The Week Ahead

The attack on Iran by U.S. and Israeli forces has brought foreign affairs back to the forefront of Washington’s attention. However, concerns about affordability continue to dominate domestic headlines, as Republicans and Democrats begin to refine their messaging for the November midterm elections. Health care is a critical part of that messaging, and both sides are trying to shape the narrative. How will they do it? Let’s get into it. Welcome to the Week Ahead!

The Administration

In response to the Supreme Court decision striking down most of his 2025 tariffs, President Trump imposed a new 10% tariff for the next 150 days. While there were carve-outs for some products, such as pharmaceuticals and pharmaceutical ingredients, there are still implications for the wider health sector. The impacts are still to be felt, but concerns have been raised by groups such as the Healthcare Financial Management Association about supply chain delays  impacting the availability of personal protective equipment (PPE) and other medical equipment and supplies.

Meanwhile, March marks the start of much of the annual payment rules season, so the Office of Management and Budget (OMB) is busy. OMB has already received the Inpatient Psychiatric Facilities and Hospice Prospective Payment System proposed rules, and more are on their way, including IPPS and OPPS for FY 2027. We expect these proposed rules in March or April.

The Senate

There were fireworks during the Senate HELP Committee hearing to consider the nomination of Dr. Casey Means to be the next United States Surgeon General. Chairman Bill Cassidy (R-LA) and Sen. Lisa Murkowski (R-AK), along with many Democrats, expressed concerns about Dr. Means’ views on vaccines. While these concerns are not the same as voting against the nomination, they could make Dr. Means’ road to the office a bit bumpier. At the time of publication, Sens. Murkowski and Susan Collins (R-ME) were still undecided on the nomination. Dr. Means can only afford one Republican defection in order to avoid being rejected by the Committee.

Will HHS Sec. Robert F. Kennedy, Jr. be heading to the Hill any time soon? During an executive session on February 26, Sen. Christopher Murphy (D-CT) urged the Committee to hold future hearings on the impact of last summer’s Reconciliation bill on health care. While Chairman Cassidy did not comment on that request, he did express support for bringing Kennedy, Jr. to testify before the committee again, where the department’s changes to the Childhood Vaccination Schedule and the Advisory Committee on Immunization Practices are likely to be a hot topic.

Health Care Hearings This Week

• March 5: Senate HELP Committee hearing on transforming health care with data and improving patient outcomes

The House

Whispers of Reconciliation 2.0 are making the rounds, and Rep. Richard Hudson, Chair of the National Republican Congressional Committee, told an audience at a BGov event that his members have begun discussing what could potentially be included. According to Rep. Hudson, any potential 2^nd reconciliation package would be smaller in scope and would need alignment from all Republicans, likely making it more difficult to get off the ground.

The House Appropriations Committee is getting started on FY 2027 funding, holding a Member Day hearing for Labor-HHS on March 5. The deadline for programmatic language has been moved up several weeks (now March 20). The Labor-HHS bill will allow earmarks for the first time in 3 years, specifically for the Health Resources and Services Administration’s community project funding. This would see funds allocated to rural clinics, hospitals, and Federally Qualified Health Centers. March 20 is also the deadline for members to get these community project funding requests submitted.

Other Health Care Hearings This Week

• March 4: House Oversight Committee hearing on fraud and misuse of federal funds in Minnesota
• March 4: House Veterans’ Affairs Oversight Subcommittee hearing on oversight of Veterans’ health care and benefits legislation
• March 5: House Veterans’ Affairs Health Subcommittee hearing on supporting Veterans with traumatic brain injury

There You Have It

The newly renamed Actor Awards were last night, with many worthy nominations. Were you surprised by the winners? Let us know. Make it a great week!

Now that most of the government funding fight is over, all eyes are focused on whether Congress can figure out a path forward for funding for the Department of Homeland Security (DHS) past February 13. Will love be in the air as Valentine’s Day approaches, or will things remain at an ICE-y impasse over recent border control actions? Let’s find out. Welcome to the Week Ahead!

The Administration

The Office of Personnel Management finalized a rule on February 6 that authorizes agencies to reclassify policy-influencing employees into a new Schedule Policy/Career category. The reclassification reduces some of the job protections that career employees usually have, like the right to appeal removals, suspensions, or demotions, thereby making it easier for agencies to fire civil servants. For the Department of Health and Human Services (HHS), a whole slew of employees could fall into the “policy-influencing” category, including anyone who

• helps write, shape, or clear policy or regulations
• advises leadership on policy choices
• translates statue into operational policy

Recently reported layoffs at the Advanced Research Projects Agency for Health (ARPA-H) indicate that the Trump administration is letting go non-political staff to ensure agencies are matching its priorities.

TrumpRx has launched, featuring drugs from 5 manufacturers that have agreed to most-favored-nation pricing deals. According to the White House, additional drugs will be available for purchase on the website in the coming months. However, not everyone is as optimistic as the president about the extent to which this will actually save patients money. Democratic Senators have dismissed the site, with Senate Finance Committee Ranking Member Wyden (D-OR) calling it “a glorified coupon book.” But it’s not just Democratic/progressive voices that are raising concerns. The Libertarian-leaning CATO Institute has commented that the federal government’s involvement will crowd out private innovation and incentivize cronyism. These are familiar arguments on the right, but we don’t expect many congressional Republicans to rain on the president’s parade.

The Senate

The on-again, off-again deal on extending the Advance Premium Tax Credits (APTCs) seems to be headed for a permanent breakup. Unsurprisingly, the cause of the breakup seems to be applying Hyde Amendment language to ensure subsidy funding does not go to abortion providers from the bill. Sen. Tim Kaine (D-VA) has indicated that it’s his understanding that Republicans are not willing to drop this from the bill and that Democrats need it to be dropped.

In non-APTC news, the Senate Aging Committee is scheduled to have a hearing on February 11 to examine regulatory challenges to physician practices. There are many ways this hearing could go, but policy proposals that may be brought up include ensuring appropriate Medicare physician reimbursement, reducing administrative burden on physicians, and addressing workforce shortages and burnout.

The House

While the House is busy working on a deal for DHS funding, should the health care sector care? DHS funds the Federal Emergency Management Agency, but all essential services under DHS continue like public emergencies and cybersecurity. A prolonged funding lapse could certainly affect visa processing and delay the medical supply chain. But we would argue the real reason DHS may get funded quickly is the Transportation Security Administration and all those flights lawmakers have lined up for the weekend.

House Energy and Commerce leaders are keeping true to their promise to highlight healthcare affordability by holding a Health Subcommittee hearing to examine the prescription drug supply chain on February 11. Major pharmaceutical interest groups, like PhARMA and PCMA, have been asked to testify before the committee. If the hearing goes anything like the health insurance hearings, expect a lot of finger pointing to other areas of the health sector for being the reason for increasing costs.

There You Have It

Last night’s Super Bowl was an event to watch. While it’s hard to pick just one commercial, Novartis’ commercial about blood test screenings for prostate cancer sure grabbed our attention. Talk about a tush push! Did you have a favorite commercial? Let us know. Make it a great week!

The idea of a snow day was always exciting as a kid: not going to school, playing in the snow, and getting a sugar rush from drinking hot chocolate. While Congress might wish for the childhood magic to return now that DC has been hit by a snow storm, it does not stop their growing to-do list for the week. So, let’s get into it. Welcome to the Week Ahead!

The Administration  

President Trump plans to meet with health insurance executives on the heels of their recent questioning during two House committee hearings.  

But what could President Trump actually have to say to them? We think it could go something like this: “Look, I like you people. I really do. You’re smart, you run big companies, very successful. But the system? The system is a mess. This is why I introduced my Great Healthcare Plan. We’re going to lower drug prices and insurance premiums, and you’re going to do it. We can help you but only if you help us, no excuses.”  

No matter the verbiage the president uses, expect him to make a big deal of this meeting and highlight his plan to show that his administration is doing something to address affordability concerns.   

It’s important to remember that in announcing the plan, President Trump called on Congress to enact his plan. So, it’s unclear what, if anything, the president plans on doing beyond pressuring Congress to put the principles in his plan into effect.   

The Senate  

The ball is now in the Senate’s court, after the House passed by a wide margin the minibus and the fiscal year 2026 (FY 26) Homeland Security funding bill last week to finish its work on the remaining FY26 funding bills. The minibus included over a dozen health care extenders (i.e., Medicare telehealth flexibilities, community health center funding) and 35 new health care policies (i.e., pharmacy benefit manager reform, Medicare coverage of multi-cancer early detection screening tests). There are a few procedural motions that need to happen before the Senate can vote on the bills to avoid a government shutdown on January 30.  

Minority Leader Chuck Schumer (D-NY) said that Democrats will block the minibus if it includes funding for the Department of Homeland Security, after the second fatal ICE shooting in Minnesota. This creates a wrinkle that will need to be ironed out if the Senate wants to avoid a partial government shutdown.  

So, what happened to those APTC conversations? With the funding bills taking up all the debate time, it seems that conversations about an APTC extension have been put on hold. With the end of January deadline from Leader John Thune (R-SD) fast approaching, the likelihood of an extension coming together is shrinking.  

Health Care Hearings This Week 

• January 28: Senate VA Committee hearing on modernizing the VA health care system  

• January 29: Senate Aging Committee hearing on drug labeling  

The House 

With the House out of session, let’s reflect on the recent Energy and Commerce and Ways and Means Committee hearings with health insurance executives.  While we saw passionate questioning from members on both sides of the aisle, there is more to come as Committee leaders have promised more hear care hearings hearings and future hearings with leaders from other areas of the health care sector. So, the question is: who’s next? hospital CEOs? pharma execs? If we were either, we would be look at our calendars and get ready to travel to DC.  

But what actually happened at the hearings? Although there was plenty of partisan fighting at the hearings, there was also strong support on both sides to tackle issues related to prior authorization and anger over the high compensation packages for insurance CEOs. While this could be the spark needed for bipartisan action on health care, expect the harsh winds of partisanship (especially during an election year) to make getting a fire going very difficult. 

There You Have It 

We hope everyone has stayed safe and warm with the snow. What is your favorite snow day tradition? Let us know. Make it a great week!