This week (June 15-19)

The Senate is in session this week while the House is scheduled to be on recess.

Senate Health, Education, Labor & Pensions Committee will hold a legislative hearing on health-related bills.

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

Last week (June 8-12)

Congressional Highlights

Reconciliation 3.0? President Trump on Wednesday (June 10) in a social media post called for a defense funding reconciliation bill that also includes voter ID legislation. He wrote, "I am hereby calling on Republicans in Congress to IMMEDIATELY advance and pass the forthcoming $350 Billion Reconciliation Bill (Recon 3.0) — which, at the request of our Great Department of War — will include THE SAVE AMERICA ACT as well. No games, no delays, and no weak compromises! Do this ASAP." The new insistence on a third reconciliation bill could help propel the measure that has been discussed by House Republican leaders and committee chairs but more coolly received in the Senate, where longtime Republican members Mitch McConnell (R-KY) and Susan Collins (R-ME), the Appropriations Committee Chair, said at a subpanel hearing this week that such a bill wasn't likely. In addition to defense funding and the voter ID proposal, some Republicans envision that a Reconciliation 3.0 bill could include affordability proposals possibly offset with provisions to combat waste, fraud and abuse in federal safety net programs, including federal health care programs. Other policies that have been floated for potential inclusion include expansion of health savings accounts, but there is currently no working set of proposals that has been laid out publicly and many are opposed to including additional health care items at this time.

Administrative Highlights

CMS issues RFI on ACA essential health benefits. On Friday (June 12), CMS issued a request for information that seeks public input on the Affordable Care Act's essential health benefits (EHBs) framework. Specifically, CMS is accepting comments on state's approaches and methodologies used in selecting and updating EHBs, interpretations of EHBs, and more. CMS said it will use the information as it considers updates to EHB regulations. Comments are due 30 days after the RFI is posted in Federal Register, which is scheduled to be June 15.

CMS issues proposed rule to implement fourth round of drug price negotiations. On Friday (June 12), CMS issued a proposed rule that would establish a permanent framework for the Medicare Drug Price Negotiation Program created under the Inflation Reduction Act. For the 2029 initial price applicability year, which marks the fourth cycle of the program, CMS said it will select up to 20 Part B or Part D drugs. The rule also proposes to update a policy used to identify qualifying single source drugs and implement several statutorily required updates, including implementing the Temporary Floor for Small Biotech Drugs. Comments are due 60 days after the RFI is posted in Federal Register, which is scheduled to be June 16. Click here for the fact sheet.

340B Rebate Model Pilot. On Friday (June 12), HRSA's Office of Pharmacy Affairs (OPA) published a notice detailing its intent to introduce a revised 340B Rebate Model Pilot Program that would allow drug manufacturers who wish to participate to implement rebate models for the 340B Drug Pricing Program. The notice seeks information on the collection of drug manufacturer applications, the collection of sales data from manufacturers, and the collection of data submitted by covered entities to request a rebate from manufacturers.

CMS issues guidance on budget neutrality standards for Section 1115 demonstrations. On Thursday (June 11), CMS issued new guidance, required by statute, about its plans to strengthen budget neutrality standards for Medicaid section 1115 demonstrations. Beginning January 1, 2027, the CMS Chief Actuary must certify that a demonstration project is not expected to increase federal spending compared to the state's Medicaid program without the demonstration. The certification will take place for all new demonstrations, demonstration renewals, and demonstration amendments. CMS said it would provide more guidance and technical assistance in future rulemaking.

HHS ramps up hospital price transparency enforcement. On Wednesday (June 10), HHS in a social media post announced it sent 519 hospitals either warning letters or a Corrective Action Plan (CAP) request after reviewing compliance with federal hospital price transparency rules. A list obtained by the Associated Press shows Texas-based hospitals received the most warning letters or CAP requests with 42, followed by California (38) and Indiana (34). Every state except Alaska had at least one hospital receive a warning letter.

Medicare Trustees Report. On Tuesday (June 9), the Medicare Trustees published theirannual report projecting the Medicare Hospital Insurance (HI) Trust Fund would become insolvent in 2033. While the insolvency date is in line with last year's projections, the actuaries also estimated that the funding shortfall has increased by 33% due in part to H.R. 1's changes to income taxes.

DEA issues final rule on opioid treatment and recovery options. On Monday (June 8), the Drug Enforcement Administration (DEA) issued a final rule implementing provisions of the SUPPORT Act and MAT Act. The rule largely codifies and operationalizes statutory changes, including elimination of the DATA/X-waiver and expansion of core MAT providers. It also implements the one-time controlled substance training requirement, which includes provider self-attestation incorporated into DEA registration forms 224/224a.

Judge strikes down new H-1B visa fee. On Monday (June 8), US District Judge Richard Stearns blocked the White House's plan to add a $100,000 fee on H-1B visa applications, labeling the policy an unauthorized "tax" that required congressional approval. The ruling came in a case brought by 20 states who said the fee would harm their ability to hire foreign workers at publicly run institutions, including hospitals.

Hearings, Markups, and Other Committee Activity

House Energy and Commerce Health Subcommittee held a hearing on "Lowering Health Care Costs for All Americans: Examining Policies to Increase Health Care Transparency." On Wednesday (May 20), the House Energy and Commerce Health Subcommittee held a hearing during which lawmakers heard from a panel of witnesses representing a health care transparency platform, employers, academics, think tanks and patient advocates. During the hearing, Republicans largely focused on the usability of transparency and employer tools to lower health care costs, while Democrats emphasized the limits of transparency and need to also address the underlying drivers of health care costs. During the hearing, members and witnesses discussed nine bills intended to increase transparency across health care, with members from both parties expressing support for the Lower Costs More Transparency Act, the Patients Deserve Price Tags Act and legislation to increase ownership transparency.

House Appropriations Committee held a markup of FY 2027 Labor, Health and Human Services, Education, and Related Agencies. On Tuesday (June 9), the Committee voted 34-28, along party lines, to advance the FY 2027 HHS spending bill, which would allocate $110.8 billion to HHS, a roughly 4% cut from the FY 2026 enacted budget. The bill would provide a small budget increase to the National Institutes of Health (NIH), but cut millions of dollars from HRSA, CDC, SAMHSA, and other programs. The bill does not include HHS Secretary Robert F. Kennedy Jr.'s proposal to reorganize the department, but the committee majority said in the report attached to the bill that it supports the effort.

Reports, Studies, and Journals

• HHS Office of Inspector General: Medicare Advantage Organizations Overturned Nearly All Appealed Prior Authorization Denials for Skilled Nursing Facility Admission, Raising Concerns About Initial Denials. The report found that Medicare Advantage organizations overturned 95% of appeals for SNF denials in favor of the enrollee. The report recommends CMS regularly collect request-level prior authorization data that include service type and contractor information.
• Government Accountability Office: Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care. The report found Medicare may have spent about $7.6 billion more on hospice routine home care than it would have under comparable home health payment rates between 2022 and 2024, and recommends Congress take action to revise the hospice payment system to promote payment efficiency.
• Kaiser Family Foundation: How Has Insurer Participation in the ACA Marketplaces Changed in 2026? The analysis found the average number of issuers offering plans in the ACA Marketplaces declined from 9.6 issuers per state in 2025 to 9.0 issuers per state in 2026, but more insurers are now offering plans than were before the enhanced tax credits were introduced in 2021.