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On June 24, 2025, the House Energy and Commerce Health Subcommittee held a hearing on the FY 26 Department of Health and Human Services (HHS) budget. Republicans praised Sec. Kennedy’s reorganization of HHS and the Make America Healthy Again (MAHA) Commission, while Democrats expressed concerns about Medicaid savings and the status of Medicare drug pricing negotiations. Unlike Sec. Kennedy’s prior appearances, this hearing centered on a different set of issues.
OPENING STATEMENTS
WITNESS TESTIMONY
MEMBER DISCUSSION
HHS Reorganizaton
Chairman Buddy Carter (R-GA) opened the discussion by expressing serious concern about the national debt, calling it “one of the greatest threats” to the country’s future. He questioned how the HHS reorganization would lead to measurable efficiencies for patients and providers.
In response, HHS Sec. Robert F. Kennedy Jr. framed the reorganization as a necessary modernization effort aimed at eliminating long-standing bureaucratic waste, fraud, and abuse. He also noted that the department’s restructured framework is designed to shift HHS from a reactive posture to a more proactive, prevention-focused health model. Sec. Kennedy also argued that despite spending $1.5 trillion each year on chronic disease, America has the highest chronic disease burden in the world. He placed a large share of the blame for that on fragmented care delivery and outdated infrastructure within HHS.
Rep. Brett Guthrie (R-KY) followed up by inquiring about the status of the department’s broader workforce reduction efforts, asking whether Sec. Kennedy could provide more information about potential staffing changes or consolidations. Sec. Kennedy responded that the reduction in force is currently under litigation and declined to elaborate further. Rep. Guthrie also raised questions about whether the reorganization would prompt CMS to revisit or modify innovation and technology policies established under the Biden administration. Kennedy replied that HHS is doing more than any other cabinet agency to integrate AI into the health care system, emphasizing the department’s commitment to using emerging technologies to modernize care delivery.
Democratic members such as Rep. Lori Trahan (D-MA) expressed skepticism that the reorganization would protect essential programs and services, warning that hospitals could be forced to cut services or close if Medicaid coverage is reduced or workforce pipelines are disrupted. She pointed to potential impacts on programs that train pediatricians, claiming that the Secretary’s budget “slashes Medicaid” and undermines the health workforce. Kennedy pushed back on these and similar arguments, asserting that the budget does not cut Medicaid and insisting that coverage levels would not be reduced under the new structure.
Drug Pricing
Rep. Debbie Dingell (D-MI) led a robust line of questioning focused on HHS’s ability and commitment to deliver on the Inflation Reduction Act’s (IRA’s)Medicare negotiation program. She pressed Sec. Kennedy on whether he would uphold the law’s drug negotiation provisions and resist any proposed rollbacks. Kennedy stated that he is committed to maintaining the IRA’s mechanisms for lowering prices. Rep. Dingell also sought clarity on the Department’s progress toward implementing negotiated drug prices by November 1, 2025, which she argued would allow seniors to see the benefits reflected in their out-ofpocket costs by January 2027. Kennedy confirmed that HHS is on track to meet that timeline. He further explained that HHS is currently negotiating with manufacturers to implement a Most Favored Nation (MFN) model—an international pricing benchmark that bases what prescription drug costs on what is charged in other Organization for Economic Co-operation and Development (OECD) countries, particularly in Europe. When asked how drug manufacturers are being brought into the negotiation process, Kennedy acknowledged the complexity of the effort and stressed that bipartisan cooperation is essential.
Reps. Gus Bilirakis (R-FL) and Dan Crenshaw (R-TX) also expressed strong support for lowering drug costs but brought the conversation into the realm of rare and pediatric diseases. For example, Rep. Bilirakis praised the Food and Drug Administration’s (FDA’s) Rare Pediatric Disease Priority Review Voucher (PRV) program. Rep. Bilirakis asked whether Sec. Kennedy would support preserving this incentive in the President’s budget and commit to ensuring the continuation of the program. Kennedy responded affirmatively, stating that it is a departmental priority and acknowledging that the budget includes provisions to maintain and improve regulatory pathways for these treatments. Rep. Bilirakis further raised the idea of a national priority voucher program to expand incentives for drug development in other high-need areas. Kennedy responded that the department is using the current programs extensively but continues to face regulatory and bureaucratic challenges—describing a “clash with red tape” that limits the approval pipeline for new therapies. He emphasized the need for additional flexibility and support to reduce delays and increase innovation. Rep. Crenshaw also mentioned that the House provision related to Orphan CURES Act was passed out of the House but needs Senate support.
Energy and Commerce Ranking Member Frank Pallone (D-NJ) warned that the Department’s recent actions could lead to preventable deaths if drug access and affordability are not improved. He demanded a written, substantive response from HHS to outstanding letters from lawmakers by August 1, to which Kennedy said they only respond as fast as they can.
Finally, Rep. Diana Harshbarger (R-TN) asked if the President’s budget includes any efforts to address concerns about pharmacy benefit managers (PBMs). Sec. Kennedy responded that PBM reform is currently under negotiation and again pointed to the MFN approach as a broader strategy to address systemic price distortions.
National Institutes of Health (NIH)
Rep. Nanette Barragán (D-CA) turned the conversation toward the NIH’s role in Alzheimer’s and dementia research. She began by affirming the importance of Alzheimer’s research and accused Kennedy of proposing cuts to the agency responsible for advancing this area of science. She specifically asked whether he was familiar with Alzheimer’s Disease Research Centers, key NIH-funded programs located across the country that serve as hubs for basic and translational neuroscience. Kennedy appeared unfamiliar with the centers and denied that any cuts to Alzheimer’s research were being proposed. His lack of awareness about a flagship NIH program drew concern and raised questions about whether research priorities are being sufficiently safeguarded within the HHS budget proposal.
OTHER TOPICS
- Reps. Kat Cammack (R-FL) and Greg Landsman (D-OH) raised concerns about maternal health deserts and requested coordination on efforts like the Save Infant Health Program; Sec. Kennedy expressed willingness to collaborate.
- Rep. Robin Kelly (D-IL) questioned HHS’s recommendation against COVID-19 vaccination for pregnant women and children, but Sec. Kennedy denied claims of coercion or unsupported guidance.
- Rep. Landsman (D-OH) emphasized restoring funding to improve birth outcomes and reduce disparities; Kennedy agreed to work with him.
- Rep. John James (R-MI) asked how HHS is addressing large corporations abusing government programs; Kennedy stressed the need to realign incentives, including improvements to food in military and school programs.
Senate Republican leaders return to Washington this week with just enough time to pass reconciliation and get home to see 4th of July fireworks. But Congress and the administration also have to deal with the fallout from the bombing of Iran. There is certainly a lot going on in DC! So, let’s get into it – welcome to the Week Ahead!
The Administration
The Centers for Medicare and Medicaid Services (CMS) has kicked off its own fireworks show by finalizing the 2025 Marketplace Integrity and Affordability Final Rule. The final rule largely retains the provisions of the proposed rule released in March, including shortening of the Affordable Care Act (ACA) open enrollment period and prohibiting ACA coverage for Deferred Action for Childhood Arrivals (DACA) recipients.
However, the rule also finalizes other parts of the proposal on a temporary basis, including several provisions strengthening income eligibility requirements. Why would CMS do that?
According to reports, by sunsetting some of the rule’s provisions, Congress could get “budget credit” if these provisions are included in the final reconciliation bill being debated in Congress. The Congressional Budget Office (CBO) previously estimated that many of these same provisions in the House-passed version of the reconciliation bill would save $101 billion over ten years.
The Senate draft did not include these provisions, but having an extra >$100 billion of “walking around money” could be very useful to Republican leaders either to reduce the overall cost of the bill or mitigate the need for savings from other controversial provisions like Medicaid provider taxes or state directed payments.
We expect CMS to finalize several other final rules over the next month, including rules setting Medicare payment rates for the coming year. These rules will set the stage for how Medicare reimburses different providers and services.
The Senate
Senate Republicans are feeling the heat, and it’s not just because of the temperature. Ever since the Senate Finance Committee released its reconciliation text on June 16, several Republican Senators have raised concerns about those provisions. For example, there are concerns about proposed reductions in the use of provider taxes to 3.5% by 2031 for Medicaid expansion states, as well as an annual 10% reduction in state directed payments until they match Medicare rates. This group includes Sens. Josh Hawley (R-MO), Jim Justice (R-WV), Lisa Murkowski (R-AK), and Susan Collins (R-ME). When you add in Senators such as Sens. Ron Johnson (R-WI) and Rand Paul (R-KY), who have raised concerns about the bill’s impact on the deficit, you are up to six Senators with major concerns over the current draft. Remember, Republicans can only afford three no votes and still pass the reconciliation bill. That’s certainly enough to make Senate Republican leadership sweat.
That said, conversations are continuing to address these Medicaid concerns. For example, Sen. Hawley has been pitching a return to the House-passed moratorium on new provider taxes and changes to state directed payments with additional guarantees that existing rates would be grandfathered in. Additionally, there have been discussions about creating a fund to help rural hospitals survive any changes to provider taxes or state directed payments. Something will need to be done to ensure the bill doesn’t burn up on the Senate floor.
In non-reconciliation news, the Senate Committee on Health, Education, Labor, and Pensions (HELP) is scheduled to consider the nomination of Dr. Susan Monarez to be the Director of the Centers for Disease Control and Prevention (CDC) on June 25. Expect this hearing to feature fiery remarks about the removal and replacement of the entire CDC’s Advisory Committee on Immunization Practices (ACIP) by Health and Human Services Sec. Kennedy.
Other Health Care Hearings
- June 25: Senate Aging Committee hearing on sports medicine’s role in older Americans’ health
- June 25: Senate VA Committee hearing on the Veterans Crisis Line
The House
House Speaker Mike Johnson (R-LA) is prepared to cancel the House’s upcoming recess if it means there is a chance that the reconciliation bill could be sent to President Trump’s desk before July 4th. But even with additional time, navigating the various factions within the House GOP caucus will be more difficult than leaving the National Mall after the fireworks end. That’s because, in addition to addressing concerns from members about Medicaid or the deficit, the Speaker also has to find a way to address concerns from House Republicans on the SALT Caucus.
The Senate reconciliation bill’s dropping of the SALT deduction cap from $40,000 to $10,000 is an insult to the SALT Caucus GOP members. Senate Republican leaders say their amount is a placeholder amount for negotiations, but it’s hard to see how that number makes GOP SALT Caucus members excited to come to the table.
Meanwhile, the House Budget Committee will be wading into the debate over Medicaid work requirements at a June 25 hearing. While not specifically mentioning Medicaid in the announcement, we expect Republicans to use the hearing as a platform to argue in support of provisions of the reconciliation bill that implement work requirements for certain individuals enrolled in Medicaid and the Supplemental Nutrition Assistance Program. Expect Democrats to use their time to highlight what they argue will be the detrimental effects of such policies on beneficiaries, although they have yet to name a witness for the hearing.
Other Health Hearings
- June 23: House Appropriations Committee continued markup of FY 26 Ag-FDA bill
- June 24: House Energy and Commerce Health Subcommittee hearing on FY 26 HHS budget
- June 25: House Ways and Means Health Subcommittee hearing on digital health
There You Have It
June 20 marked the Summer Solstice and First Day of Summer for the Northern hemisphere, otherwise known as the longest day of the year. How did you make use of the extra daylight? Let us know. Make it a great week!
Coalition meetings with policymakers are powerful opportunities—but only if they’re well-prepared. A successful meeting requires more than showing up with shared goals; it demands coordination, clarity, and a thoughtful approach to who delivers which message. When each coalition partner knows their role and contributes strategically, the group can present a united, persuasive front that leaves a lasting impression on decision-makers.
Maximizing Policy Meetings Through Strategic Coalition Preparation
Coalition meetings with policymakers are high-stakes opportunities to drive your message forward. When done right, they show unity, strength, and shared purpose. But these meetings don’t just happen—they require thoughtful planning, coordination, and a smart use of resources. Here’s how to make the most of your coalition’s next policy meeting.
Assign Roles and Play to Strengths
Before the meeting, identify which coalition members are best positioned to speak on specific policy points. For example, if one organization has deep expertise in how a policy impacts a particular population, let them lead that part of the conversation. If a coalition partner can bring a constituent voice to the table—someone directly affected by the issue—consider starting the meeting with their story to set a compelling tone. Map out the speaking order, assign key messages to each speaker, and make sure everyone keeps their remarks focused and impactful.
Make the Case for Why You Matter
Every policymaker meeting should begin by establishing credibility. Why should this office pay attention to your group? Use your coalition’s collective reach to your advantage—highlight your members’ expertise, geographic footprint, and community presence. Whether it’s a strong presence in the policymaker’s district or a specialized industry perspective, demonstrate clearly why your coalition’s voice matters.
Leverage Coalition Resources for Greater Impact
One of the greatest benefits of working in a coalition is having access to a range of tools and resources. Tap into these assets to strengthen your message. A policy organization within your coalition might provide compelling data, while a corporate partner might offer powerful visuals or localized insights. Sharing these materials during or after the meeting can reinforce your points and leave a lasting impression.
Use Principals for High-Level Engagement
When engaging at a higher level—such as with senior congressional staff or members themselves—consider bringing in principals from your coalition organizations. Having CEOs, executive directors, or other high-profile leaders speak to shared goals can signal just how serious and unified your coalition is about the issue. Their participation underscores commitment and can help build momentum toward your desired policy outcome.
Keep in Mind
Coalition meetings are most effective when they’re carefully orchestrated. By assigning clear roles, using your members’ unique strengths, and delivering a polished, unified message, you’ll be better positioned to influence policy and build long-term relationships with decision-makers. With the right preparation, your coalition can become a force that policymakers not only hear—but remember.
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.
It’s a high-stakes week in Washington as Senate Republicans work furiously to finalize their budget reconciliation bill and as Republicans’ self-imposed July 4 deadline gets ever closer. Meanwhile, the Trump administration continues to work on drug pricing reform. Let’s get into it. Welcome to the Week Ahead!
The Administration
The Trump administration is looking at advancing its “Most Favored Nation” (MFN) policy as a demonstration through the Center for Medicare and Medicaid Innovation (CMMI). The proposal would tie the price of blockbuster drugs in the U.S. to the lowest prices paid in OECD countries, adjusted for rebates.
The possibility of this new model comes as manufacturers were dealt an ultimatum: cut prices voluntarily by June 12 or face regulatory roulette. The price benchmark? The lowest among countries with a GDP per capita of at least 60% of the U.S.—a move that could shake up the entire pricing deck. Discussions among pharmaceutical executives and administration officials are taking place behind closed doors. However, the policy is still being shuffled, and no one is yet sure who will emerge with the winning hand
But that’s not the only game in town. The Trump administration is also seeking to turn the tables on foreign players who they feel are freeloading off U.S. innovation. Specifically, they’re eyeing trade tools such as those found under Section 301 of the Trade Act of 1974. Additionally, a report is expected soon on an investigation into the effects of pharmaceutical imports on national security (aka a “Section 232 report”). Both of these actions could result in the administration dealing out tariffs or other retaliatory actions against countries with strict price controls.
The Senate
Over in the Senate, the stakes couldn’t be higher as lawmakers head into what’s shaping up to be a critical week for meeting the self-imposed July 4 deadline for passage of a budget reconciliation bill. Senate Finance Committee Chair Mike Crapo (R-ID) is set to present on the committee’s provisions, including the tax and health care provisions, on June 16 at a GOP conference meeting. Meanwhile, the Senate Parliamentarian is playing the role of dealer, making sure every provision of the legislative text comports with the complex Byrd Rule. The July 4th recess is looming over the whole game, and lawmakers are racing the clock to wrap negotiations before the fireworks fly.
One of the biggest issues in the negotiations is over State and Local Income Tax (SALT) deductions. Negotiators are caught between a rock and a hard place: a $30,000 cap can’t clear the House, but a $40,000 cap can’t make it through the Senate. On one side of the table, you have blue state Republicans, like Rep. Mike Lawler (R-NY), threatening to vote no if the Senate does not preserve enough of a deduction. On the other side of the Capitol, Republican Senators, who don’t represent many constituents impacted by high state and local income taxes, but have voiced concerns over the house passed cap. Will the Senate jam the House, or can they come to an agreement during a truncated conference committee process?
For health care, many Republicans like Senators Josh Hawley (R-MO), Susan Collins (R-ME), Lisa Murkowski (R-AK), and Jim Justice (R-WV) are concerned about the Medicaid provisions, such as limits on provider taxes, work requirements, and new copays. On the other side, Sens. Rand Paul (R-KY), Rick Scott (R-FL), and Mike Lee (R-UT) are wanting to up the ante on spending cuts. Senate Republican leadership can’t lose more than three members if they want to pass the bill.
Some Republican members, such as Rep. Young Kim (R-CA), have a stake in both the SALT and Medicaid games. It’s possible that Senate Republican leadership tries to make reductions to SALT easier to swallow by pushing back work requirements or grandfathering existing provider tax rates. However, that will no doubt anger conservatives in both chambers. Balancing both interests has turned this into a real high-wire act, with leadership trying to keep the coalition together without losing key votes. Much like a table full of pros waiting for someone to blink, everyone’s watching for tells, backroom deals, and surprise plays that could shift the momentum before time runs out.
The House
The House may be in recess, but the players aren’t far from the table. House members are watching the Senate’s every move, trying to influence things, and getting ready to receive the Senate’s revised bill. Even Speaker Johnson is waiting to see how the Senate plays its hand and is constantly reminding the Senate that the House passed its version by a single vote.
Meanwhile, the government funding for FY 26 remains in the air. The House Appropriations Committee has advanced legislation to fund the Department of Defense and the Department of Veterans Affairs. However, a June 11 Appropriations markup of the Ag-FDA funding bill ended after 11 hours when committee Chair Cole (R-OK) realized they wouldn’t be able to finish ahead of the scheduled markup of the defense bill due to numerous amendments that were filed. The House also passed a rescissions package before leaving town with cuts to global HIV/AIDS prevention funding. However, that’s for already approved funding and is considered a dead hand by many in the Senate, including some Republicans.
There you Have It
New NBA and Stanley Cup champions could both be crowned this week—who’s your pick to take it all? Make it a great week!
