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Congress returns for its second full week of work as Southern California battles wildfires. As Members of Congress respond to this issue, they also continue to discuss decisions that must be made about government funding, health care extenders, and confirmation hearings for President-elect Trump’s cabinet nominees. So, let’s get into it. Welcome to the Week Ahead!
The Administration
Biden’s Nicotine Ban
President Biden is expected to propose limitations on nicotine in cigarettes before he leaves office on January 20. This move is in line with a long-standing goal of the administration, but it also comes after the Biden administration failed to move forward with a rule to ban menthol cigarettes.
Presidents often push last-minute policies at the end of their time in office. However, that carries a risk, especially when the president’s party does not control the incoming administration and new Congress. That being said, it’s not a foregone conclusion that the second Trump administration will repeal this proposal. On the one hand, during the first Trump administration, the FDA restricted the sale of certain flavored e-cigarettes over concerns that they were being marketed in a way that appealed to minors. He also signed legislation that increased the federal minimum age to purchase tobacco to 21 years of age. On the other hand, during the presidential campaign, Trump said he would “Save vaping again.” However, as President Biden prepares to leave office and President-elect Trump prepares to assume it, the future is as cloudy as a smoky room.
ACA Deadline
The January 15 deadline to enroll in an Affordable Care Act plan for 2025 is fast approaching. The Department of Health and Human Services is touting that 24 million people have already signed up for coverage, and that this is the fourth year of record enrollment. But once again, the future of this program depends on the actions of a very different administration and a Congress under complete Republican control. Even if Republicans are unlikely to push for a full-scale repeal and replace because of bad memories of the 2017 effort, Congress and the second Trump administration will have to decide on the expanded tax credits that expire at the year’s end.
The Senate
Confirmation hearings for President-elect Trump’s nominees begin in force with hearings for the Attorney General, Secretary of State, Secretary of Treasury, and several other nominations scheduled for the week of January 13. One hearing that hasn’t been scheduled? The hearing for Secretary of Health and Human Services nominee RFK Jr. Sen. Crapo (R-ID), who chairs the Senate Finance Committee, had stated he hoped to get this hearing scheduled for the week of January 13. However, as of the writing of this newsletter, the paperwork required to schedule the hearing has not been filed. In the meantime, RFK Jr. Continues talking with Republicans and Democrats to get his nomination across the finish line. But will it be enough, given the reticence from Senate Health, Education, Labor, and Pensions Committee chair Sen. Bill Cassidy (R-LA)?
Another hearing you might have missed with all the confirmation excitement is the Senate Aging Committee hearing on Jan. 15 on improving senior wellness.
The House
Rep. Buddy Carter (R-GA), chair of the Energy and Commerce Health Subcommittee, told the press he is working with House leadership to pass a health care package that was at one point part of the end-of-the-year spending bill. Although the individual provisions (such as telehealth and reforms to pharmacy benefit managers) have bipartisan buy-in, there is not much of an incentive to negotiate if differences arise, and costs could complicate efforts. One thing that could help get Republicans on board is if Trump weighed in with support. Trump has criticized PBMs, so it’s not impossible. It will be interesting to watch to see how Carter moves forward on this.
There You Have It
Following the NFL’s Wild Card Weekend, nine teams remain in the hunt for a Super Bowl LIX appearance. For those who’ve made brackets, how is it going? Let us know. Make it a great week!
With Republicans maintaining control of the House of Representatives and regaining control of the White House and Senate, the landscape of U.S. health policy has changed significantly. The incoming leadership on key congressional committees will be pivotal in determining the future direction of health care legislation and reforms over the next two years. Here’s an overview of the new leaders in these committees and what we can expect in the 119th Congress.
House Committee on Energy and Commerce
Chairman: Rep. Brett Guthrie (R-KY)
Rep. Brett Guthrie (R-KY), now at the helm of the House Energy and Commerce Committee, replaces retiring Rep. Cathy McMorris Rodgers (R-WA). Rep. Guthrie previously served as the chair of the committee’s Health Subcommittee. During his subcommittee chairmanship, Guthrie supported legislation to reauthorize Alzheimer’s research funding, address the opioid epidemic, and increase transparency in the health care industry.
So, what does a Guthrie-led Energy and Commerce focus mean for health care? We could see the committee take up bills that failed to pass the House in the 118th Congress. For example, the committee could renew efforts to pass the Building America’s Health Care Workforce Act, which Rep. Guthrie introduced in the last Congress. This bill would have extended certain COVID-era flexibilities, which waived certain training and competency requirements for nurse aids to help skilled nursing facilities and nursing facilities maintain an adequate workforce. This bill passed out of the Energy and Commerce Committee but failed to become law before the last Congress adjourned. This could be especially relevant if the incoming Trump administration repeals President Biden’s nursing home staffing mandate and Rep. Guthrie wants to show the Energy and Commerce Republicans have policy ideas to tackle the nursing home staffing issue. Rep. Guthrie’s new position as chair of the Energy and Commerce Committee also positions him to influence the debate over the Inflation Reduction Act (IRA’s) drug pricing provisions, which are likely to face scrutiny from the incoming Trump administration and Republican majorities in Congress.
Ranking Member: Rep. Frank Pallone (D-NJ)
As the returning Ranking Member, Rep. Pallone will lead Energy and Commerce Democrats in opposing any Republican efforts to repeal or roll back the ACA or the IRA. Additionally, Rep. Pallone will certainly oppose any attempts to change Medicaid to a block grant funding model, which Democrats have argued will gut the program and harm beneficiaries. He will also likely focus on bipartisan opportunities, such as Medicare payment reforms and the potential for revisiting the CURES Act to expand medical research.
Rep. Pallone could also advocate for legislation to advance key Democratic health care priorities and showcase what Democrats would do with a House majority. For example, on December 19, 2024, Rep. Pallone introduced the Lowering Drug Costs for American Families Act.
House Energy and Commerce Health Subcommittee
Chairman Buddy Carter (R-GA)
Rep. Carter, who is a pharmacist by profession, is the newly selected Chairman of the House Energy and Commerce Health Subcommittee. Carter is expected to advocate strongly for issues related to prescription drug prices and pharmacy regulations. He also may find ways to push reform in Medicaid and Medicare by tackling fraud and waste in these programs. Carter is also a critic of the ACA and may try to reduce government spending on health care.
New Ranking Member: Rep. Diana DeGette (D-CO)
Rep. DeGette is expected to continue her advocacy for protecting the ACA and the IRA. She has been an active proponent of women’s health and reproductive services and was a key player in the development of the CURES Act. DeGette may also find common ground with Republicans on issues like Medicare Advantage and Pharmacy Benefit Manager (PBM) reform.
House Committee on Ways and Means
Chairman: Rep. Jason Smith (R-MO)
Returning as Chairman of the Ways and Means Committee, Rep. Jason Smith will influence key health policies, especially those impacting Medicare. As a champion of improving access to care in rural communities, he will likely push for reforms to Medicare payments, particularly to hospitals, with an eye toward addressing access to care in rural and underserved areas. Additionally, with the Committee’s jurisdiction over tax policy, Smith could be instrumental in efforts to address health care costs through tax reforms and expanding Health Savings Accounts (HSAs). Smith may also play a central role if Republicans seek to revisit the ACA or IRA.
Ranking Member: Rep. Richard Neal (D-MA)
Rep. Neal returns as Ranking Member and will likely continue his efforts to protect the ACA and IRA. Known for his bipartisan approach, Neal could potentially work with Republicans on Medicare payment reforms and other areas where there is potential for collaboration.
House Ways and Means Health Subcommittee
Chairman: Rep. Vern Buchanan (R-FL)
Rep. Vern Buchanan, returning as Chair of the Ways and Means Health Subcommittee, will play a key role in debates related to Medicare payment reforms, particularly those related to Medicare Advantage. Buchanan has long advocated for transparency and market-driven health care solutions, which will likely continue as focal points of his leadership.
Ranking Member: Rep. Lloyd Doggett (D-TX)
Rep. Lloyd Doggett, as the Health Subcommittee Ranking Member, will focus on protecting the ACA and IRA while continuing his strong advocacy for controlling drug prices and ensuring robust consumer protections.
Senate Committee on Finance
Chair: Sen. Mike Crapo (R-ID)
With Republicans taking control of the Senate, Sen. Mike Crapo becomes the influential Senate Finance Committee Chair. Crapo is expected to be a driving force behind changes to the ACA, IRA, and Medicaid. He has expressed support for increasing Medicaid flexibility for states, which could lead to proposals like block grants or per capita caps. Additionally, Crapo has shown interest in lowering prescription drug costs through increased competition and transparency.
Ranking Member: Sen. Ron Wyden (D-OR)
Sen. Ron Wyden, now the Ranking Member of the Finance Committee, can be expected to continue to protect the ACA and IRA. Wyden, a known advocate for bipartisan Medicare payment reforms and PBM reform, will likely seek opportunities to collaborate with Republicans where possible.
Senate Committee on Health, Education, Labor & Pensions (HELP)
Chair: Sen. Bill Cassidy (R-LA)
Sen. Bill Cassidy takes the reins as Chair of the Senate HELP Committee. Known for his background as a physician, Cassidy is expected to focus on tackling health workforce shortages and reforming programs at the FDA. As a member of both Finance and HELP, he will also play a significant role in discussions on Medicare and Medicaid. As a past leader on legislation to address surprise medical bills, expect Cassidy to play a leading role should concerns arise surrounding this issue or around health plans’ provider networks.
Ranking Member: Sen. Bernie Sanders (I-VT)
Sen. Bernie Sanders, as Ranking Member, will focus on protecting the ACA and IRA. However, there may be opportunities for bipartisanship on issues like health workforce initiatives and community health center funding, areas where Sanders and Republicans like Cassidy could find common ground. In related news, Sanders joins the Senate Finance Committee, where he will also have the ability to directly impact Medicare and Medicaid payment policy.
What’s Next for Health Policy?
With new leadership in both the House and Senate, various health care proposals will be debated and shaped in the coming years. From potential changes to the ACA and Medicaid to efforts to tackle rising drug costs, the leadership of these committees will be instrumental in shaping the next chapter of U.S. health policy.
While partisan divides remain, there are significant areas for bipartisanship—particularly on issues like Medicare reform, PBM regulation, and workforce shortages. The coming months will likely see a flurry of activity as these new leaders make their mark on the future of health care in the United States.
The holidays may be over, but the weather in D.C. reminds us that winter is still here. Between the snowstorm and the funeral of Jimmy Carter, it might not seem like a lot will get done in Washington this week. However, with the start of a new Congress and the incoming Trump administration, there is still a lot to dig into. So, let’s start digging. Welcome to the Week Ahead!
The Administration
Former Center for Medicare and Medicaid Innovation (CMMI) Director Brad Smith has reportedly taken a leadership role within the next administration’s Department of Government Efficiency (DOGE) effort. CMMI has faced years of criticism that the center has failed to live up to its mandate to improve care quality and lower costs. Mr. Smith would be in a prime position to either protect the center he used to run, reform it, or help dismantle it in service of DOGE’s mission to find and eliminate spending it determines to be wasteful.
Mr. Smith’s involvement in DOGE could also have other implications for health care policy. For example, Mr. Smith might use DOGE to look into other areas of health care, such as Medicare Advantage (MA). MA has been under bipartisan attack in the last several years, and the timing couldn’t be more perfect given that the Centers for Medicare and Medicaid Services (CMS) is set to finalize the Contract Year 2026 MA and Part D rule in the spring of 2025.
The Senate
The 119th Congress officially began on January 3, and at least one confirmation hearing is currently scheduled by the Armed Services Committee on January 14 to consider Pete Hegseth to be Secretary of Defense. We expect more noms hearings to be announced for next week as the Senate looks to get as many of President-elect Trump’s cabinet members as possible confirmed by January 20.
We also now have a full picture of the committee assignments for Republican and Democratic Senators in the 119th Congress, including the following new members:
- Senate Finance Committee: Sens. Roger Marshall (R-KS), Bernie Sanders (I-VT), Tina Smith (D-MN), Raphael Warnock (D-GA), and Peter Welch (D-VT).
- Senate HELP Committee: Sens. Jim Banks (R-IN), Tim Scott (R-SC), Josh Hawley (R-MO), Mike Crapo (R-ID), Marsha Blackburn (R-TN), John Hickenlooper (D-CO), Andy Kim (D-NJ), Lisa Blunt Rochester (D-DE), and Angela Alsobrooks (D-MD).
- Senate Appropriations Committee: Sens. Markwayne Mullin (R-OK), Mike Rounds (R-SD), Kirsten Gillibrand (D-NY), and Jon Ossoff (D-GA).
The House
President-elect Trump gave Speaker Johnson a belated Christmas gift this year when he reached out on the Speaker’s behalf to swing two defectors to support Johnson in his successful bid to retain the speakership. Speaker Johnson and his leadership team still has very slim margins to work with, especially until the special elections fill vacant seats held by Republicans heading to the administration.
Already, it’s been reported that Speaker Johnson told members of his caucus that President-elect Trump wants to see Congress pass “one big, beautiful bill” for reconciliation instead of the two-bill strategy that the House Freedom Caucus and others have previously endorsed. Trump weighing on House matters caused quite the headache for the Speaker to complete a government funding patch in December, so expect to see more intraparty, inter-chamber squabbling this year.
There You Have It
Politics often gets compared with entertainment especially in an age where members of Congress have their own podcasts. But on January 5, we saw a different kind of entertainment with the 2025 Golden Globes. Did your favorites win? Which ones surprised you? Let us know. Make it a great week!
Florida’s growing influence in U.S. politics is becoming more apparent with the new appointments from the incoming Trump administration and leadership positions in Congress. With several key nominees from the state and a strong presence in congressional committee chairs, the compass needle with respect to funding and policy control is swinging toward the sunshine state.
Floridians in the Trump Administration
While it is well-known that President-elect Trump hails from Florida, it is not as well publicized that many of his cabinet position picks also hail from the Sunshine State, contributing to Florida’s emerging role as a political hub.
Some of the Florida notables nominated include Senator Mark Rubio for Secretary of State, Pam Bondi to lead Veterans’ Affairs, Dr. Mehmet Oz to head the Centers for Medicare and Medicaid (CMS) and Mike Waltz to serve as the future National Security Advisor. Other Floridians nominated include:
- Janette Nesheiwat – Surgeon General
- Todd Blanche – Deputy Attorney General
- Dr. Dave Weldon – Centers for Disease Control and Prevention (CDC)
- Jared Isaacman – NASA
- Jay Bhattacharya – National Institutes of Health
- Paul Atkins – SEC Chairman
- Susie Wiles – White House Chief of Staff
In addition, while not from Florida, Trump’s nominee to head Health and Human Services (HHS), Robert F. Kennedy Jr., has strong political and family ties to the state.
Florida’s Power in Congressional Committees
Florida’s influence extends beyond the executive branch and into the legislative branch, where the state just gained a new committee chairmanship. Rep. Brian Mast (R-FL) who represents the Treasure Coast be the next chair of the House Foreign Affairs Committee. Rep. Mast edged out more senior members like Rep. Joe Willson (R-SC) and Darrell Issa (R-CA) for the position.
Other powerful Floridians in the House include Rep. Mario Diaz-Balart (R-FL) who is a senior member of the influential House Appropriations Committee. On the Democratic side, Rep. Debbie Wasserman-Schultz (D-FL) is also a high-ranking member on the House Appropriations Committee.
Florida’s Growing Political Influence
As Florida continues to increase its influence within the Trump administration and on Capitol Hill, its political power is becoming undeniable. Trump has chosen to remain in the state after his election victory, coming to Washington only once to meet with President Joe Biden at the White House and speak with House Republicans near Capitol Hill. It is also likely that Trump will continue to spend his downtime in Florida after the election, as he did in his first term.
This power nexus will likely lead to Florida policies gaining a more central role in federal policy consideration, most likely through issues related to immigration and health care. For example, will Florida’s law that hospitals are required report undocumented immigrants seeking care to authorities w be elevated to a national level? Will the Trump Administration look to adopt Florida state provisions penalizing companies for hiring undocumented workers? The Florida Policy Institute estimated that Florida’s state economy lost $12.6 billion one year after the bill signing, so these policies could have a large effect on the national economy if enacted at the federal level.
Meanwhile, Florida’s health care laws might begin to gain a wider audience at the national level. Florida’s sweeping 2023 bill restricting gender-affirming care might rise to the national level. The law contains provisions that ban all gender-affirming care for persons 18 or younger. The law also prohibits gender-affirming care for adults in many ways as well, the including provision that prohibits physicians from prescribing sex-reassignment medications to adults via telemedicine.
Looking at the mix of influential lawmakers, strategic appointments, and high-profile state leaders, it seems Florida is firmly positioned to be a central player in national policy-making in the years ahead. Whether it’s through its political leadership in Washington or the success of its state government, Florida’s rise is shaping the political landscape for the future.
