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The Week Ahead

Stay informed with our weekly buzz about what’s going on in Washington, DC.

Week Ahead: Love in the Air or ICE in the Heart

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!

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Snowy with a Side of Shutdown

While DC is still digging the city out of one of the worst winter storms of the last decade, Congress is in a storm of its own. The government entered a partial shutdown on January 31 after the Senate passed an amended minibus.  As we await House action, let’s get into it. Welcome to the Week Ahead!

The Administration

The anticipated launch of TrumpRx has gotten off to a rocky start. The platform, which will allow individuals to purchase prescription drugs at discounted rates, was supposed to launch on January 30, but is experiencing delays. While the administration has not given a reason, there has been speculation that deals with pharmaceutical companies are violating anti-kickback statute laws.

Department of Health and Human Services (HHS) Secretary Kennedy reportedly said that TrumpRx will launch “probably in the next 10 days,” indicating optimism that the holdup will be addressed quickly.

Meanwhile, changes to the Medicare Advantage (MA) program in the proposed Calendar Year 2027 MA and Part D Advance Notice are causing alarm among stakeholders.  Both AHIP and the Better Medicare Alliance hinted at possible benefits cuts should the rates be finalized as proposed.  The Association of Community Health Plans expressed concerns about the impact to safety net plans.  Even the American Hospital Association piled on, worrying that changes to the Star Ratings program could affect access to care.  With comments due February 25, proponents are scrambling to change the minds of CMS officials.

The Senate

As if the Senate heard us wondering, discussions on a potential enhanced advance premium tax credit (APTC) deal have renewed. Sen. Bernie Moreno (R-OH) reportedly shared legislative text on a compromise extension bill with 4 Democratic colleagues and is awaiting responses. But time has run out for the request by Senate Majority Leader Thune (R-SD) to have a bipartisan deal by the end of January.

Health Care Hearings This Week

  • February 3: Senate Health, Education, Labor, and Pensions (HELP) hearing on modernizing the National Institutes of Health
  • February 4: Senate Veterans’ Affairs Committee hearing on Veteran health and healing through adaptive sports

The House

Speaker Mike Johnson (R-LA-04) may have thought he had finished FY26 funding, but it is back on his to-do list.   With health care programs and health policy extenders taken care of in the Senate minibus, Johnson has to steer his caucus through a new vote strategy.

House Freedom Caucus members have previously stated that they will oppose a funding bill that does not include funding for the Department of Homeland Security. However, that was before President Trump endorsed the idea, and the Senate fell in line.  The House Rules Committee meets February 2 to set up floor debate and passage.

The House Energy and Commerce Oversight Subcommittee will hold a hearing on February 3 to examine Medicare and Medicaid fraud. The Subcommittee has recently been investigating allegations of Medicare home health and hospice payment fraud in Los Angeles County as well as Medicaid fraud in Minnesota, so this hearing will be a prime opportunity for the Subcommittee majority to highlight those actions. While the hearing is timely, remember that the Oversight Subcommittee is not responsible for writing policy related to Medicare and Medicaid fraud.  That’s up to the Health Subcommittee to determine any legislative activity in relation to the investigations.

There You Have It

We were on the edge of our seats watching the Grammys last night. Did your favorites win? Anyone you think got snubbed a la Bill Belichick? Let us know. Make it a great week!

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Week Ahead: Snow Day Decisions

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! 

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Week Ahead: 365 Days Later

As we approach the one-year anniversary of President Trump taking office for the second time, we have just as many questions about what the next 3 years will look like as we did on day one.  President Trump has already achieved one of his personal goals – a Nobel Peace prize – when Venezuelan opposition leader Maria Corina Machado gifted her Peace Prize medal during a White House visit. What else could President Trump check off from his bucket list? Let’s find out –welcome to the Week Ahead!

The Administration

President Trump released his Great Healthcare Plan which calls for lowering prescription drug prices and insurance premiums, and increasing transparency in health care costs and insurance benefits. The lack of details in the fact sheet creates more questions than it answers, but it’s clear the plan targets pharmacy benefit managers (PBMs) and health insurance companies, calling out those entities for deceptive practices and for accepting subsidies that the administration argues raise the cost of health insurance. Pharmaceutical companies are also under a microscope, with calls to codify most-favored-nation (MFN) pricing agreements and increase access to over-the-counter drugs. Many of the specific proposals in the plan, such as codifying MFN deals and PBM reform will require Congress to act. As we’ve seen, getting this Congress to act on health care is not easy, but getting the White House involvement is a necessary first step to unify the Republican majorities in both chambers.

The White House has promoted Farnoosh Faezi-Marian to Chief of the Health and Human Services (HHS) Branch at Office of Management and Budget (OMB). Faezi-Marian previously serviced as a Program Examiner at OMB, where she worked on budget development and execution for the Administration for Strategic Preparedness and Response. The promotion now has her leading the OMB office that is responsible for examining budget requests and making funding recommendations for HHS agencies so she will be an important voice in developing the President’s upcoming budget request to Congress for HHS.

The Senate

The Senate has left town without reaching an agreement on an extension of the enhanced advance premium tax credits (APTCs). The Open Enrollment period has already closed for most states, but a handful have deadlines to sign up for coverage through the end of January, which provides external pressure to reach an agreement. Senate Majority Leader Thune (R-SD) also previously told Punchbowl News that a deal would need to come together by the end of January, creating internal political pressure to move things along. Sen. Susan Collins (R-ME) who has been involved with negotiations on a bipartisan agreement has said negotiations will continue over the recess, but Leader Thune has cast doubt on the talks saying, “it doesn’t look like they’re close.”

The House

With the House scheduled to be out of session next week, it’s crunch time to pass the six remaining  appropriations bills to avoid at least a partial government shutdown on January 30. Although reports indicate neither side wants another shutdown, the remaining bills are some of the trickiest. These include Labor-HHS, Defense, and Homeland Security. The House has been working to pass appropriations bills in the form of minibus packages, and we expect that to continue. However, the controversy over ICE involved shootings in Minneapolis has made many believe that Homeland Security funding may need to be passed through a continuing resolution (CR).

Adding to the frenzy, over a dozen health care extenders, including telehealth flexibilities, community health center funding, and more, are set to expire at the end of the month. These have often been tied to government funding bills, but the possibility of a minibus for most and a CR for the Homeland Security bill raises questions as to whether the House has the stomach to authorize a longer-term extension for health care extenders or if they will keep kicking the can down the road. Extending funding for a year or two could provide stability for crucial health programs but would require more discussion than a shorter-term funding decision.

The House Budget Committee is holding a hearing on Health Care Costs that will feature witnesses from the Foundation for Research on Equal Opportunity and the Council for Affordable Health Coverage, both of whom might as well have offices in the Capitol Building for how often they’ve appeared in the last 4 months. But while there has been a lot of testimony, we have not seen any legislation as a result.

 Other Health Care Hearings This Week

  • January 22: House Energy and Commerce Health Subcommittee hearing on health insurance affordability
  • January 22: House Ways and Means Committee hearing with health insurance CEOs

There You Have It

With the NFL and College football playoffs happening, we’re seeing the season end for teams week after week. Are you prepared for the post-football seasonal depression? Let us know. Make it a great week!

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Week Ahead: Republicans Revolt

Lawmakers return to Washington following a week of Republican rebellion, including a bipartisan Senate War Powers Resolution to limit future military action against Venezuela and a House bill to extend Obamacare subsidies with more than a dozen House Republicans voting yes.  2026 is off to a rough start for party unity but let’s see what happens this week! Welcome to the Week Ahead!

The Administration

Speaking of Republicans sticking together, did you see this one?  The President casually mentioned he might veto an extension of enhanced Advance Premium Tax Credits (APTCs) if the Senate passed one.  Wait, what?

It’s one thing to break with leaders on Hyde Amendment restrictions – the President doesn’t necessarily agree with his party on that one – but comments like these make the already-difficult path ahead on the insurance subsidies just that much harder.

And on the AI front, the President also praised the Meta’s hiring of Dina Powell McCormick in a new role to impact governments and sovereigns on AI.  Reporting directly to Mark Zuckerberg, Powell McCormick has been a leader in global finance since her post with President George W. Bush, and also happens to be the wife of Sen. Dave McCormick of Pennsylvania.

The Senate

The Senate is feeling the heat to act on APTCs, given the House passage of a 3-year extension of the enhanced APTCs with a whopping 17 GOP members voting for it.  As we mentioned previously, this bill has no chance in the Senate, but there has been discussion of using it as a vehicle for the bipartisan proposal.

Now, the details of what that bipartisan package could look like are starting to come into focus. It’s expected that the bipartisan bill would include a 2-year extension of the enhanced APTCs, with reforms such as an income cap, the elimination of zero-premium plans, and expanded access to health savings accounts.

The talks over this proposal have been complicated by the fact that Republicans want to include language called the Hyde Amendment which prevents tax dollars from going to plans that provide abortions.  Although some Senate Republicans have reportedly indicated a willingness to be flexible on this point, our conversations on the Hill indicate that this remains a potential pitfall. Democratic Senators, including Senate Finance Committee Chair Ron Wyden (D-OR), have also raised concerns that eliminating zero-premium plans would harm low-income enrollees.

The Senate Appropriations Committee released text for a Fiscal Year minibus for State and Financial Services programs, a step towards preventing a government shutdown at the end of the month. However, the package notably does not fund the Department of Homeland Security, which was reportedly under consideration. This may mean there is disagreement, or this may be a reaction to the continuing controversial actions by the U.S. Immigration and Customs Enforcement.

Health Care Hearings This Week

  • January 15: Senate HELP Committee Executive Session to consider legislation on lung cancer research, ED fentanyl testing, rural hospital cybersecurity, and infant formula safety

The House

The House made progress on appropriations by passing H.R.6938 to fund Commerce, Energy and Water, and Interior.  House Majority Leader Steve Scalise’s (R-LA) schedule for the week of January 12  says “consideration of items related to FY26 Appropriations are possible” as leaders work to combine the remaining appropriations bills into at least two separate minibuses.

In case you’ve lost count, there are still six appropriations bills left to pass before January 30 to avoid a partial government shutdown, including the bill that funds the Department of Health and Human Services (HHS).

House health care committee leaders are busy prepping for their affordability hearing on January 22.  The Energy and Commerce and Ways and Means Committees announced they would haul in 5 of the largest insurance companies to face questions about lower costs in the commercial market.

 Health Care Hearings This Week

  • January 13: House Oversight Subcommittee on Gov Operations hearing on preventing fraud in federal programs
  • January 13: House VA Health Subcommittee legislative hearing

There You Have It

Did you watch the Golden Globes?  Hamnet, a recently released dramatic tale about Shakespeare and his family, won Best Picture and Best Female Actor.  Have you seen it?  Tell us if you would have voted for it!  Make it a great week.

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