Soccer fans had a Messi-filled weekend, and Congress is shaping up to have a messy week of its own. As congressional committees continue to work through legislation and nominations, House Republican leadership is looking to push a budget resolution, the NDAA, a stock trading ban, and a continuing resolution ahead of their August recess. But can they get it all done before the whistle blows? Let’s get into it. Welcome to the Week Ahead!
The Administration
The Centers for Medicare and Medicaid Services (CMS) is counting down to July 31, when the comment period for the interim final rule that implements the Medicaid work requirements put in place by the One Big Beautiful Bill Act closes. The rule’s provisions are legally in effect on that day (although states are not mandated to have their operational programs until January 1, 2027). 25 states, plus the District of Columbia, have challenged some of the agency’s interpretations of requirements under H.R. 1, the most notable being the narrow medical frailty exemption, arguing that the 2-part test goes beyond a plain language reading of the statute and puts vulnerable individuals with significant health care needs at risk of losing their coverage.
Meanwhile, the Trump administration is continuing its focus on the visa system, imposing more restrictions on the green card process. The State Department is considering adding a $100,000 bond to green card applications to “ensure immigrants are financially self-sufficient,” according to spokesperson Tommy Pigott. If the bond were to go into effect, it could be a significant barrier to nurses and medical technicians applying for a green card abroad as well as act as a deterrent for international medical graduates who apply outside the country. At the same time, the Department of Homeland Security has issued a final rule rescinding the 2022 regulation on public charge determinations that allowed authorities to consider only a green-card applicant’s use of cash benefits when determining whether the applicant would be a “public charge”. This change would mean that authorities could consider use of benefits, including Medicaid, in decisions about green card applications. Advocates have raised concerns that this would cause immigrants to avoid using programs like Medicaid, thus delaying care and ultimately forcing more individuals to rely on emergency room care.
The Senate
It’s a packed week for the Senate Committee on Health, Education, Labor, and Pensions (HELP). First up is the Committee’s executive session on a variety of health care bills on July 22. One of those bills is S. 4189, the INSULIN Act of 2026, which would cap the cost of insulin at $35 per month for individuals with private health insurance. This bipartisan bill is being co-led by Sen. Susan Collins (R-ME) and has eight other committee members as cosponsors. Also on the docket is S. 2355, the Patients Deserve Price Tags Act, which is being led by HELP Committee members Sens. Roger Marshall (R-KS) and John Hickenlooper (D-CO). While the House Energy and Commerce and Ways and Means Committees have passed a number of health price transparency bills, the Patients Deserve Price Tags Act stands apart mainly on employer access to claims data. Other bills being considered include legislation on country-of-origin prescription labeling, access to generic medications, and food safety.
On July 23, the Senate HELP Committee will be voting on the nominations of Dr. Erica Schwartz, to be Director of the Centers for Disease Control and Prevention (CDC), and Sean Kaufman, to be Assistant Secretary of Preparedness and Response (ASPR). During the nomination hearing on July 15, sparks flew as HELP Chairman Bill Cassidy (R-LA) pressed both nominees on their view of vaccines and whether they would be influenced by political pressures. Several senators on the committee, including Sens. Lisa Murkowski (R-AK), Andy Kim (D-NJ), Tim Kaine (D-VA), Tammy Baldwin (D-WI), and John Hickenlooper (D-CO), told reporters on July 16 they were undecided on how they will vote. This complicates the path forward as the nominees will need the support of all Republicans on the Committee if all Democratic members oppose their nominations.
Other Health Care Hearings This Week
- July 22: Senate Indian Affairs Committee meeting to consider the nomination of Mark Cruz to be Indian Health Service Director
The House
House Republican leaders are hoping for a hat trick as they look to advance the resolution necessary for a third budget reconciliation package. The House Budget Committee has set up the shot by passing a resolution that calls for $95 billion in spending for the military, aid for farmers, and election measures. Although it also included a provision allowing for additional funding for the Health Care Fraud and Abuse Control Program, there were no instructions for the Committees with jurisdiction over Medicare and Medicaid. Despite the movement on the resolution, challenges still remain. These challenges include a thin majority in the House, limited floor time, and concerns from fiscal hawks who will want to offset the price tag, as well as from more moderate Republicans who may have issues with either funding tied to the Iran war or the election measures. And that’s just in the House. Some Senate Republicans, such as Sens. Rick Scott (R-FL) and Bill Cassidy (R-LA) have also voiced their concerns about the need for pay-fors.
At the same time, House Republicans have released the text for a Continuing Resolution (CR) that would fund the government at fiscal year 2026 levels through December 4, 2026. Speaker of the House Mike Johnson (R-LA-1) has plans to put the bill on the floor before they leave town. Although the CR does not include health care extenders (such as community health center funding and Medicare add-on payments) it does include funding for Indian Health Service staffing and facilities as well as funding for the Supplemental Nutrition Program for Women, Infants, and Children (WIC), which is currently set to lapse on September 30, 2026. The House is also slated to consider thirteen health care bills. These include bills to reauthorize public health programs and to address needs for specific diseases and conditions. They also include a bill directing the Food and Drug Administration (FDA) to publish a final rule allowing non-animal testing in drug approvals, a bill clarifying Medicare payment rules for manual wheelchairs, and a bill allowing for the Secretary of Labor to suspend Federal Employees’ Compensation Act payments to medical providers convicted of fraud.
As the House deals with all this, the House Energy and Commerce Committee is holding a markup of various bills on July 20, including bills related to illicit drugs and health price transparency, that have passed out of the Health Subcommittee.
Other Health Care Hearings This Week
- July 21: House Education and Workforce markup, including a bill to classify certain health care professionals serving in temporary roles as independent contractors
- July 22: House Oversight Committee markup, including a bill to address concerns about certain pharmacy benefit manager (PBM) practices within the federal employee health insurance system
There You Have It
The World Cup has finally ended, with Spain emerging as the victors. Were you happy with the final game? Let us know. Make it a great week!
