The Week Ahead

The clock keeps ticking toward September 30, and the stakes are particularly high given that Congress is out next week for the Rosh Hashanah holiday. This week, the stakes feel particularly high. All eyes are on Senate Minority Leader Chuck Schumer (D-NY) as he has taken a strong stance on what he wants for his support on must-pass government funding legislation. The central question: Will Congress find a path forward on critical health care provisions, or are we headed toward yet another shutdown showdown? So – let’s get into it, welcome to the Week Ahead! 

The Administration  

It’s politics and prose with the administration this week.  On the political side, President Trump and Vice President Vance are expected to continue focusing on the brutal murder of political activist Charlie Kirk.  Both will be attending Kirk’s funeral, and the President has announced he will honor Kirk with a posthumous Presidential Medal of Freedom.  In addition to eulogizing the fallen leader, the President has taken to excoriating progressive politicians and organizations and has said he will launch investigations into “groups of interest” that may have fed into the torment that led to the assassination. 

On the prose front, the Centers for Medicare and Medicaid Services are pouring through stakeholder comments to the calendar year payment rules, including hospital outpatient, physician fee schedule, home health, and end-stage renal disease.  While CMS often includes policies that health care providers seek to tone down during the comment period, of particular focus is the home health rule that takes $1 billion in payments away from home health providers, according to the National Home Care Alliance.  

In other exciting news, CMS released guidance on September 15 for states to submit their applications for the $50B Rural Health Transformation Program. This guidance provides states with the official roadmap for accessing a major new federal investment aimed at strengthening health care in rural areas.

The Senate  

The Senate is bracing for a fierce battle over advanced premium tax credits (APTCs), a cornerstone of affordable health coverage for millions of Americans. Schumer is holding firm, insisting that any continuing resolution (CR) to keep the government open must include an extension of these subsidies. 

Schumer, who faced intense backlash from his caucus after siding with Republicans on a funding measure in March, is determined not to repeat that mistake. He has already made it clear to reporters—no APTCs, no CR. 

Republicans, meanwhile, are pushing for a “clean CR” that would extend all existing programs and funding, including health extenders such as Medicare add-on payments for rural hospitals, funding for community health centers, the Teaching Health Center Graduate Medical Education program, and delays to Disproportionate Share Hospital (DSH) cuts.  

Under normal circumstances, compromise might be within reach. But with the political climate highly charged, APTCs looming large, and open enrollment around the corner, Schumer appears unlikely to back down. The result? A heightened risk of a government shutdown—one that could leave both APTCs and health extenders hanging in the balance. 

Senate Hearings this Week  

• September 17: Senate Committee on Aging Hearing on Drug Safety, Supply Chains, and Risk to Aging Americans 

• September 17: Senate HELP Hearing on “Restoring Trust Through Radical Transparency: Reviewing Recent Events at the Centers for Disease Control and Prevention and Implications for Children’s Health” 

• September 17: Senate Committee on Veterans’ Affairs Hearing on Strengthening Services for Veterans with Spinal Cord Injury and Disorder 

The House 

Over on the House side, the question is whether leadership will try to force the Senate’s hand by moving its own appropriations bill. Democratic Leader Hakeem Jeffries (D-NY) has remained tightly aligned with Schumer, keeping the focus squarely on APTCs.  

At the same time, Congress is feeling pressure from stakeholders to avoid any lapse in health extenders. Hospitals, health centers, and other providers depend on predictable funding to plan services, retain staff, and keep doors open—especially in rural and underserved areas. A disruption, even a temporary one, could have real-world consequences for patients. 

Word is that some time on September 15 we will see the text of a “clean” CR that would run through November 20 or 21. House Republican leaders were said to be close to putting the final touches on a CR. The CR is said to extend expiring health provisions through the length of the CR and not include the APTC extension the Democrats have been calling for. House Republicans are reportedly eyeing September 17 for a vote on the CR. 

Later this week, attention will be on the Medicaid and CHIP Payment Access Commission (MACPAC) as they meet for the first time since Congress passed the One Big Beautiful Bill Act. The meeting will include a review of the legislation and start to explore the work and community engagement requirements in Medicaid.  

 House Hearings this Week  

• September 16: House Ways and Means Hearing on “Virtue Signaling vs. Vital Services: Where Tax-Exempt Hospitals are Spending Your Tax Dollars”  

• September 18: House Energy and Commerce Health Subcommittee Hearing on Legislation to Expand Seniors’ Access to Innovative Medical Care 

There You Have It  

September marks Healthy Aging Month—a perfect reminder to celebrate every stage of life and enjoy the fall season. Make it a great week! 

It’s the dog days of the D.C. summer—and it’s been a historically muggy one and the second worst on record for the nation’s capital. House Speaker Mike Johnson (R-LA) rang the recess bells as the House broke for its August recess last week, and despite speculation the Senate may stick around, it looks like Senate Majority Leader John Thune (R-SD) will let the Senate follow suit in a few days. So, let’s get into it—welcome to the Week Ahead! 

The Administration  

The President departed Washington on July 25, 2025, the U.S. Department of Health & Human Services (HHS) is busy forwarding the Make America Healthy Again (MAHA) agenda.  With obesity top of mind, the National Academies of Sciences, Engineering, and Medicine (NASEM) will host a virtual event titled Exploring the Role of Physical Activity in Obesity Treatment, Body Weight Management, and Related Health Outcomes in Adults: A Workshop. 

At the same time, the American Medical Association is urging HHS Secretary Robert F. Kennedy to reverse course on reported plans to remove all members of the U.S. Preventive Services Task Force. In a letter sent July 25, the AMA warned that such a move would disrupt the task force’s evidence-based process for developing clinical preventive recommendations—guidance that directly shapes insurance coverage for services like cancer screenings and mental health assessments. The organization called on Secretary Kennedy to retain the current members and maintain the group’s regular meeting schedule to avoid undermining patient access to essential care. 

The Senate 

In the Senate, there could be bipartisan agreement in getting at least a few assignments done before the recess bells start dinging as senators try to approve multiple appropriations bills.  Senate Appropriations Chair Susan Collins (R-ME) is leading an effort to package various appropriations bills covering Military Construction-Veterans Affairs, Agriculture, Commerce-Justice-Science, and Legislative Branch into one beautiful “minibus” bill that can clear the Senate. All bills easily cleared the Senate Appropriations Committee with bipartisan support, and things bode well with the Senate clearing the way for consideration of the Mil Con-VA bill last week.  However, as we reported last week, Minority Leader Chuck Schumer and Senate Democrats may stand in the way.  

On the health care front, Senate Health, Education, Labor & Pension (HELP) Chair Bill Cassidy (R-LA) is not pencils-down yet, having given the Committee an active agenda.  On July 31, HELP will hold a hearing on “Making Health Care Affordable: Solutions to Lower Costs and Empower Patients.” While tax measures like the advance premium tax credits (APTCs) fall under the jurisdiction of the Senate Finance Committee, they may still surface in this discussion as part of broader testimony on affordability and access to marketplace coverage. 

Cassidy has been working with Sen. Tammy Baldwin (D-WI) to lay the groundwork for a bipartisan health package, and the 4 health care bills that are set for markup on July 30, include the Over-the-Counter Monograph Drug User Fee Amendments (S. 2292), the Improving Care in Rural America Reauthorization Act (S.2301), the Kay Hagan Tick Reauthorization Act (S. 2294) and the Uniformed Services Leave Parity Act (S. 1440).  

The House 

The House is out and departed swampy DC until September.  Perhaps they are enjoying more enjoyable weather as they meet with constituents about OB3.  (Yes, OB3 is one of the many emergent acronyms for the One Big Beautiful Bill!) 

There You Have It 

July 28 marks “National Milk Chocolate Day” so do yourself a favor and treat yourself to something cold and chocolatey today and…. Make it a great week!  

The House is back after a week of celebrating/demagoguing the One Big Beautiful Bill Act (OBBBA) and the Senate has a rescissions package on the table. Meanwhile, the deadlines to fund the government and pass health care extenders are fast approaching.  So, let’s get into it – welcome to the Week Ahead!

The Administration

The Rural Health Transformation Fund is getting all the attention in the newly signed OBBBA, which provides $50B over 5 years to states to improve access, outcomes and financial stability for rural hospitals and other providers.  The fund is meant to blunt the law’s $155B cut in funding over 10 years for rural areas, an estimate from the Kaiser Family Foundation.

With an application deadline of December 31, states, rural health care providers, and other stakeholders are eagerly awaiting guidance from the Centers for Medicare and Medicaid Services (CMS).

Funding for the program can be used for:

• Payments to health care providers
• Recruitment and workforce training
• Purchasing new technologies
• Supporting access to opioid use disorder treatment and mental health services
• Promoting evidence-based interventions to improve preventive care and chronic disease management

Food and Drug Administration (FDA) Commissioner Marty Makary is also making news by saying the agency may fast track new drugs from pharmaceutical companies that “equalize” the cost of their medicines between the U.S. and other OPEC countries.  In a Bloomberg Television interview, he floated the idea that price adjustments may give companies another way to obtain vouchers under the National Priority Review Voucher program. The program, launched last month, is designed to shorten the approval process for companies it says are backing national interests.

While Makary described the idea as supporting President Trump’s goal of preventing foreign countries from securing lower drug prices at Americans’ expense, he did not provide details about how drug companies would have to adjust their prices to qualify for a voucher under the program.

This announcement follows the issuance of a May executive order on most-favored nation (MFN) prescription drug pricing and repeated threats to impose tariffs on foreign pharmaceutical products, including a July 8 threat to impose tariffs up to 200% “very soon.” However, this voucher proposal takes a “carrot” approach to pricing that may be more palatable to congressional Republicans who’ve expressed anxiety about MFN and tariffs.

The Senate

The White House is hoping to score another win by passing a $9.4B rescissions package which would make significant cuts to federal HIV funding and global health programs, including $400M from the President’s Emergency Plan for AIDS Relief (PEPFAR).

Despite opposition from certain Senate Republicans about the bill’s impact on domestic HIV prevention and global health diplomacy, as well as on emergency alerts in rural areas if federal funding is eliminated to public broadcasting, the package still has a path forward because Senate rules require only a simple majority to pass it. However, the package faces a strict procedural deadline: it must be passed within 45 days of submission, which in this case would be July 18.

Deja vu all over again?  If the Senate waters down the savings in the bill to accommodate concerns from the Senators mentioned above, it could complicate passage in the House by the deadline, given Freedom Caucus interests in holding firm on the President’s requests for cuts to these programs.

The bigger impact may be on the FY 2026 appropriations process, and the potential for the government to run out of funding on September 30.  In a Dear Colleague, Senate Leader Chuck Schumer (D-NY) called the recissions package “…an affront to the bipartisan appropriations process” and added that it would be “absurd” for GOP lawmakers to then “expect Democrats to act as business as usual and engage in a partisan appropriations process to fund government.”

Senate Health Hearings

• Senate HELP Nomination Hearing for Assistant Secretary for HHS

The House

With the House only in session for two more weeks before Labor Day, speculation is already growing on how Congress will handle the health care provisions, like Medicare telehealth waivers, that expire with the continuing resolution (CR) on September 30.  Will there be a straight extension of current policy for a few more months, as has been done in the past?  Or will Speaker Mike Johnson (R-LA) try to address health care in a second reconciliation bill he has hinted at this fall?

Speaking of health care priorities, the Energy and Commerce Health Subcommittee will hold a July 16 hearing on the public health workforce, rural health, and over-the-counter drug legislation.  This will be the first hearing for the subcommittee since Rep. Morgan Griffith (R-VA) was selected as the Subcommittee Chair. Griffith has long shown interest in streamlining FDA processes, and he might prioritize legislation aimed at faster drug approvals, clarifying regulatory pathways, or encouraging domestic drug manufacturing to reduce foreign dependence.

There You Have It

Summer travel season is in full swing! Where are you traveling this summer?  Be on the lookout for our summer reading recs on LinkedIn!  Make it a great week!