This week (February 16-20)

Both the House and Senate are scheduled to be in recess this week.

Last week (February 9-13)

Congressional Highlights

Congressional Democrats release report on TrumpRx. On Friday (February 13), Democrats on the Joint Economic Committee released a report that found a family could pay nearly $2,500 per year in higher prescription drug costs by using TrumpRx, as opposed to GoodRx. The report analyzes the price differences between several drugs listed on TrumpRx and the prescription drug comparison tool GoodRx, finding that more than a dozen drugs listed on TrumpRx have a lower-cost generic alternative.

Members of Congress send bipartisan letter on provider H-1B visa fee exemptions. On Wednesday (February 11), Reps. Michael Lawler (R-NY) and Yvette Clarke (D-NY) and a group of 100 lawmakers sent a letter to US Department of Homeland Security (DHS) Secretary Noem, calling for her Department to exempt the health care sector from the new $100,000 H-1B visa fee. The letter states that the fee would exacerbate workforce shortages, destabilize financially strained hospitals, and diminish access to care in rural and urban communities across the country.

Senate Republicans urge DOJ action on ACA subsidy fraud. Sen. John Cornyn (R-TX) and 14 other Senate Republicans sent a letter to the Department of Justice (DOJ), calling on the Department to pursue civil remedies to recover ACA premium tax credits that flowed to insurers "due to fraudulent, unauthorized or improper enrollment" in the plans.

House committee seeks data on ACA subsidy fraud. On Monday (February 9), the House Judiciary Committee issued subpoenas to eight health insurers, seeking information on fraud and fraud-protection measures related to the ACA's premium tax credits.

Administrative Highlights

HRSA issues RFI on new 340B rebate model. On Friday (February 13), the Health Resources and Services Administration (HRSA) issued a request for information on a potential 340B rebate model pilot program following the administration's agreement to vacate the prior model. HRSA is inviting comments on a range of issues, including operational and financial concerns related to rebate models; reliance interests in continuing to obtain the 340B ceiling prices; potential cash-flow impacts; proposed alternatives, scope limiting measures; and more. Comments are due March 19.

Payers agree to align with CMS ACCESS Model. On Thursday (February 12), CMS announced that health plans representing 165 million Americans across coverage markets have voluntarily pledged to offer payment arrangements that align with the core principles of the ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model. The ACCESS Model, which is set to launch in July 2026, will test an outcome-based payment approach in Medicare for technology-supported care management and prevention. CMS said it plans to release "optional alignment resources" for payers in the near future.

FDA approves label changes for HRT products. On Thursday (February 12), the FDA announced it has approved drug labeling changes for six hormone replacement therapy (HRT) products. The update remove risk statements related to cardiovascular disease, breast cancer and probable dementia.

ONC/ASTP announce efforts on interoperability. On Wednesday (February 11), Office of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP/ONC), announced that nearly 500 million health records have been exchanged through the Trusted Exchange Framework and Common Agreement (TEFCA), up from about 10 million in January 2025. The announcement also states that ASTP/ONC is in the process of "notices of potential non-conformity" to certain developers of certified health IT related to information blocking.

States get brief reprieve in CDC funding cuts. On Wednesday (February 11), California, Colorado, Illinois and Minnesota filed a lawsuit against the Trump administration over its plans to cut $602 million in CDC funding from the states. The lawsuit argues that the funding cuts violate the Administrative Procedure Act and exceed federal agencies' statutory authority by imposing retroactive conditions on previously awarded funding. The judge on Thursday (February 12) granted the states a temporary-restraining order, blocking the cuts for 14 days.

CMS issues ACA exchange proposed rule. On Monday (February 9), CMS issued the Plan Year (PY) 2027 Notice of Benefit and Payment Parameter (NBPP) Proposed Rule. Among other changes, the rule includes updates needed to align regulations with changes in H.R. 1, also known as the One Big Beautiful Bill Act (OBBBA), and builds on changes finalized in the 2025 Marketplace Integrity and Affordability rule. If finalized, the proposed rule would make substantial changes to ACA exchange plan eligibility rules, benefit designs, verification requirements, marketing practices, and more. CMS in the rule also requests comment on other potential changes to the medical loss ratio standard and implementation of pre-eligibility verification requirements under the OBBBA. CMS in the proposed rule estimates the changes would lower average enrollment in exchange plans by up to 2 million people for 2027. Overall, CMS says it expects proposed changes would improve the health of the risk pool and result in a net premium reduction of up to 1.8% for 2027. The rule is open for public comment through March 13. Click here for the press release, Click here for the fact sheet, Click here for the proposed rule.

Hearings, Markups, and Other Committee Activity

House Energy and Commerce Health Subcommittee held a hearing on "Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain." On Wednesday (February 11), the Subcommittee held a hearing during which members heard testimony from a panel of nine witnesses, including eight executives of associations whose members are part of the pharmaceutical drug supply chain and an academic. During the hearing, members asked questions on a range of topics to better understand the drivers of drug prices including competition, vertical consolidation, price transparency, biosimilar interchangeability, PBM practices, and more. While most members praised the recent enactment of bipartisan PBM reforms, they said that more needs to be done to improve the affordability of prescription drugs, without jeopardizing innovation. The witnesses all highlighted the ways in which their member companies work to lower patients' drug costs, and pointing to other stakeholders for the increased costs

• More information available here.

Senate Aging Committee held a hearing on "The Doctor Is Out: How Washington's Rules Drove Physicians Out of Medicine." On Wednesday (February 11), the Committee held a hearing during which they heard from a panel of witnesses representing providers and provider advocacy groups who spoke on the topic of physician burnout. During the hearing, members and witnesses raised concerns about unsustainable administrative burdens and other factors driving physician burnout. Lawmakers and witnesses discussed several potential reforms, including expanded access to mental health resources and alternative care models such as direct primary care.

• More information available here.

Reports, Studies, and Journals

• Congressional Budget Office: The Budget and Economic Outlook: 2026 to 2036. CBO updated its budget and economic outlooks to account for the One Big Beautiful Bill Act, tariffs, and other factors, finding that annual deficits will grow from $1.9 trillion in FY 2026 to $3.1 trillion in 2036. The report also projected that health care provisions in the OBBBA will reduce Medicaid enrollment by 12.9 million and will increase the number of uninsured by 7.5 million in 2034.
• Kaiser Family Foundation: Hospital Spending Accounted for 40% of the Growth in National Health Spending Between 2022 and 2024. The analysis of national health expenditure data shows hospital spending accounted for the largest portion of CMS' national health care expenditures between 2022 and 2024, and grew by 20% during that time period, outpacing the growth rate for total health spending.
• Congressional Research Service: Litigation over State Attempts to Lower Drug Costs: Prescription Drug Affordability Boards (PDABs). The report concluded that federal lawmakers could address legal questions regarding states' prescription drug affordability boards by amending federal patent laws to rebalance market incentives and clarify whether and how states can regulate drug pricing.