20 January 2026 This Week in Health Policy for January 19 The Senate is on recess next week, but the House will be in session with several hearings on the schedule, including two featuring CEOs of several health insurance companies. House Energy and Commerce Health Subcommittee will hold a hearing on "Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability."
House Budget Committee will hold a hearing on "Reverse the Curse: Skyrocketing Health Care Costs and America's Fiscal Future."
Latest on expired enhanced ACA premium tax credits. The Senate adjourned this week without a deal on the enhanced Affordable Care Act (ACA) premium tax credits (PTCs) that expired at the end of December. A bipartisan group of lawmakers has been working to reach a compromise on legislation to lower coverage costs, but they do not appear to be close to releasing a proposal and without the White House's support any deal could struggle to pass. The open enrollment period for the federal ACA marketplace closed on Thursday (January 15), though some state-run marketplaces have longer enrollment periods. Trump calls on Congress to enact the Great Healthcare Plan. On Thursday (January 15), President Trump unveiled the Great Healthcare Plan, which does not include an enhanced ACA tax credit extension, and instead, calls on Congress to lower health insurance premiums by enacting policies that redirect the enhanced ACA tax credits to consumers instead of insurance companies. Sen. Bill Cassidy (R-LA) and other lawmakers have proposed leveraging health savings accounts (HSAs) to provide individuals with direct funds. President Trump's plan also calls for increasing transparency into coverage costs and medical prices, funding cost sharing reduction payments, and enacting pharmacy benefit manager (PBM) reforms, the latter of which the Senate Finance Committee may be revisiting. In addition, the plan calls on Congress to lower drug prices by codifying the Administration's Most Favored Nations drug pricing deals with pharmaceutical companies and increase access to over-the-counter medications. The plan, which was more of a framework or blueprint, did not include specific policy details, leaving those to Congress to iron out. In a video message, President Trump said, "I'm calling on Congress to pass this framework into law without delay — have to do it right now so that we can get immediate relief to the American people," Sen. Cassidy in a post on X spoke in support of Trump's plan and said the Senate HELP Committee "has and will take action on the President's affordability agenda." While the plan includes some bipartisan policy ideas, such as PBM reform and price transparency, Republicans in Congress have generally opposed policies that would set prices for the pharmaceutical industry, such as Most Favored Nations policy, and Democrats have historically raised concerns about expanding HSAs, which could present obstacles to passage. Reconciliation 2.0. On Tuesday (January 13), the Republican Study Committee released a framework for a potential second reconciliation bill that focuses on affordability and includes several policy proposals intended to lower health care costs, including site neutral payments, pharmacy benefit manager reform, codifying TrumpRx, and funding cost-sharing reduction payments. FY 2026 appropriations. Government funding for several federal agencies, including the Department of Health and Human Services (HHS), and health extenders, such as Medicare telehealth flexibilities, expire on January 30. The House and Senate this week have continued to work through the remaining appropriations, sending a three-bill package (Commerce, Justice, Science/Energy and Water Development/Interior and Environment) to President Trump's desk. The remaining appropriations bills include the more controversial bills: Labor-HHS, Department of Homeland Security (DHS), Defense and Transportation-HUD. Appropriators are expected to release the final four bills at the beginning of next week. The House is scheduled to be out of session the last week in January. That raises the question of whether members will need to patch some funding through a continuing resolution (CR) or change the recess schedule, to avoid a partial government shutdown. SAMHSA terminates, then reinstates nearly $2B in grants. On Wednesday (January 14), the Substance Abuse and Mental Health Services Administration (SAMHSA) reinstated nearly 3,000 substance use disorder and mental health services grants worth nearly $2 billion that had been terminated the day before as part of the Administration's efforts to realign around the President's priorities. The reversal came after strong pushback from Congress, including more than 100 bipartisan House members, and advocacy groups. DOJ backs off appeal of 340B rebate model pilot. On Monday (January 12), the Trump Administration signaled it may drop its appeal of a legal challenge that has delayed the January 1, 2026 launch of the 340B rebate model pilot. In a court filing, the Department of Justice said it is engaged in negotiations with the American Hospital Association — who filed the suit — and several health systems and that it "intends to resolve such proceedings promptly." FDA issues draft guidance on Bayesian methodologies. On Monday (January 12), the FDA issued draft guidance on the use of Bayesian methodologies, which call for leveraging previous studies and data, in trials of drugs and biological products. The draft guidance will be open for comment for 60 days. House Veterans' Affairs (VA) Health Subcommittee held a hearing on several health bills. On Tuesday (January 13), the Subcommittee held a hearing to discuss 12 bills intended to expand access to mental health care for veterans, increase research brain injury, increase access to care for veterans living in rural areas, and require the VA to create a new provider directory. Senate Health, Education, Labor and Pensions (HELP) Committee held an executive session to consider several health-related bills. On Thursday (January 15), the Committee unanimously advanced four bills, each of which passed by a 22-0 vote. The bills would expand research on lung cancer for women, require HHS to issue guidance on fentanyl testing, increase rural hospital cybersecurity, and increase reporting on contaminants in infant formula.
Senate HELP Committee held a hearing on "Protecting Women: Exposing the Dangers of Chemical Abortion Drugs." On Wednesday (January 14), the Committee heard from a panel of witnesses, including the attorney general of Louisiana, a senior fellow focused on ethics and culture at the Indiana University School of Medicine, and a reproductive health physician in Georgia. During the hearing, Republicans calls on the FDA to reinstate more stringent safety rules for medication abortion drugs, while Democrats spoke in favor of the existing rules, which do not require a face-to-face encounter.
House Ways and Means Committee held a markup of bills. On Wednesday (January 14), the Committee advanced four bills, including the Supporting Pregnant and Parenting Women and Families Act (H.R. 6945), which would ensure faith-based pregnancy centers continue to have access to TANF funding. The bill passed the Committee in a 25-18 vote.
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