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On April 29, 2025, the House Energy and Commerce Committee held a Markup of 6 health care bills. The health care bills focused on a variety of topics including funding for opioid recovery and treatment, research for lung cancer, regulation of human cell and tissue products, and changing the law to allow caregivers to pick up their patient’s medications. All of these bills were advanced to the House floor.
OPENING STATEMENTS
- Chairman Brett Guthrie (R-KY) praised the committee’s efforts to reauthorize and enhance programs addressing substance use disorders, protect seniors’ access to prescription medications, prevent discrimination in organ transplants for individuals with disabilities, and improve safety standards for human cell and tissue products. Guthrie highlighted the SUPPORT for Patients and Communities Reauthorization Act.
- Ranking Member Frank Pallone (D-NJ) criticized Republican colleagues for what he described as partisan approaches to health legislation. He expressed concern that certain bills under consideration lacked adequate funding increases and failed to address critical issues such as public health data improvements and medical supply chain vulnerabilities. Pallone emphasized the importance of bipartisan cooperation to effectively support public health initiatives and ensure comprehensive preparedness for future health emergencies.
LEGISLATION INCLUDED IN THE MARKUP
- H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025 (Reps. Guthrie and Petterson): This bill would reauthorize key parts of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, which was signed into law in 2018. This reauthorization would include public health programs focused on prevention, treatment, and recovery for patients with substance use disorder. Passed 36-13 with amendment.
- H.R. 1520, Charlotte Woodward Organ Transplant Discrimination Prevention Act (Reps. Cammack, Dingell, Issa, and Wasserman Schultz): This bill would prohibit health care providers and other entities from denying or restricting an individual’s access to organ transplants solely on the basis of the individual’s disability, except in limited circumstances. Passed 46-1.
- H.R. 2319, Women and Lung Cancer Research and Preventive Services Act of 2025 (Reps. Boyle and Fitzpatrick): This bill would require the Department of Health and Human Services (HHS) to conduct an interagency review on the status of, and identify research related to, women and underserved populations with lung cancer. The review would include assessments of current research and access to prevention services, the availability of research opportunities regarding prevention, detection, and treatment, and recommendations for national public education and screening strategies. Passed by voice vote.
- H.R. 1669, To amend the Public Health Service Act to reauthorize the Stop, Observe, Ask, and Respond to Health and Wellness Training Program (Reps. Cohen and Buddy Carter ): This bill would reauthorize the Stop, Observe, and Respond (SOAR) to Health and Wellness Training Program for five years. The SOAR to Health and Wellness Act was originally signed into law in 2018 and authorizes resources to help build capacity in local communities to identify and respond to the various needs of individuals who have experienced trafficking. Passed by voice vote.
- H.R. 1082, Shandra Eisenga Human Cell and Tissue Product Safety Act (Reps. Moolenaar and Dingell): This bill would require the Secretary of HHS to conduct a national education campaign to increase public and health care provider awareness regarding the potential risks and benefits of human cell and tissue product transplants. It would also direct the Food and Drug Administration (FDA) to take additional steps to streamline regulatory oversight of human cell and tissue products, including by publishing educational materials, best practices, and other relevant information related to FDA’s Tissue Reference Group, as well as by conducting workshops and other educational sessions for relevant stakeholders and establish a public docket for related comments. Lastly, the bill would require the Secretary of HHS to report to Congress with recommendations for modernizing the regulation of human cell and tissue products. Passed by voice vote.
- H.R. 2484, Seniors’ Access to Critical Medications Act (Reps. Harshbarger and Wasserman Schultz): This bill would amend the physician self-referral law to permit Medicare patients to receive prescription drugs through caregivers picking up drugs on the patient’s behalf, through the mail, or by couriers delivering the drug to the patient in instances when a provider prescribes a drug to be dispensed by a pharmacy that falls under the self-referral law’s definition of an in office ancillary service. Current law prohibits such arrangements for Medicare beneficiaries. The amendments made by this bill would be implemented on January 1, 2026, and sunset on December 31, 2030. Passed 38-7.
Since its passage in 2014, the Protecting Access to Medicare Act (PAMA) has had a significant impact on the health care landscape—particularly in how clinical laboratory services are reimbursed under Medicare. While PAMA aimed to modernize the payment system by tying lab test reimbursement rates to market data, the implementation has been fraught with challenges. Now, Congress is revisiting PAMA with bipartisan calls for reform—efforts that could shape the future of diagnostic testing and access to timely care.
What PAMA Was Meant to Do
PAMA was designed to create a more accurate, market-based pricing model for clinical laboratory tests. By collecting private payer rates from a sample of laboratories, the Centers for Medicare & Medicaid Services (CMS) would set Medicare reimbursement rates that better reflect the actual market value of lab services.
However, in practice, the data collection process under PAMA has been criticized for being both incomplete and unrepresentative. Large national labs dominated the data submissions, while many smaller and hospital-based labs—where a significant portion of testing occurs—were left out. As a result, CMS reimbursement rates have plummeted for many essential lab tests, putting smaller labs at financial risk and potentially limiting patient access to critical diagnostics.
Delays in Data Reporting and Reimbursement Cuts: A Legislative Lifeline
Recognizing the problematic rollout of the data collection process, Congress has repeatedly stepped in to delay upcoming data reporting requirements and postpone associated reimbursement cuts. These legislative delays have provided temporary relief to the clinical laboratory community and bought time to pursue more permanent reforms.
Originally, PAMA required applicable laboratories to report private payer data every three years, with each reporting period leading to updated—and often lower—payment rates. However, the COVID-19 pandemic and growing bipartisan concerns over the fairness of the system led Congress to pass several delays, including:
- Coronavirus Aid, Relief, and Economic Security (CARES) Act (2020) – Delayed the reporting period and postponed cuts.
- Consolidated Appropriations Act (2022) – Further delayed cuts scheduled for 2023 and pushed back the next reporting cycle to 2024.
Most recently, additional delays passed in late 2023 have suspended further reductions and postponed the next data collection deadline, which was expected to trigger another round of cuts. Without these interventions, laboratories could have seen reimbursement slashed by up to 15% for hundreds of common diagnostic tests—at a time when the healthcare system is still recovering from pandemic-related disruptions.
These legislative pauses have prevented a downward spiral of access and affordability. However, they are stop-gap measures. According to the American Laboratory Association (ACLA), long-term stability in lab reimbursement requires structural changes to the PAMA framework, not just short-term legislative patches.
Congressional Reform Efforts
A top priority for ACLA is comprehensive change to PAMA through enactment of the Saving Access to Laboratory Services Act (SALSA) which aims to:
- Establish a more statistically valid and representative approach to data collection.
- Protect labs from steep year-over-year reimbursement cuts.
- Ensure better oversight and transparency in how rates are determined.
Bipartisan, bicameral support for SALSA highlights a shared understanding that accurate diagnostics are foundational to effective treatment and patient care. However, likely cost to the federal government associated with enactment of comprehensive reform has been a barrier to passage. Whereas, yearly short term legislative delays in data reporting and reimbursement cuts have resulted in budget savings. In fact. Congress has stepped in six times to delay the data reporting period and five times to delay further cuts.
Looking Ahead
As Congress deliberates reforms to PAMA, cost will continue to be a driving factor determining further action. Without action, clinical labs will again face reimbursement cuts of up to 15% on January 1, 2026. While enactment of comprehensive reform to PAMA will continue to be a top priority for ACLA and the clinical lab industry, given legislative history and congressional pressure to limit congressional outlays, Congress is again most likely to pass another short term patch to prevent the impending cuts.
Congress is back in town, and the race is on to meet House Speaker Mike Johnson’s ambitious goal of passing a budget reconciliation bill by Memorial Day. Meanwhile, the Trump administration is busy with plans to change civil service classification and restructure the Department of Health and Human Services. So, with that, let’s get into it. Welcome to the Week Ahead!
The Administration
The Treasury Department is expected this week to provide an estimate of when the X Day will occur – the day on which the federal government will have exhausted its ability to pay its bills. This date is expected to be sometime in the summer or early fall of 2025.
Remember, Republican leaders in Congress included raising the debt ceiling in the reconciliation bill they are trying to pass. An earlier X Day means an earlier deadline for when Congress would need to raise the debt ceiling.
The Trump administration is also dealing with the fallout of a leaked copy of the proposed fiscal year 2026 (FY 26) budget for HHS to the Washington Post. Health care advocacy groups are concerned about the proposed $80B in cuts to discretionary spending, plans to eliminate funding for several agencies and programs, and the restructuring of several parts of the department into a new “Administration for a Healthy America.” The official budget is expected in May, and the president’s proposed budget is just that, a proposal that Congress can change or even ignore.
Proposed cuts to spending and reorganizing federal agencies are nothing new for an administration’s budget proposals. However, these proposals hit differently coming from an administration that has not been shy about exerting executive branch authority to move forward with its agenda. Case in point: the Trump administration plans to move forward with a plan to reclassify civil servants to make it easier for them to be removed.
The Senate
We don’t have dates yet for the Senate committee markups for their budget reconciliation legislation, but they are under pressure to get a reconciliation bill passed by Memorial Day. We are paying particular attention to the Senate Committee on Health, Education, Labor, and Pensions (HELP), as this committee has been instructed to find at least $1 billion in savings over ten years.
Senate Hearings
- April 29: Senate Veterans’ Affairs Committee hearing on veterans’ mental health
- April 30: Senate Appropriations Committee hearing on biomedical research
The House
The House Committees on Armed Services, Education and Workforce, and Homeland Security will kick off the reconciliation markup process on April 29. House Energy and Commerce Committee is still working to find $880B in savings including what and how much Medicaid spending will be cut.
Based on conversations with the Hill, Republican leadership thinks it can get to $500B over ten years by addressing “waste, fraud, and abuse” within the Medicaid program, according to previous work from the Government Accountability Office.
Other potential sources of savings within the Medicaid program that have been mentioned include work requirements, changes to provider taxes, and penalties on states that provide care for undocumented immigrants. Republicans are saying other non-Medicaid policies, such as cuts to Medicare Advantage plans and policies to address Medicare reimbursement for physicians, are unlikely for reconciliation but could come later in the year.
House Hearings
- April 29: House Education & Workforce Committee markup of reconciliation directives and H. Res. 344, a resolution directing President Trump and HHS Sec. Kennedy to provide documents related to the elimination of the Administration for Community Living
- April 29: House Energy and Commerce Committee markup of 6 health care bills (not reconciliation)
- April 29: House Veterans’ Affairs Health Subcommittee hearing on reforming state veterans homes
- April 30: House Veterans’ Affairs Oversight and Investigations Subcommittee hearing on the VA’s mental health policies
- April 30: House Education & Workforce HELP Subcommittee hearing on ERISA
There You Have It
If you need a break from betting on the likelihood that Congress will pass a reconciliation bill by Memorial Day, the 151st Kentucky Derby takes place on May 3. Do you have plans to watch? Make it a great week!
The way health care is legislated in the U.S. is spread out between multiple committees in Congress. What this means is that getting comprehensive bills passed is a power chess game among the committees, requiring negotiation and knowledge.
As Congress considers legislative action to reform Medicaid, Medicare, and other health care priorities in this Congress, it’s important to understand a committee’s “jurisdiction.” The jurisdiction of each Senate committee is specified in Senate Rule XXV, while each House committee draws from House Rule X. Below you can find each congressional committee’s jurisdiction over health policy, along with a brief description of each committee’s role, issues that each committee covers, and the recent activities of each committee.
Senate Finance Committee
This committee, in addition to various issues related to taxation and trade, oversees health programs under the Social Security Act, such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), Temporary Assistance to Needy Families (TANF), and other programs financed by a certain tax or trust fund. The committee also shares or has sole jurisdiction over numerous departments and agencies, including the Department of Health and Human Services (HHS) (which includes the Centers for Medicare and Medicaid Services), and the Social Security Administration. The committee is additionally tasked with reviewing nominations for the HHS Secretary, the CMS Administrator, and other high-ranking appointed positions with HHS and other departments under its jurisdiction. Furthermore, the committee oversees employer-sponsored insurance per the Employee Retirement Income Security Act of 1974.
Recent Activity: Leaders of the Senate Finance Committee are working on how, and even if they want, to address the $2.3 trillion dollars of spending cuts passed in the budget resolutions. There hasn’t been much time this year to address health care in the committee’s legislative agenda given the Committee has been busy with President Trump’s cabinet nominations and trade negotiations.
Senate Health, Education, Labor, and Pensions Committee
Commonly abbreviated as “HELP,” this committee has wide jurisdiction over health care, education, labor and retirement policies, and public welfare. Broadly speaking, the issues it deals with entail biomedical research and development, public health, and occupational health. The HELP Committee also has jurisdiction over matters within the Food, Drug, and Cosmetics Act, including user fees, and the Commissioner of Food and Drugs is subject to the committee’s nomination process.
Recent Activity: Almost all of the committee’s work so far this year has been regarding cabinet and agency-level nominations from the new Trump administration. However, they have been active in the reconciliation process, tasked with identifying $4 billion in spending cuts over ten years. Chairman Bill Cassidy (R-LA) and six Republican senators formed a working group to draft legislation aimed at restructuring the Center for Disease Control and Prevention to better respond to public health needs. The committee is also monitoring proposed changes to the CDC’s Advisory Committee on Immunization Practices (ACIP).
Senate Aging Committee
The committee conducts investigations into fraud, abuse, and exploitation targeting seniors; holds hearings on topics such as retirement security, Medicare, Social Security, elder justice, caregiving, and long-term care; and issues reports and recommendations to influence legislation considered by other committees.
Recent Activity: Recent hearings addressed topics like reducing chronic disease through community-based wellness programs, translating longevity research into actionable policy, and combating opioid use among seniors. The committee also supported legislation such as the SENIOR Act to address loneliness as a critical health issue under the Older Americans Act.
Senate and House Judiciary Committees
Broadly, these committees consider legislation related to the judicial system and play a critical role in providing oversight of the Department of Justice (DOJ) and the agencies under the Department’s jurisdiction, including the Federal Bureau of Investigation (FBI), and the Department of Homeland Security (DHS). In particular, the Senate Judiciary Committee considers executive nominations for positions in the DOJ, FBI, and DHS. The Senate committee also reviews all judiciary nominations, including the Supreme Court, appellate court, and district court nominees. Specific to health care, both committees review matters relating to antitrust law, such as the merger and acquisition of health providers. The committee also oversees the visa programs on which many health care providers rely. The committees also review patent law issues as they apply to drug and medical device manufacturers.
Recent Activity: The Senate Judiciary Committee has focused much of its work this year on nominations. But in the past few weeks, the committee has been focusing on the pharmaceutical benefit manager (PBMs) organizations and their role in health care costs. The committee passed a bill out on April 7th to pressure the FTC to continue with their investigation into PBM business practices.
Senate and House Appropriations Committees
These committees are responsible for the appropriation of revenue for the support of the government. Appropriations is divided into 12 accounts, with two having the most influence on health care: Labor, Health and Human Service, Education, and Related Agencies (LHHS); and Agriculture, Rural Development, Food and Drug Administration, and Related Agencies (Ag-FDA). LHHS dictates funding for all major components of HHS except for the Food and Drug Administration (FDA), which is covered under Ag-FDA.
Recent Activity: The Committees passed a Continuing Resolution (CR) to keep the government running until the end of September of this year. House and Senate Appropriations Committees are also working on drafting their spending bills Fiscal Year (FY) 2026.
Senate and House Budget Committees
These committees focus on the details of the federal budget, drafting of the budget resolution, and compiling and reconciling legislation for all areas including health care. These committees also oversee the Congressional Budget Office (CBO), which “scores” bills according to how much they would cost once enacted. The Senate Budget Committee specifically reviews the nominee for the Director of the Office of Management and Budget.
Recent Activity: Both committees have passed their budgets for fiscal year 2026, setting up for a health care policy heavy reconciliation bill. Note that the Budget Committees are in charge of reconciliation, and while the other committees will weigh in on health care policy changes, Budget can override these policies and make their own legislation.
House Ways and Means Committee
This committee’s jurisdiction is very similar to that of the Senate Finance Committee in that it also oversees health programs under the Social Security Act, such as Medicare, Social Security, and TANF. Ways and Means is the only House committee that has jurisdiction over Medicare Part A because of the Social Security payroll tax. The committee does not have jurisdiction over Medicaid. The committee is considered particularly impactful among congressional members because of its authority on tax issues.
House Energy and Commerce Committee
In addition to being the oldest standing committee in the House of Representatives, this committee has the broadest jurisdiction of any House committee. On health care, it oversees a variety of issues, including Medicare (except Medicare Part A), Medicaid, health insurance (except for employer-sponsored plans), biomedical research and development, drug and device safety, and public health issues. The health-related departments and agencies it oversees are HHS, FDA, the Centers for Disease Control and Prevention, and the National Institutes of Health.
Recent Activity: The House Energy and Commerce Committee has been focusing on drugs lately in their hearings, illicit drugs, pharmacy benefit managers (PBMs). They have not yet marked up any health care bills, but they will be a key player in Medicaid reform this year.
House Education and Labor Committee
This committee has jurisdiction over education and labor issues. This includes all employment-related health and retirement security issues, including employer-sponsored health plans. The committee is also interested in health care workforce issues.
Recent Activity: The committee has held two health care hearings this year – one on the affordability of health care, another on employer-sponsored health plans. They have been mostly focusing on marking up bills to reform universities/colleges in the U.S.