Insights

On June 25, 2025, the House Ways and Means Health Subcommittee held a hearing on the role of digital health in improving patient outcomes. Members from both parties asked questions related to improving chronic disease, rural health, and data privacy and security. Ultimately, there was bipartisan agreement that digital health is vital for improving access to health care.

OPENING STATEMENTS

• Health Subcommittee Chair Vern Buchanan (R-FL)
• Health Subcommittee Ranking Member Lloyd Doggett (D-TX)

WITNESS TESTIMONY

• Kristen Holmes, Ph.D. Global Head of Human Performance and Principal Scientist of WHOOP – Testimony
• Josh Phelps, President of Winchester Metals Inc. – Testimony
• Andrew Zengilowski, CEO and Co-Founder of CoachCare – Testimony
• Dr. Jackie Gerhart, Chief Medical Officer and VP of Clinical Informatics Epic Systems – Testimony
• Sabrina Corlette, Research Professor and Co-Director at the Center on Health Insurance Reforms, Georgetown University McCourt School of Public Policy – Testimony

MEMBER DISCUSSION

Rural Health Care

Rural access and infrastructure were central concerns during the hearing. Health Subcommittee Ranking Member Lloyd Doggett (D-TX) asked what sustained funding cuts would mean for providers under the House reconciliation bill. In response, Ms. Corlette explained that the bill would trigger annual 4% mandatory cuts to providers, placing rural hospitals under significant financial strain. She warned that repeated reductions would make it difficult for rural facilities to maintain operations and services.

Rep. Greg Steube (R-FL) expressed skepticism about the practical benefits of digital health technologies if rural hospitals lack the capacity to implement them. He asked what specific steps could be taken to support rural health providers. Dr. Gerhardt emphasized the need for continued innovation, noting that small and rural providers must be empowered to tailor digital solutions to their communities’ needs.

When Rep. Kevin Hern (R-OK) raised questions about bipartisan collaboration for Rep. David Kustoff (RTN) bill H.R. 3108 which addresses the impact of remote monitoring devices on patient outcomes, Mr. Zengilowski explained how providers contact patients directly when digital readings fall out of range. Still, he warned that many small practices simply cannot afford to absorb the financial loss of adopting new technologies without policy support.

Chronic Disease

Rep. Brian Fitzpatrick (R-PA) spotlighted the alarming prevalence of chronic disease, citing Centers for Medicare and Medicaid Services (CMS) data that 60% of Americans suffer from one or more chronic conditions. He asked how digital tools and data-sharing can enhance care coordination and outcomes. Dr. Gerhardt pointed to diabetes and prediabetes management as examples where digital monitoring has been especially effective. Dr. Gerhardt said that by regularly reviewing patients’ data, providers can make informed decisions more quickly and adjust treatment plans as needed.

Rep. Fitzpatrick also asked about the barriers doctors face in adopting digital tools in rural areas. Witnesses pointed to workflow challenges, limited reimbursement, and the steep learning curve for providers unfamiliar with technology integration. Without incentives and clear guidance, many providers struggle to fully incorporate digital solutions into their practice.

Data Privacy and Security

Data privacy emerged as another central concern throughout the hearing, with members from both sides voicing alarm over the increasing vulnerability of health records in the digital age. Rep. Judy Chu (DCA) raised concerns about the proliferation of wearable health devices, questioning whether companies collecting this data adequately safeguard users. She warned that as more patients are pushed toward digital tools, particularly in the wake of potential rollbacks to the Affordable Care Act (ACA) subsidies and health coverage, many may not fully understand how their information is being used or shared.

Ms. Corlette responded by emphasizing that when individuals lose access to health insurance, they are not only less likely to receive in-person care, but also less able or willing to engage with digital health solutions. This disengagement, she noted, carries implications for both health outcomes and privacy, as patients may resort to unregulated tools or delay care altogether. The issue of health data being collected by devices such as fitness trackers, mobile health apps, and wearable devices, outside of traditional Health Insurance Portability and Accountability Act (HIPAA) protections, was raised multiple times. Several witnesses highlighted that these platforms operate in a legal gray area, where user data is often shared with third parties for marketing or analytics purposes without the explicit consent of patients.

Rep. Brian Fitzpatrick (R-PA) asked whether HIPAA needs to be updated to reflect the current digital health ecosystem. Dr. Gerhart affirmed that while HIPAA still provides a baseline of protections, it does not adequately address the types of data now routinely gathered by consumer-facing technologies. She urged Congress to consider modernizing the law to extend protections beyond the walls of traditional clinical settings. This includes establishing clearer rules for data collection, use, and storage by thirdparty tech companies that are not classified as health care providers or insurers but still handle sensitive health information.

Rep. Mike Thompson (D-CA) questioned whether federal agencies outside of the Department of Health and Human Services (HHS)—such as the Department of Government Efficiency (DOGE) should have access to any form of health-related data. Though witnesses did not have insight into the specific agency reference, they echoed a broader concern about cross-agency data sharing without public transparency. Calls for comprehensive federal privacy legislation were repeatedly echoed throughout the hearing, with panelists warning that piecemeal regulations would not be sufficient to address emerging threats, such as hacking, unauthorized use of biometric data, and data aggregation from multiple sources.

On June 25, the House Budget Committee held a hearing on work requirements in federal programs, including Medicaid. This hearing takes place as the Senate prepares to consider its version of reconciliation legislation, following the House’s passage of its bill in May. The hearing included both sides accusing the other of misleading the public about the impact of the House reconciliation bill. Any person(s) or organization(s) wishing to submit written comments for the hearing record can do so by emailing Ryan.Bailey@mail.house.gov by the close of business on June 27, 2025.

OPENING STATEMENTS

• House Budget Committee Chair Jodey Arrington (R-TX)
• House Budget Committee Ranking Member Brendan Boyle (D-PA)

WITNESS TESTIMONY

• Dr. Brian Blase Ph.D., President, Paragon Health Institute
  • See Witness Support Document #1
• Mr. Nick Stehle, Vice President of Communications, Foundation for Government Accountability
• Mr. Matthew Dickerson, Director of Budget Policy, Economic Policy Innovation Center
• The Honorable Robert Gordon, Duke Distinguished Visiting Fellow, McCourt School of Public Policy, Georgetown University

MEMBER QUESTIONS

The hearing provided Republicans an opportunity to defend provisions they argue will address waste, fraud, and abuse within federal programs. Republicans praised the provisions to strengthen eligibility verification, prevent undocumented immigrants from accessing federal benefits, and limit certain state f inancing options, such as provider taxes and state-directed payments, which they argued have been used by states like California to secure more Medicaid funding. They also argued the bill does not cut Medicaid but ensures the program can provide care to those who genuinely need it. Republicans, such as Chair Jodey Arrington (R-TX) and Rep. Ralph Northam (R-SC), also said that the bill could go further to address waste, fraud, and abuse in federal programs. Reps. Chip Roy (R-TX) and Andrew Clyde (RGA) expressed concerns that a Senate proposal to change the expanded Federal Medical Assistance Percentage (FMAP) for the Medicaid expansion population does not go far enough in addressing their concerns about spending in the program.

Democratic members responded to these arguments by stating that these Medicaid and SNAP work requirements will increase bureaucratic burden and will cause Americans to lose access to legitimate benefits in order to fund tax cuts for the wealthy, and that most people impacted by the bill will be citizens and legal residents. Additionally, Democrats argued that instead of enacting the work requirements in the House reconciliation bill, Congress should focus on eliminating what they see as real waste, fraud, and abuse, including examples they cited within the Trump administration. Notably, Rep. Lloyd Doggett (D-TX) and Pramila Jayapal (D-WA) argued that there should be an increased focus on provider and insurer fraud. Chairman Arrington noted that he and other Republicans have an interest in addressing concerns about fraud and abuse within the Medicare Advantage program. Reps. Jimmy Panetta (D-CA), John McGarvey (D-KY), Veronica Escobar (D-TX), and Marcy Kaptur (D-OH) also argued that Medicaid provisions in the House’s bill would lead to hospital closures, especially in rural and underserved areas.

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

• Health Subcommittee Chairman Buddy Carter (R-GA)
• Full Committee Ranking Member Frank Pallone (D-NJ)

WITNESS TESTIMONY

• HHS Sec. Robert F. Kennedy Jr.

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.