerable populations.

• More information available here.

House Judiciary Subcommittees on Oversight and on the Administrative State, Regulatory Reform, and Antitrust held a hearing on "Fighting Obamacare Subsidy Fraud: Is the Administrative Procedure Act Working as Intended?" On Wednesday (December 10), the Subcommittee held a hearing centered on the ACA's enhanced PTCs. During the hearing, Republicans raised concerns about a recent Government Accountability Office report that found evidence of fraud in exchange enrollments. Democrats and some Republicans spoke of the importance of immediately extending the enhanced PTCs to avoid significant increases in premiums for enrollees while broader reforms are pursued.

• More information available here.

Senate Homeland Security and Governmental Affairs Permanent Subcommittee on Investigations held a hearing on "Defining Our Health Care Problem, and Principles We Should Follow To Solve It." On Wednesday (December 10), the Subcommittee held a hearing during which members discussed the factors contributing to premium increases. Republicans discussed how the ACA's design is contributing to rising premiums and discussed alternative policies, including federally funded HSAs, exempting health care spending from taxes, implementing high-risk pools, and more. Democrats also acknowledged the need for broader reforms but said lawmakers must first extend the enhanced PTCs to avoid coverage losses.

• More information available here.

House Oversight and Government Reform Subcommittees held a joint hearing on "Lowering the Cost of Healthcare: Technology's Role in Driving Affordability." On Wednesday (December 10), the Subcommittees on Economic Growth, Energy Policy, and Regulatory Affairs and on Health Care and Financial Services discussed ways in which innovative technologies can help lower health care costs. During the hearing, members also discussed the looming expiration of the ACA's enhanced PTCs with Democrats in favor of extending and Republicans largely in favor of alternatives.

• More information available here.

House Ways and Means Committee held a markup of legislation. On Wednesday (December 10), the Committee advanced several bills, including unanimously advancing the Joe Fiandra Access to Home Infusion Act (HR 4993), which would expand Medicare coverage to include external infusion pumps and non-self-administrable home infusion drugs.

• More information available here.

House Energy and Commerce Subcommittee on Commerce, Manufacturing and Trade held a hearing on "Legislative Solutions to Protect Children and Teens Online." On Thursday (December 11), the Subcommittee voted along party lines to advance two bills that include provisions to protect children from online content that could harm their mental health. The Subcommittee voted 13-10 to advance the Kids Online Safety Act (HR 6484) and 14-10 to advance Children and Teens' Online Privacy Protection Act (H.R. 6291), with Democrats voting against the measures.

• More information available here.

Reports, Studies, and Journals

• Government Accountability Office: VA Electronic Health Record Modernization: Critical Actions Needed to Support Accelerated System Deployments. The report outlines 18 recommendations to improve cost estimating, schedule, program management, user adoption and satisfaction, and operational testing of the VA's EHR modernization efforts.
• Government Accountability Office: Medical Device Recalls: HHS and FDA Should Address Limitations in Oversight of Recall Process. The report provides two recommendations for HHS and FDA to improve the medical device recall system.
• Congressional Research Service: Work Requirements: Comparison of Medicaid and Supplemental Nutrition Assistance Program (SNAP) After P.L. 119-21. The report provides an overview of the Medicaid and SNAP programs reflecting the provisions included in the OBBBA.