This week (May 25-29)

Both the House and Senate are in recess this week for Memorial Day. This Week in Health Policy will not publish during the recess.

Last week (May 18-22)

Congressional Highlights

Reconciliation 2.0. The Senate postponed until after the one-week Memorial Day recess the "vote-a-rama" process of limitless amendment votes and a final vote on the Reconciliation 2.0 bill funding the Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) agencies, over internal Republican disagreements on issues including security enhancements for President Trump's proposed White House ballroom and the newly announced $1.8 billion "anti-weaponization" fund. The current reconciliation bill is expected to remain focused on immigration and ICE and CBP funding, leaving health care discussions for future legislative action. Health care items could surface during discussions regarding a potential reconciliation 3.0, but those talks are currently in the early stages. President Trump set a June 1 deadline for getting the ICE/CBP bill to his desk — a deadline Republicans will no longer be able to meet.

Senate Democrats signal focus on long-term care. On Wednesday (May 20), Senate Finance Committee Ranking Member Ron Wyden (D-OR) led a group of 17 Senate Democrats in a Dear Colleague letter that details their intent to develop policies that aim to improve home care affordability and access, improve care quality in nursing homes, and strengthen the long-term care workforce.

Senate HELP Chairman loses primary race. On Sunday (May 17), Sen. Bill Cassidy (R-LA), chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, lost his Louisiana primary race. The outcome guarantees a change in leadership at the HELP Committee next Congress, which has jurisdiction over non-Medicare and non-Medicaid public health activities and biomedical research, including those at NIH, FDA, and the CDC.

Select Committee letter on biotech. On Wednesday (May 21), Select Committee on China Chairman John Moolenaar sent a letter to Secretary of Treasury Scott Bessent requesting the addition of biotechnology as a prohibited technology under the Comprehensive Outbound Investment National Security (COINS) Act of 2025. The letter cites a rise in American capital and intellectual property entering China's biotechnology sector.

Administrative Highlights

HHS announces new fraud initiative. On Thursday (May 21), HHS announced a department-wide program integrity effort designed to hold states and grantees accountable for persistent audit noncompliance. The initiative called AERO — the Audit Enforcement and Risk Oversight — will leverage AI to conduct a comprehensive, ongoing analysis of single audit information across all 50 states examining at least five years of audit history.

CMS issues proposed rule on state-directed payments. On Wednesday (May 20), CMS issued a proposed rule to implement the One Big Beautiful Bill Act's reductions to state-directed payments (SDPs) and proposal additional program integrity measures to address waste, fraud and abuse within Medicaid. Under the proposed rule, SDP provider payment rates would be capped at 100% of Medicare payment rates for expansion states and 110% of Medicare payment rates for non-expansion states, in line with statute, and proposes to expand the limits to all SDPs for services in all states beginning or after January 1, 2029. The rule also would apply limits to certain Medicaid fee-for-service payments and make various other changes to allowable SDP design. If finalized, CMS estimates the rule would generate an estimated $775 billion in total savings over 10 years, including $510 billion in federal savings. CMS is accepting public comments on the rule for 60 days following publication in the Federal Register. Click here for the fact sheet.

HHS Secretary fires USPSTF leaders. On Wednesday (May 20), several media outlets reported that HHS Secretary Robert F. Kennedy Jr. fired U.S. Preventive Task Force Chair John Wong and Deputy Chair Esa Davis. The task force, which has seen several meetings cancelled this year, serves as an independent panel of experts who make recommendations for coverage of preventive services.

TrumpRx expands to generics. On Monday (May 18), the White House announced more than 600 generic medications have been added to TrumpRx.gov and that the Administration has partnered with Amazon Pharmacy, Cost Plus Drugs, and GoodRx to include their discounted prices. Patients may be able to use their insurance at CostPlus or Amazon Pharmacy, but they still can't do so for brand-name drugs offered on TrumpRx.

Supreme Court declines pharma challenge to Medicare drug price negotiation program. On Monday (May 18), the Supreme Court declined to hear six petitions from drug manufacturers challenging lower court rulings upholding the Medicare drug price negotiation program, created by the Inflation Reduction Act. While the Court's decision largely ends the six cases, other challenges from Merck, PhRMA, AbbVie and Teva Pharmaceuticals remain pending in lower courts.

HHS restructures Office for Civil Rights. On Monday (May 18), HHS announced plans to reorganize the Office for Civil Rights, which serves as the Department's law enforcement agency to enforce laws, and restore its focus on conscience and religious freedom. As part of the reorganization, the Office will create three divisions: Conscience and Religious Freedom; Civil Rights; and Health Information Privacy, Data, and Cybersecurity.

Hearings, Markups, and Other Committee Activity

House Energy and Commerce Health Subcommittee held a hearing on "Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms." On Wednesday (May 20), the Subcommittee held a hearing during which members heard from a panel of witnesses representing independent physicians and accountable care organizations. During the hearing, there was bipartisan consensus that the Medicare physician fee schedule has not kept up with inflation or the cost of operating an independent practice. Witnesses noted that this payment structure is contributing to hospital acquisition of independent physician practices and urged Congress to incorporate an inflationary adjuster to the Medicare physician fee schedule. Several lawmakers expressed support for legislation that would tie Medicare physician payments to the Medicare economic index (MEI). Lawmakers and witnesses also said the current Medicare physician fee schedule does not appropriately reimburse primary care providers for managing chronic conditions over extended periods of time and spoke about the discrepancy in payments between primary care and specialty providers, noting that current reimbursement rates are contributing to the primary care physician workforce shortage. Members of the GOP and Democratic Doctors Caucuses said they are working together on a bipartisan Medicare physician reimbursement package that would increase Medicare payment, invest in primary care, and reduce administrative burden for doctors.

House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions held a hearing on "Bad Medicine: Politics, Unions, and Antisemitism in Health Care." On Wednesday (May 20), the Subcommittee held a hearing during which they heard testimony from individuals representing civil rights attorneys, cardiologists, and the Jewish community. The hearing focused on reports of antisemitism in health care settings and among medical labor unions, with individuals sharing stories of Jewish doctors, residents, nurses, and medical students who have been negatively impacted.

House Education and Workforce Committee held a markup of legislation. On Thursday (May 21), the Committee advanced five bills, including three related to pharmacy benefit managers and employer benefits:

• Form 5500 Filing Simplification Act (H.R. 7362), was advanced as amended by a roll call vote of 22-12.
• PBM Kickback Prohibition Act (H.R. 7895), was advanced as amended by a roll call vote of 34-0.
• Transparency in Billing Act of 2026 (H.R. 8684), was advanced as amended by a roll call vote of 34-0.

House Ways and Means Committee held a markup of "Anti-Fraud, Health, and Social Security Legislation." On Thursday (May 21), advanced eight bills, including seven related to health care:

• The Ensuring Community Access to Pharmacist Services Act (H.R. 3164), was advanced as amended by voice vote. Among other things, the amendment retitled the bill to Main Street Pharmacy Access Act.
• The Provider Reimbursement Stability Act of 2026 (H.R. 8163), was advanced as amended by a roll call vote of 44-0.
• The Improving Home Dialysis Act of 2026 (H.R. 8875), was advanced by a roll call vote of 28-13.
• The Protecting Seniors and Stopping Fraudsters Act (H.R. 8883), was advanced as amended by a roll call vote of 27-16.
• The DME Scammer Prevention Act of 2026 (H.R. 8871), was advanced as amended by a roll call vote of 25-19.
• The Removing Barriers to Work for Disabled Americans Act (H.R. 8884), was advanced by a roll call vote of 27-16
• The Preventing Waste, Fraud, and Abuse in TANF Act (H.R. 8872), was advanced by a roll call vote of 23-19.

House Energy and Commerce Committee held a markup of 16 bills. On Thursday (May 21), the Committee reported to the Full House 16 bills, including several related to health care:

• The Accelerating Access to Dementia and Alzheimer's Provider Training (AADAPT) Act (H.R. 3747), was advanced by a roll call vote of 48-0.
• The School-Based Health Centers Reauthorization Act of 2026 (H.R. 8209), was advanced by a roll call vote of 46-0.
• The Stem Cell Therapeutic and Research Reauthorization Act of 2025 (H.R. 5160), was advanced as amended by a roll call vote of 46-0.
• To amend the Public Health Service Act to reauthorize a grant program for addressing dental workforce needs (H.R. 2001), was advanced as amended by a roll call vote of 44-0.
• The DeOndra Dixon INCLUDE Project Act of 2025 (H.R. 3491), was advanced by a roll call vote of 46-0.
• The NIH IMPROVE Act (H.R. 6238) was advanced as amended by a roll call vote of 46-0.
• The Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026 (H.R. 8205), was advanced as amended by a roll call vote of 46-0.
• The FDA Modernization Act 3.0 (H.R. 2821), was advanced by a roll call vote of 44-0.
• The Health Care Efficiency Through Flexibility Act (H.R. 5347), was advanced by a roll call vote of 44-0.
• The Choices for Increased Mobility Act of 2025 (H.R. 1703), was advanced by a roll call vote of 45-0.

Senate Appropriations Committee held a hearing on "The President's Fiscal Year 2027 Budget Request for the National Institutes of Health." On Thursday (May 21), the Committee held a hearing during which members heard testimony from NIH Director Jay Bhattacharya on the agency's proposed budget for FY 2027. During the hearing, Democrats questioned how NIH can continue to lead in research amid staff and funding reductions. Sen. Tammy Baldwin (D-WI) and others also raised concerns about leadership within the agency, with Sen. Baldwin noting that Jeffery Taubenberger, the acting director of the National Institute of Allergy and Infectious Disease had stepped down from his role.

Reports, Studies, and Journals

• Government Accountability Office: Artificial Intelligence: A Framework to Assess U.S. Competitiveness and Inform Policy Options. The report details a framework for identifying policy options that policymakers could use to improve U.S. competitiveness in AI, including in research and development, workforce, and businesses.
• HHS Office of Inspector General: Impacts of Vertical Integration in Medicare Part D on Sponsors' Drug Costs, Pharmacy Reimbursement, and Enrollee Cost Sharing. The report states that the Part D market is highly concentrated and found that Part D enrollees in plans offered by vertically integrated Part D sponsors paid lower monthly premiums but substantially higher drug out-of-pocket costs. The report said there was insufficient data to determine the impact of vertical integration on pharmacies.