The Week Ahead

While it looked like the Senate was going to make an early exit from DC, there are still a few items Senate Majority Leader John Thune (R-SD) would like to hammer out before the midterms. This includes advancing nominees and a bill to address concerns about the impact of data centers on electricity rates. So, let’s get into it. Welcome to the Week Ahead!

The Administration

The use of appropriated funding has been called into question again, and once again Senate Appropriations Committee Chair Susan Collins (R-ME) is taking a leading role. In a letter sent to administration officials, Chair Collins urged that the remaining $1.3 billion appropriated for Global Health Programs (GHP) be obligated before the fiscal year ends on September 30. GHP funding is used to administer maternal and child health programs as well as counter infectious diseases like HIV/AIDS, malaria, and tuberculosis. Chair Collins recently succeeded in getting the White House to reverse a planned Executive Order that would establish a new committee at the National Institutes of Health (NIH) to oversee grant funding. It will be interesting to see how the administration responds to this request. We expect Collins to highlight this as an example of her independence from the administration in her tough re-election fight.

Meanwhile, the Centers for Medicare and Medicaid Services (CMS), has announced the removal of 760,000 people from Affordable Care Act (ACA) coverage. According to CMS Administrator Mehmet Oz, this determination was made because these enrollees never filed a claim and the agency was unable to contact them. The agency expects this to result in an estimated $2.2 billion in returned subsidies. CMS has also identified an additional 419,000 enrollees for additional verification. Along with this, the Department of Health and Human Services (HHS) published an interim final rule that pauses new broker registrations for 2027 open enrollment on the federal exchanges. Both HHS Secretary Kennedy and CMS Administrator Oz highlighted this action as being part of an effort to ensure federal dollars go to people they were intended to serve. This lines up with the administration’s broader messaging that combating fraud helps programs that are meant to make life more affordable. We expect the administration to continue making this argument in the final months leading up to the midterms.

In other CMS news, states have until September 30 to sign agreements to participate in the GENErating cost Reductions fOr US Medicaid (GENEROUS) Model. This model provides Most-Favored-Nation (MFN) pricing for certain prescription drugs from participating companies to Medicaid enrollees in participating states. According to a CMS press release, all 50 states plus DC and Puerto Rico have applied to participate and 40 states and Puerto Rico have already signed their final agreements.

The Senate

The confirmation process is moving along for HHS leadership nominees. The nomination of Chris Klomp, to be Deputy Secretary, and Ge Bai, to be Assistant Secretary for Planning and Evaluation (ASPE), have advanced out of the Senate Finance Committee. Their last hurdle will be a vote on the Senate Floor. The Senate Health, Education, Labor, and Pensions (HELP) Committee postponed its votes on Nicole Saphier, to be US Surgeon General, Timothy Westlake, to be Assistant Secretary for Mental Health and Substance Use, and Mary Lazare, to be Assistant Secretary for Aging, to September 30. Not included in the voting block is Heidi Overton, to be Food and Drug Administration (FDA) Commissioner, who testified before the HELP Committee on September 24.

Prescription drug labeling could also be getting some floor time before the end of the year, if Senate Aging Committee Chairman Rick Scott (R-FL) gets his way. During the Aging Committee hearing on September 23, Chairman Scott predicted that S. 3788, the CLEAR LABELS Act, would be voted on by the Senate before 2027. The bill would require drugs and active pharmaceutical ingredients (API) to be labeled with the name and place of business of the manufacturers. The bill could be moved through the unanimous consent process, but that could be a difficult lift as only one Senator needs to object, or it could be part of a larger legislative package.

The House

House members are back in their districts.

There You Have It

The National Hockey League (NHL) regular season kicks off tomorrow after a couple of weeks of preseason matchups. How’s your team shaping up? Are they ready to go all the way to the Stanley Cup finals? Let us know. Make it a great week!

Congress returns to Washington after the GOP held a rarely seen midterm convention where President Trump promised that every American adult would receive a $5,000 dividend if Republicans keep both the House and Senate. Meanwhile, it’s hearing central in Congress as members look to hone their messages before returning to the campaign trail for the final sprint before the midterms. So, let’s get into it. Welcome to the Week Ahead!

The Administration

If one check wasn’t enough, the Trump administration has also pledged to send checks to individuals they claim were overcharged for health insurance premiums through the Affordable Care Act (ACA) federal marketplace. The $500 checks would be mailed in October, just ahead of the midterm elections, and seem to be another way for the administration to highlight actions to address concerns about health care affordability.

President Trump also used the podium at the Republican National Convention to call on Congress to pass his “Great Healthcare Plan.” This plan calls for redirecting ACA subsidies to taxpayers and codifying executive actions related to price transparency and the Most-Favored-Nation drug pricing deals the administration has negotiated. It will be important to see how Republicans in Congress react as they return to Washington.

Speaking of health care affordability messaging, the Centers for Medicare and Medicaid Services (CMS) has spent the past month highlighting how states are benefiting from the Rural Health Transformation Program (RHTP). The 18 press releases published as of September 14, have each featured how individual states are using the funds, such as Arkansas expanding telehealth services and West Virginia investing in medical transportation. We expect the administration to continue to highlight RHTP funding.

The Senate

It’s nomination week in the Senate, as multiple health care appointees are slated for committee hearings. The most notable is Chris Klomp, who currently serves as Chief Counselor at the Department of Health and Human Services (HHS) but is up for Deputy Secretary of HHS. Klomp has been a star in the second Trump administration who has been involved with several major policy initiatives and has often served as an HHS spokesperson at events around the country. Klomp will appear before the Senate Finance Committee on September 15 and the Senate Health, Education, Labor, and Pensions (HELP) Committee on September 16. Although both committees will have a hearing with Klomp, it will ultimately be up to the Senate Finance Committee to decide whether to advance Klomp’s nomination. In addition to Klomp, the Senate Finance Committee will also consider the nomination of Ge Bai to be an Assistant Secretary of Health and Human Services.

The Senate HELP Committee will also be hearing from the nominee for US Surgeon General, Dr. Nicole Saphier, and Assistant Secretary for Mental Health and Substance Use, Dr. Timothy Westlake. Notably absent from the list is Dr. Heidi Overton, who is the nominee to be the Food and Drug Administration (FDA) Commissioner. Our conversations on the hill indicate that if her nomination hearing is not held this week, it will likely be pushed until after the midterms due to the limited calendar and other items demanding the Senate’s attention.

Other Health Care Hearings This Week

• September 16: Senate Aging Committee hearing on the menopause care gap

The House

With the pesky issue of funding the government out of the way, the House is focusing on hearings. These are the last opportunities for committee leadership to use their hearings to highlight the issues that matter to them before the midterms. The health care hearings scheduled hit on a couple of familiar notes including health care affordability as well as health care fraud and anticompetitive behavior. Additionally, we have what may be the last legislative hearing related to health care in the House as the Energy and Commerce Health Subcommittee is scheduled to discuss legislative proposals to reform Medicare provider payments and bolster health care cybersecurity. The biggest focus is likely to be on the provider payment bills. One such bill is H.R. 9693, the Patients First Act, the legislation introduced by the leaders of the GOP and Democratic Doctors Caucuses that seeks to reform the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Also up for consideration is H.R. 8163, the Provider Reimbursement Stability Act, which seeks to reform the budget neutrality framework of the Medicare Physician Fee Schedule. Importantly, this hearing is not a markup, so there will not be a vote on these bills. However, this is the first step in moving a bill through a Committee and could signal what may come if there is any appetite for year-end legislation.

Additionally, there are a four health care bills that are on the schedule for floor consideration this week, including legislation related to the Indian Health Service (IHS), a bill to reauthorize a program to combat tick-borne disease, and a bill that would issue guidance on fentanyl testing in emergency departments.

More Health Care Hearings This Week

• September 14: House Judiciary Administrative State, Regulatory Reform, and Antitrust Subcommittee field hearing on health care markets, fraud, and competition
• September 15: House Oversight Health Care and Financial Services Subcommittee hearing on addressing the unaffordability of oral chemotherapy
• September 16: House Science, Space, and Technology Investigations and Oversight Subcommittee hearing on balancing biotechnology innovation and biosecurity

There You Have It

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If there is one thing senators on both sides can usually agree on, it’s the importance of August recess, especially during an election year. However, President Donald Trump’s demand that the Senate cancel the planned recess to pass the SAVE America Act and advance a budget reconciliation resolution has put pressure on Republicans to stay in town. Will the demands work? We’re on the edge of our seats. So, let’s get into it. Welcome to the Week Ahead!

The Administration

The Centers for Medicare and Medicaid Services (CMS) is hard at work on Medicare payment rules, reviewing stakeholder comments and getting rules finalized ahead of the next fiscal and calendar years. All of the final fiscal year rules for 2027, including the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, the Inpatient Rehabilitation Facility Prospective Payment System, the Skilled Nursing Facility Prospective Payment System, the Inpatient Psychiatric Facility Prospective Payment System, and the Hospice Wage Index Proposed Payment System, have been pushed out the door but the comment periods for the 2027 calendar year payment rules, including the Physician Fee Schedule, Changes to the End-Stage Renal Disease Prospective Payment System, the Home Health Prospective Payment System, and the Hospital Outpatient Prospective Payment System, are still ongoing, so stakeholders are working on submitting their statements before the deadlines.

Meanwhile, the administration was handed a momentary win when a federal judge in Massachusetts denied a request for a preliminary injunction against parts  of the Medicaid work requirements interim final rule. The injunction request was made by 25 states and Washington, D.C., who are challenging the inclusion of a work requirement in the definition of medically frail, the use of a 12-month look-back period in assessing medical frailty claims, and the imposition of a work requirement on the short-term hardship exception. The judge ruled against the injunction request on the basis that the states did not show that it was necessary to prevent irreparable harm. However, the judge also noted that the denial was not a reflection or anticipation of what the court will ultimately decide in the lawsuit and the ruling said the court will set an expedited schedule to allow for full briefing ahead of the January 1, 2027, implementation deadline. Furthermore, the ruling noted that the injunction request was being denied without prejudice, meaning if the briefing continues to the implementation date of January 1, 2027, states could again ask the court to issue an injunction.

The Senate

Despite the pressure from President Trump and over a dozen senators to cancel recess, Senate Majority Leader John Thune (R-SD) has said he doesn’t see a reason to do so. Specifically, Leader Thune has said that the Senate has voted on the SAVE Act multiple times, and he doesn’t see how staying in town would change the result.  

As that drama plays out, Leader Thune has filed cloture on the legislative vehicle to extend government funding through December 4. The measure includes a provision to block President Trump’s rule to change the approval of grants (at least through December 11). There is also plenty of Committee-level work related to health care. The Senate Budget Committee is holding a hearing on Medicaid on August 4, which will be the first hearing that Sen. Ron Johnson (R-WI) has called since becoming Budget Chair, other than a previously scheduled business meeting to advance a nomination. Also on August 4, the Senate Finance Health Subcommittee is holding a hearing on biotechnology, and the Senate Judiciary Committee was planning on holding a hearing on how competition and transparency can lower drug costs, but it has been postponed.

The House

House members are enjoying their August recess.

There You Have It

Those of us here at Chamber Hill are also looking forward to the possibilities that August has to offer. What is your favorite summer activity? Let us know. Make it a great week!