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The Week Ahead

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

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Week Ahead: The Final Stretch

Remember when you were a kid, and someone else’s school got out for summer before yours? That same deeply unfair feeling is settling over the Senate right about now. The House has packed its bags and headed home for summer break, while senators are still stuck at their desks watching their colleagues disappear into the sunshine while feeling the heat from the President on the SAVE Act. So, let’s get into it. Welcome to the Week Ahead!

The Administration

President Trump has announced his next set of tariffs on the pharmaceutical sector with a 100% tariff on imported generic drugs beginning in August 2028. John Murphy III, the President and CEO of the Association for Accessible Medicines (AAM)has said they need to see more specifics about the policy, but that the generics industry is committed to policies that stabilize the industry and patient access to affordable medications. On the Hill, Senate Finance Committee Ranking Member Ron Wyden (D-OR) introduced legislation to require congressional approval of tariffs before they take effect.

Attention is divided at the Centers for Disease Control and Prevention (CDC) as the agency deals with rising measles cases and the cyclosporiasis outbreak. Measles was declared eliminated in the US in 2000, but cases have been on the rise over the past few years. Over halfway through 2026, and the number of reported cases has surpassed 2025 levels, which was the most reported since 1991. Cyclosporiasis is also hitting new milestones as 9 states are now battling outbreaks. The Food and Drug Administration (FDA) is working with the CDC to investigate sources of the parasite and contain its spread. The simultaneous public health threats have fueled criticisms about public health funding levels and staffing cuts at the agencies. The lack of permanent leadership at the CDC and FDA is likely not helping the administration to contain the issues and will mean that any nominee will have a lot to clean up.

The Senate

The Senate must now pick up where the House left off and decide on the direction for Reconciliation 3.0. Senate Majority Leader John Thune (R-SD) has said he doesn’t have the votes to pass the House resolution and that his focus is on government funding. Thune has said that he plans to bring the House-passed continuing resolution (CR), which extends existing government funding through December 4, up for a vote before the Senate’s August recess. However, he has also said he would consider using Reconciliation to fund the government and avoid a shutdown if a CR cannot be passed. Notably, the CR does not include health care extenders, such as telehealth flexibilities and funding for Medicare-dependent and low-volume hospitals, that often accompany government funding bills because most of them are already extended until at least the end of the year.

Meanwhile, new Senate Budget Committee Chairman Ron Johnson (R-WI) shared that he has directed Budget Committee staff to begin drafting two Senate budget resolutions, with the goal to pass one of them before the August recess. The first would mirror the House resolution, and the second would be more expansive to ensure GOP funding priorities are met. Chairman Johnson also said he supports a fourth reconciliation package focused on addressing fraud. In discussing this, he cited Centers for Medicare and Medicaid Services actions against hospice providers in Los Angeles as an example of the sort of rampant fraud that needs to be addressed.

Also on our radar: Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Bill Cassidy (R-LA) is looking to move on the Committee vote to advance the nomination of Dr. Erica Schwartz to be Director of the Centers for Disease Control and Prevention (CDC). This vote had to be delayed, despite Cassidy’s support, due to a family emergency affecting Sen. Lisa Murkowski (R-AK). Along with Dr. Schwartz’s nomination, the Committee also delayed a vote on the nomination of Sean Kaufman to serve as Assistant Secretary for Preparedness and Response (ASPR). During his nomination hearing, bipartisan concerns were raised about his views on vaccines. A HELP Committee spokesperson has shared that “there are ongoing conversations with the administration on the path forward for Mr. Kaufman’s nomination.” The Committee is scheduled to vote on his nomination, as well as bill from Chairman Cassidy on health privacy, during the July 30 executive session.

Other Health Care Hearings This Week

  • July 29: Senate Homeland Security Committee hearing with Dr. Anthony Fauci

The House

House Members are out of session until August 31.

There You Have It

What was your final week of school like when you were little?  Field days, yearbook signings, class parties?  Let us know your favorites!  Make it a great week.

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Week Ahead: The Messi Calendar

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!

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Crunch Time

There are only 8 more days left with both the House and the Senate in session before the August recess, and Congress has a lot on its plate. The top of the list includes fiscal year 2027 appropriations bills, Republican hopes for Reconciliation 3.0, and dealing with renewed conflict in Iran. Overshadowing it all is the unexpected death of Senate Budget Committee Chairman Lindsey Graham (R-SC). Let’s get into it. Welcome to the Week Ahead!

The Administration

The Department of Health and Human Services (HHS) postponed the U.S. Preventive Services Task Force’s meeting for the fourth time in the past year, citing an “unprecedented” volume of applications from prospective members. The delay follows a broader overhaul of the task force’s membership. In May, HHS removed chair John Wong and vice chair Esa Davis, and the agency has been soliciting nominations for a new slate of members. Given the pattern of repeated delays over the past year, it will be important to see if HHS names new task force members or sets a new meeting date in the coming weeks, and whether congressional Democrats and advocacy groups, who have previously pushed back on changes to the task force, respond to this latest postponement.

Meanwhile, the White House is once again focusing on the H-1B visa program with new a Department of Labor (DOL) investigation into visa fraud. Vice President Vance announced the new effort, following court challenges to the $100,000 H-1B fee imposed by the Trump administration in September 2025. The initiative will focus on checking underpayment of foreign workers, layoffs of qualified Americans, and labor trafficking. While much of the focus has been on the information technology industry, it will be important to pay attention to how the investigation impacts the health care workforce, which includes a significant number of H-1B visa holders.

The Senate

The passing of Sen. Graham has major implications for the Senate’s agenda, as he chaired the Senate Budget Committee, which would be responsible for drafting instructions for a third reconciliation bill. Sen. Ron Johnson (R-WI) is the most senior Republican on the Committee without an existing chairmanship, is next in line for the post and his office has said he is “prepared to serve.” Sen. Johnson is a staunch fiscal hawk who previously called for cuts during the debates over the first reconciliation package. This suggests he may demand cuts to offset the price tag of a third package. Sen. Graham’s passing also means that, until his temporary replacement is named and until Sen. Mitch McConnell (R-KY) returns, the Republican majority is down to 51 Senators.

The Senate Health, Education, Labor, and Pensions (HELP) Committee is looking to start filling in the gaps in federal health policy leadership with a nomination hearing on July 15. Up for review are Sean Kaufman to be Assistant Secretary for Preparedness and Response (ASPR) and Dr. Erica Schwartz to be Director of the Centers for Disease Control and Prevention (CDC). The nomination hearings indicate that HELP Committee Chairman Bill Cassidy (R-LA) is willing to work with the Trump administration to move forward with their picks despite losing his primary in May. Also, on his to-do list are nomination hearings for the US Surgeon General and the yet-to-be-announced Director for the Food and Drug Administration (FDA). And that’s assuming that Dr. Schwartz lasts longer than her predecessors’ 29 days!

We are also tracking a July 14 Senate Judiciary Committee hearing on how the debate over what products are eligible for patents impacts genetic medicine. Our conversations on the Hill indicate that the hearing will be focused on S. 1545, the Patent Eligibility Restoration Act of 2025 (PERA). If this bill were to eventually become law it would make it easier for diagnostic methods, genetic testing applications, and personalized-medicine inventions built around genetic material to be patented.

Other Health Care Hearings This Week

  • July 15: Senate Armed Services Personnel Subcommittee hearing on the Tricare pharmacy program
  • July 15: Senate Aging Committee hearing on foreign ownership and control in America’s drug supply chain

The House

House Republican leadership is returning to Washington after failing to advance appropriations bills before the July 4th recess. The House Rules Committee is scheduled to consider a rule on July 13 that would include the national security and Department of State appropriations legislation (along with a Veterans bill with a variety of health care provisions). However, it remains to be seen if House Republican leadership can overcome the efforts by some House Republicans to halt floor action unless progress is made on the SAVE America Act. At the same time, there continues to be interest in reconciliation 3.0 in the House, with some calling for provisions to enact health care priorities such as expanding access to health savings accounts and strengthening federal price transparency requirements. House Speaker Mike Johnson (R-LA-4) reportedly met with members of the House Budget Committee on July 12. Despite this movement, hurdles such as a thin Republican majority and dwindling days on the calendar make a third reconciliation package a tall order.

While the House as a whole deals with all these priorities and more, the House Energy and Commerce Health Subcommittee is set to examine America’s leadership in biomedical innovation and the FDA’s role in drug development on July 15. Based on our conversations on the Hill, we expect the hearing to include a focus on how the US can improve the drug research and approval process to be competitive with China, as well as drug user fee reauthorization.

Other Health Care Hearings This Week

  • July 14: House Education and Workforce Committee hearing on the impact of DEI on medical schools
  • July 15: House Select Committee on China hearing on the federal research security enterprise

There You Have It

Movies are a great way to take shelter from the summer heat, and July is setting up to have a lot of options between the new live-action Moana, The Odyssey, the next Spider-Man, and more. Is there one that you are looking forward to? Let us know. Make it a great week!

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Week Ahead: 250 Years and Counting

Washington is looking forward to a three-day weekend, as the nation gears up to celebrate 250 years of independence. However, there’s still a lot going on in the health care space. Medicare payment rules are being reviewed, House conservatives are making a push for health care reform in Reconciliation 3.0, and a 340B reform discussion draft has been published. So, let’s get into it. Welcome to the Week Ahead!

The Administration

Minds may be focused on summer, but it’s also rules season for the Centers for Medicare and Medicaid Services (CMS) as the agency works with the Office of Management and Budget (OMB) to release both proposed and finalized versions of several of the payment rules for calendar (CY) and fiscal year (FY) 2027. The CY27 Physician Fee Schedule proposed rule and CY27 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule are usually released in early to mid-July. We expect the CY27 PFS to acknowledge the statutory end of the 2.5% pay bump that Congress provided for physicians through the 2025 reconciliation bill, which is certain to prompt renewed calls from physician groups for both a short-term fix and longer-term reform of how the PFS rate is calculated. It will also be important to see if CMS responds to concerns about other controversial provisions of the CY26 PFS final rule, such as the -2.5% efficiency adjustment and the reductions to the practice expense portion of the reimbursement calculation for facility-based services. For the CY27 HOPPS proposed rule, we expect CMS to continue its multi-year phase-out of the inpatient-only list and propose a larger 340B conversion factor offset than CY26. CMS may also propose differentiated skin-substitute rates based on Food and Drug Administration (FDA) regulatory categories. These expectations are based on CMS comments included in the CY26 HOPPS final rule fact sheet. CMS and OMB are also still working on releasing the FY27 Hospital Inpatient Prospective Payment System (IPPS) final rule and the FY27 Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) final rule, which we expect in late July-early August.

Meanwhile, speculation continues as to who will be President Trump’s next nominee for Food and Drug Administration (FDA) Commissioner. A few names have reportedly emerged as finalists, although the White House has not confirmed this report. Reported finalists include Dr. Heidi Overton, who currently serves as deputy director of the White House Domestic Policy Council, Dr. Jeffery Vacirca, who is the CEO of the board of New York Cancer & Blood Specialists, and Stephen Ferrara, who previously served as Chief Medical Officer for the Navy and the Central Intelligence Agency (CIA). A June 24 report from RBC Capital Markets also listed John Crowley, CEO of the Biotechnology Innovation Organization (BIO), and current acting commissioner Kyle Diamantas as top candidates. Crowley’s appointment would be a big win for pharmaceutical companies and could go a long way in repairing the administration’s relationship with the sector.

In other nomination news, President Trump has announced Chris Klomp will be nominated for Deputy Secretary of Health and Human Services. Klomp has been on the rise after becoming Chief Counselor of HHS in February. This role will require Senate confirmation, but he has already cleared one hurdle: approval from Senate HELP Committee Chair Bill Cassidy (R-LA), who has expressed his support on social media.

The Senate

The Senate has left town until July 13, but right before packing his bags, Senate HELP Committee Chair Cassidy dropped a discussion draft to reform the 340B Drug Pricing Program. The proposed changes aim to prevent duplication of drug discounts, create reporting requirements on how 340B revenue is being used, and impose a sliding fee scale for low-income patients. The discussion draft shows that Chair Cassidy is not taking it easy despite his lame duck status. However, it’s unclear how much progress he can make before his term ends.

The House

Whispers about Reconciliation 3.0 are getting louder again, this time focusing on potential health policy inclusions. House Freedom Caucus members authored a letter to Speaker of the House Mike Johnson (R-LA-4) calling for “health care freedom reforms”, such as expanding access to health savings accounts (HSAs) and strengthening federal price transparency requirements. However, like everything else in the House these days, passage of a third reconciliation bill is complicated by President Trump’s demands to pass his election bill, the SAVE America Act. Speaker Johnson has proposed including a grant program in a third reconciliation package to fund state efforts to implement portions of the SAVE America Act. While this could preemptively meet the Byrd Rule in the Senate, which requires measures passed through reconciliation to have a budgetary impact, it may leave both hardline conservatives (who want full passage of the SAVE America Act) and certain Senate Republicans (who have voiced concerns about the SAVE America Act) unsatisfied.

Additionally, the Ways and Means Committee is looking to take another run at a bill requiring additional transparency from nonprofit hospitals, after it was pulled from a previous Committee markup. The legislation, as previously proposed, would require nonprofit hospitals to meet new transparency requirements when filing their Form 990 with the Internal Revenue Service each year. Our conversations on the Hill indicate that Committee Republicans are still working through the process of incorporating stakeholder feedback and hope to move on it soon.

Also on our radar, the House Majority Leader’s schedule for the week of June 29 incudes H.R. 5347, the Health Care Efficiency Through Flexibility Act. This bill would preserve existing accountable care organization (ACO) quality reporting collection types through performance year (PY) 2029, bar CMS from deeming an ACO’s data “unrepresentative” solely because some participants couldn’t submit via the chosen collection type (subject to certain requirements) and establish an optional digital quality measure pilot (PY 2028–2032) with reporting relief for participants.

Looking ahead: House Democrats are gearing up for future possibilities if they retake the chamber in the midterm elections. Party leadership has established 5 Cost of Living working groups to discuss possible policies to address affordability, which will be the number 1 priority if Democrats win back control of the chamber, according to Minority Leader Hakeem Jeffries (D-NY-8). The Health working group will be headed by Reps. Alexandria Ocasio-Cortez (D-NY-14) and Terri Sewell (D-AL-7) and aims to develop policy recommendations to lower health care costs and expand access. The materials produced by the working group will likely form the backbone of Democratic health policy and signal the changes Democrats will try to enact if they regain control of the House.

House Health Care Hearings This Week

There You Have It

The 4th of July is almost here, and with it the United States is celebrating the 250th anniversary. About 45% of Americans were also alive for the 200th celebrations. If you were there, let us know what you remember about it. Make it a great week!

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Week Ahead: Under Review

Washington returns after a long weekend dealing with the fallout of President Trump’s last-minute decision to halt consideration of his nominee for Director of National Intelligence and his signing of an agreement to end the war with Iran. Vice President Vance arrived in Switzerland on Sunday to lead the next round of negotiations with Iranian officials with the goal of brokering an interim deal addressing Tehran’s nuclear program. Meanwhile, federal health care officials are working on reviewing some of their past work, and Congress continues its work on some familiar items even as the midterms grow ever closer. So, let’s get into it. Welcome to the Week Ahead!

The Administration

Hopefully, Centers for Medicare and Medicaid Services (CMS) officials tasked with managing the Medicare Advantage (MA) star ratings system enjoyed their time off because they are gearing up to recalculate the 2026 Star ratings and 2027 Quality Bonus Payments (QBP). A federal judge recently ruled that the agency relied on improper data and failed to follow the appropriate regulatory process for adding measures in determining the star rating for Clover Health. The real pressure is on insurers seeking a reconsideration of their QBP ratings, as they must notify CMS of their intent to resubmit a bid or to opt out of resubmission by 11:59 PM Pacific Daylight Time on June 22, 2026.

Meanwhile, the Congressional Budget Office (CBO) is taking another look at the impacts of the No Surprises Act. Specifically, CBO is considering how the independent dispute resolution (IDR) process may have had unanticipated impacts. According to the agency, published reports have indicated that providers are winning over 80% of cases that move through the process and are being awarded much higher payments than expected. As a result, CBO is requesting additional research that uses more recent data to understand network participation, pricing, and ownership structure trends. CBO is also looking for research on the arbitrators’ decision-making process and how health care markets continue to evolve. This call for research is the latest in the struggles that have plagued both the Biden and Trump administrations when it comes to implementing the No Surprises Act. Being able to get the balance right would be a win for the administration, but it could easily intensify the fighting between providers and insurers.

The Senate

President Trump is scheduled to attend Wednesday’s Republican Steering Committee lunch, where he is expected to continue to champion the SAVE America Act. His appearance on the Hill comes at a time when tensions are running high with the lapse of FISA and concerns about the Iran talks.

Eyes are turned to Louisiana, as voters head to the polls to cast their ballots in the Senate primary runoff. On the Republican side, voters have the choice between Rep. Julia Letlow (R-LA-5) and state Treasurer John Fleming. Not on the ballot is Senator and HELP Committee Chairman Bill Cassidy (R-LA), who came in 3rd in the May primary. His loss will leave a health leadership hole. However, Rep. Letlow, backed by President Trump and Health and Human Services Secretary Robert Kennedy, has embraced the Make America Healthy Again (MAHA) mantra, so health care has continued to feature heavily in this race. If Rep. Letlow wins, it would be a big win for the MAHA movement.

Health Care Hearings This Week

  • June 24: Senate Indian Affairs Committee nomination hearing to consider Mark Cruz to be Director of the Indian Health Service
  • June 24: Joint Economic Committee hearing on combatting health care fraud

The House

The Improving Seniors’ Timely Access to Care Act (H.R. 3514) has reached 290 cosponsors, which now allows for it to be considered outside of the standard Committee process. This longtime bipartisan bill proposes reforms for prior authorization under Medicare Advantage plans. We are still expecting the bill to follow the Committee process as a courtesy based on our conversations on the Hill. Regardless of whether the bill goes to Committee or not, this is a milestone for a bill that has lingered despite strong bipartisan support.

The House Energy and Commerce Committee’s work will take center stage this week. Chair Guthrie (R-KY) and Ranking Member Pallone (D-NJ) are expected to announce a successful bipartisan agreement on legislation surrounding children’s online safety. Thresholds for parental consent on data collection of minors have been lowered and mandatory disclosures when children interact with AI tools.  The bill is expected to move through the lower chamber quickly. The Committee’s Oversight Subcommittee will convene June 25 to examine with testimony from Minnesota’s Medicaid Director, continuing House Republicans’ focus on fraud in federal health programs.

There You Have It

The World Cup is ongoing, and the United States has secured its spot in the round of 32 with its win against Australia. How do you think the US is stacking up? Let us know. Make it a great week!

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