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Week Ahead: Senate on Deck

Date: June 2, 2025

Congress returns to Washington following weekend storms in the D.C. area. The forecast this week calls for potentially clearer skies and a busy week for both Congress and the White House. With that, let’s get into it. Welcome to the Week Ahead!

The Administration

Nearly a month after releasing its FY 26 skinny budget, the Department of Health and Human Services (HHS) has released its FY 26 Budget in Brief, which outlines a massive reorganization and shuttering of existing agencies to align with the administration’s “Make America Healthy Again” agenda.

As hard as issuing a budget request is, the real work is just beginning. Sec. Kennedy will now need to defend the full budget request against attacks from critics who argue that the reorganization is nothing more than a cut in disguise. Along with explaining the potentially bogus science in the recently published MAHA Report and plans to start publishing scientific research in-house, Sec. Kennedy has his work cut out for him.

The Senate

Senate Republicans return to Washington with only 13 legislative days to pass their version of the “One Big Beautiful Bill Act” before the self-imposed July 4 deadline. However, there are a lot of questions about how the Senate will move forward and what changes might be made to the bill. Some questions include:

What will the Byrd Bath look like? The House-passed bill includes several provisions that may not pass the Senate’s Byrd Rule, which prohibits the inclusion of provisions unrelated to the federal budget. This could kill House provisions such as a moratorium on state regulations on artificial intelligence, a ban on courts enforcing certain injunctions, and language defunding Planned Parenthood.

Will the Senate make changes to address concerns from fiscal hawks? The House bill would increase the debt limit by $4 trillion and extend borrowing authority beyond the 2026 midterms. That’s enough for Sen. Rand Paul (R-KY) to reject the bill. Additionally, Sen. Ron Johnson (R-WI) has called for more cuts if he is to support the bill. Other fiscal hawks may balk at the recent Congressional Budget Office estimate that the House bill’s tax changes would increase the deficit by $3.8 trillion.

Will the Senate bump back Medicaid work requirements? To appease House Freedom Caucus members, the implementation date for Medicaid work requirements was moved forward from 2029 to 2026. However, concerns have been raised by some, including Sen. Lisa Murkowski (R-AK), that it will be challenging for some states, including hers, to meet the new timetable.

Will the Senate remove Medicaid copays? Sen. Josh Hawley (R-MO) has criticized the House bill’s Medicaid copay provision as a “hidden tax on working poor people trying to get health care.” Other Republicans who supported Democratic amendments to protect Medicaid, like Murkowski and Sen. Susan Collins (R-ME), may share his concerns.

Will the Senate change the Medicaid provider tax provision? The House bill prohibits states from putting in place new provider taxes and freezes existing provider taxes at current rates. However, some Republicans, such as Sen. Hawley, have expressed concerns about how that provision of the House bill will impact their states.

Will we see committee markups? Initially, it sounded like the Senate might skip the committee process altogether. However, more recently, our intelligence from the Hill suggests committees such as the Senate Finance Committee might want to mark up the Senate bill. That opens the door for more proposed changes to the bill and slows things down for Republicans looking to get this bill passed.

Will the SALT deduction be touched? House Republicans from high-tax states fought hard to increase the cap on how much their constituents can deduct from federal income taxes. Senate Republicans don’t have the same incentive to defend this provision, given that they generally represent lower-tax states.

Senate Health Care Hearings

June 4: Senate HELP hearing on reauthorization of the over-the-counter monograph drug user fee program

The House

The House Appropriations Committee is kicking off the markup process for FY 26. First up are subcommittee markups for the funding bills for the Department of Veterans Affairs and the Food and Drug Administration on June 5.

Members of the House Appropriations Ag and FDA subcommittee won’t have much time to review the recently released FDA budget request before its June 5 markup. FDA highlights include:

$3.2B in discretionary budget authority (11.4% decrease from FY 25). FDA justifies this by:

Consolidating work to focus on core functions

Reducing the number of full-time equivalents by 1,940

$3.6B in user fees (4% increase over FY 25)

$234.6M to support MAHA efforts related to chronic disease and food.

If the past is any gauge, we expect Republican members of the subcommittee to praise FDA’s efforts to address chronic disease rates by improving food quality and safety, and Democratic members to criticize planned reductions in force and funding cuts as a threat to public health.

Other House Health Care Hearings

June 3: House Rules Committee meeting to consider the SUPPORT for Patients and Communities Reauthorization Act

June 5: House Appropriations Interior and Environment Subcommittee hearing on FY 26 Indian Health Service Budget Request

There You Have It

It’s graduation season, so we wanted to take a moment to say congratulations to the class of 2025. Make it a great week!

Convening a Coalition

Date: May 28, 2025

Launching a coalition is an exciting step toward advancing meaningful policy change—but the real work begins once the group comes together. Coalitions require more than shared goals; they demand structure, coordination, and compromise. To be effective, coalition members must align on principles, stay organized, and understand how to best support one another’s strengths. This post explores the essential elements of building and managing a successful policy coalition—from setting ground rules to driving actionable outcomes.

Building and Managing a Successful Policy Coalition

Forming a coalition is a powerful way to advance a policy agenda—but success depends on how well the coalition is organized, aligned, and activated. From setting shared principles to leveraging individual strengths, a well-run coalition can be greater than the sum of its parts. Below are key strategies for building and managing an effective coalition.

Establish Policy Agreement and Ground Rules

The foundation of any successful coalition is mutual agreement on core policy principles. At the outset, it is essential that all members buy into a simple but important tenet: you must give a little to get a lot. Coalitions often falter when partners overreach or become too rigid in their demands. Instead, focus on defining key policy goals and the parameters the group will work within. Building consensus early on helps avoid unnecessary conflict later and ensures the group can speak with one voice.

Prioritize Strong Administration

Good ideas will not go far without strong organization. Set a consistent cadence for meetings—whether weekly, biweekly, or monthly—to maintain momentum. Make sure to capture and distribute meeting notes to help refresh ideas, keep members accountable, and track progress over time. This structure allows members to stay focused and productive between meetings and ensures the group continues to move forward.

Leverage the Strengths of Your Partners

Each coalition partner brings something unique to the table. One group might have expertise in policy analysis and drafting, while another excels at grassroots organizing, digital advocacy, or legislative outreach. Understanding your partners’ strengths allows you to delegate effectively and play to each member’s comparative advantage. This not only builds trust but also maximizes the coalition’s collective impact.

Define Action Items and Next Steps Clearly

Before each meeting, have a clear idea of what outcomes you’re aiming to achieve. If you’re hoping for agreement on a particular action item, guide the discussion strategically toward that goal. Anticipate possible objections and be prepared to adjust the conversation without losing sight of your objective. At the end of each meeting, assign responsibilities and clarify next steps to keep the coalition on track and moving toward its shared policy goals.

Chamber Hill Strategies

When it comes to coalition building, Chamber Hill Strategies stands out among lobbying firms in DC. Our comprehensive approach helps clients achieve their advocacy goals. With strong relationships on Capitol Hill and a track record of shaping health policy, we turn complex challenges into real-world wins.

Let our expertise in Washington, DC guide your efforts towards successful and meaningful stakeholder engagement. Look for our next blog about successfully identifying the right partners.

Sec. Kennedy Testifies at Senate Appropriations Subcommittee on FY 26

Date: May 22, 2025

On May 20, 2025, the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing on the FY26 budget request for the Department of Health and Human Services (HHS). Much like Sec. Kennedy’s appearances before the House Labor-HHS and Senate Health, Education, Labor, and Pensions Committees on May 14, members asked questions about the proposed HHS reorganization, Medicaid, and rural health care. Also, like in the prior hearings, many Republican members praised Kennedy’s “Make America Health Again” (MAHA) agenda. Democrats criticized Sec. Kennedy for reducing HHS’s workforce, expressed concerns about proposed funding cuts in FY 26, and argued that Republicans were trying to cut Medicaid benefits under the reconciliation bill.

OPENING STATEMENTS

Subcommittee Chair Shelly Capito (R-WV)

WITNESS TESTIMONY

Sec. Robert Kennedy Jr.

MEMBER DISCUSSION

HHS Reorganization and Withholding Funds

As was the case with previous hearings on the FY 26 budget request, much of the focus was on HHS’s reorganization and concerns about the withholding of funds. Appropriations Committee Chair Susan Collins (R-ME) asked about the impact of the reorganization on funding for the Centers for Disease Control and Prevention’s (CDC) brain injury program. Sec. Kennedy explained that his attorneys instructed him not to comment on that matter due to ongoing legal action against the administration’s actions. Subcommittee Chair Shelly Moore Capito (R-WV) asked about the impact of the reorganization on clinical trials. Sec. Kennedy assured her that the trials were not being cut. Subcommittee Ranking Member Tammy Baldwin (D-WI) expressed concerns about specific HHS funding that had been appropriated but not yet distributed. Sen. John Kennedy (R-LA) defended the reorganization by pointing out that large companies, such as Microsoft and Meta, have continued to function after undergoing restructuring and layoffs.

FY 26 HHS Budget Request Details

Subcommittee Ranking Member Baldwin and Sen. Patty Murray (D-WA) pressed for more specifics about the President’s FY 26 HHS budget request. Specifically, Ranking Member Baldwin asked when she could expect a detailed plan for the 530 programs that currently lack designated funding amounts in the proposed budget. Sec. Kennedy replied that those decisions are being made by the Office of Management and Budget (OMB) and framed the issue as a government-wide matter rather than an HHS-specific one. Ranking Member Baldwin also raised alarm over withheld funds to the National Institutes of Health (NIH) research, particularly in immunotherapy, citing a $3 billion drop in awarded funding and a decrease in grants. She asked who was responsible for holding the grants. Sec. Kennedy responded by saying that gene therapy is a priority. When Sen. Baldwin asked if the Department of Government Efficiency (DOGE) was reviewing the cuts, he reiterated a focus on cutting waste and fraud. Sen. Patty Murray (D-WA) questioned whether HHS was required to submit an operating plan outlining how every program would be run, including funding levels. She requested a comprehensive version, citing the need to understand which programs would be cut and how taxpayer dollars were being allocated.

Medicaid

Sens. Jack Reed (D-RI) and Jeff Merkley (D-OR) raised concerns about proposed Medicaid changes in the reconciliation legislation, stating that the proposed changes would lead to millions of people losing health coverage. These Senators inquired about the rationale behind these cuts. Sec. Kennedy responded with the same arguments he made last week that the reductions were not outright cuts but rather decreases in the rate of program growth. He emphasized that the changes were intended to eliminate waste, fraud, and abuse, claiming that people are stealing from the Medicaid program. He further argued that able-bodied men who refuse to work are contributing to the strain on the program.

Rural Health Care

Subcommittee Chair Capito raised concerns about how the administration’s proposed budget cuts could impact rural health care programs, asking Sec. Kennedy how his reorganization plan would improve conditions in rural America. Kennedy acknowledged that rural health is one of the most frequently raised issues. He noted that many rural hospitals are closing and emphasized their importance as economic drivers in their communities. He mentioned ongoing discussions with leading health technology companies to help address the issue.

Sen. John Boozman (R-AR) highlighted that cancer remains a leading cause of death and pointed out the lack of designated cancer centers in rural areas. He asked how HHS could improve patient outcomes and better support rural regions. Kennedy agreed that access to cancer treatments is necessary and acknowledged the challenges. Sen. Boozman further emphasized that rural counties face serious barriers, with many providers struggling to keep their doors open. He referenced the upcoming Farm bill and asked how to help build strong health infrastructure in those communities. Sec. Kennedy pointed to several programs under the Health Resources and Services Administration (HRSA), including the 340B drug pricing program. He recognized its significance to hospitals and rural health efforts and added that a revolution in AI could bring significant advancements. This is the second time that Sec. Kennedy has expressed his understanding that the 340B program is important to rural hospitals.

Sen. Brian Schatz (D-HI) brought attention to the fact that rural Americans are less likely to receive preventive health care. He questioned whether the administration’s stance on Diversity, Equity, and Inclusion (DEI) would limit the ability to understand how different populations respond to different types of care. Kennedy replied that this was not a DEI issue, citing he is working with Sen. Tim Scott (R-SC) on the delivery of a new sickle cell treatment to all who suffer from the disease in South Carolina as an example of an effort to ensure equitable care.

OTHER TOPICS

Sen. Jerry Moran (R-KS) raised concerns about the measles outbreak in Kansas and the need for support for individuals with mental health disabilities. He also expressed his support for the BOLD Act.
Sen. Jeanne Shaheen (D-NH) asked for a commitment to preserving the state opioid grant program, emphasizing its importance. She was assured it remains a priority, though past efforts to address the opioid crisis were acknowledged as insufficient.
Committee Chair Collins asked if there would be support to restore the Leadership Education in Adolescent Health (LEAH) program and aid for low-income families.
Sen. Kennedy questioned why processed foods were allowed to be sold in America. Sec. Kennedy responded that the food industry profits on poisoning children.

Summary of FY26 HHS Budget Hearings featuring Secretary Robert F. Kennedy Jr.

Date: May 21, 2025

Over the past two weeks, Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. testified before several Congressional committees regarding the FY26 HHS budget request, including the Senate Appropriations Subcommittee on Labor-HHS, the House Appropriations Subcommittee on Labor-HHS, and the Senate Committee on Health, Education, Labor, and Pensions (HELP). These hearings covered a wide range of topics, including HHS reorganization, Medicaid changes, vaccine policies, chronic disease, rural health, research funding, and the broader Make America Healthy Again (MAHA) agenda. The hearings marked the first round of Congressional review of the FY26 request.

Budget Request Priorities and Testimony Highlights

In his testimony, Sec. Kennedy highlighted the administration’s focus on reducing chronic disease and increasing operational efficiency. The FY26 budget proposal includes:

Consolidating mental health programs to better address rising rates of mental illness and substance use.

Prioritizing nutrition, physical activity, and exercise, with $94 billion requested for the Administration for a Healthy America (AHA).

Expanding FDA food safety efforts.

Cutting research deemed redundant, dangerous, or overly focused on DEI metrics.

Leveraging AI and other technologies to improve health data management and service delivery.

Restoring public trust in federal health agencies.

HHS Reorganization and Withholding Funds

The reorganization of HHS drew criticism from Democrats. Democrats, including Sen. Tammy Baldwin (D-WI) and Rep. Rosa DeLauro (D-CT), raised alarms about funds appropriated by Congress being withheld, particularly for NIH immunotherapy research. Sec. Kennedy defended the actions as part of a larger effort to cut waste and emphasized OMB’s role in making final funding decisions. He stated that while legal action prevents him from commenting on specifics like the CDC brain injury program, all actions are intended to increase agency efficiency. Sen. Susan Collins (R-ME) and others expressed concern about funding uncertainty impacting key health initiatives.

HHS Workforce Reductions

Reductions in the HHS workforce were another flashpoint. Sec. Kennedy stated that he and his staff made the final decisions, though Elon Musk offered informal guidance. Rep. Steny Hoyer (D-MD) and Sen. Tim Kaine (D-VA) pressed for clarity on the decision-making process, while Democrats questioned whether Congress had been consulted. Republicans largely defended the cuts as part of broader government reform efforts.

Medicaid

Democratic lawmakers criticized the proposed Medicaid reforms included in the reconciliation bill, arguing the changes would significantly reduce coverage for vulnerable populations. Sec. Kennedy, joined by Republicans like Rep. Andy Harris (R-MD), countered that the reforms would reduce fraud, eliminate waste, and target coverage toward eligible recipients. Provisions such as work requirements for non-disabled adults and limits on care for undocumented immigrants were especially contentious.

Chronic Disease

Members across party lines acknowledged the importance of addressing chronic disease. While Republicans praised Kennedy’s Make America Health Again (MAHA) initiative, Democrats objected to cuts at Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of Minority Health. Sec. Kennedy characterized the changes as a realignment, not a reduction. Sen. Jon Husted (R-OH) expressed enthusiasm for MAHA’s direction, and Sen. Tim Scott (R-SC) advocated banning artificial dyes in foods.

Rural Health

Rural health care emerged as a significant theme. Lawmakers highlighted hospital closures and provider shortages. Sec. Kennedy pointed to partnerships with health tech firms and AI applications as potential solutions. He cited support for Health Resources Services and Administration (HRSA) programs like 340B and mentioned efforts to improve access to cancer treatments and preventive care. Sen. Brian Schatz (D-HI) raised equity concerns regarding DEI rollbacks, which Kennedy dismissed, citing bipartisan efforts to ensure equitable access, such as sickle cell treatment expansion in South Carolina.

Vaccines

Amid a growing measles outbreak, Democratic lawmakers pressed Kennedy on his stance on vaccines. Although Kennedy acknowledged public mistrust and concerns, he ultimately affirmed that the measles vaccine is the most effective means of prevention. He emphasized that his recommendations are based on multiple sources.

Other Topics