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The Week Ahead

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

DOGE and Health Care: Real Change or Political Theater?

Week Ahead: Buyouts and Budgets

Valentine’s Day is just around the corner, and there are signs of a lover’s quarrel between House and Senate Republicans over who gets to be first to move forward with the budget reconciliation process.  There is certainly no love lost between President Trump and congressional Democrats!  What does this week hold in DC?  Let’s get into it. Welcome to the Week Ahead! 

The Administration   

Elon Musk and his “Department of Government Efficiency (DOGE)” have turned their attention to the Department of Health and Human Services (HHS). The Centers for Medicare and Medicaid Services (CMS) confirmed in a February 5 statement that “two agency veterans” are working with DOGE staff to find “opportunities for more effective and efficient use of resources in line with meeting the goals of President Trump.” Democratic leaders of the congressional committees with jurisdiction over CMS have called for an investigation highlighting their concerns about DOGE having access to Americans’ personal health information.  While the big dollars of waste, fraud, and abuse come from Medicare and Medicaid, you know DOGE will be digging into the Centers for Disease Control and Prevention and Food and Drug Administration soon enough.  

The administration is also looking to trim the federal government by buying out federal employees.  The deadline for federal workers to take deals was February 6, but a federal judge extended that deadline to February 10, when a hearing is scheduled to consider the legality of the buyout. Regardless of what happens with the buyout and DOGE, the administration’s actions related to federal agencies and the federal workforce have already led to massive disruption at the agencies, including their unwillingness to hold meetings and respond to normal government requests. 

The Senate   

Senate Budget Committee Chair Lindsey Graham (R-SC) has released a Fiscal Year 2025 budget resolution to advance Trump Administration priorities on defense, border security, and energy. Although health care isn’t the focus, the resolution does call on the Senate Finance Committee to produce at least $1 billion in savings. Senate Finance Committee Ranking Member Ron Wyden (D-OR) sees this as a sign that Republicans will look to make cuts to public health programs to pay for their priorities. However, President Trump has communicated that he does not want to see cuts made to Medicare and Medicaid. Of course, what is and what is not a “cut” is in the eye of the beholder. The Senate Budget Committee is scheduled to consider the budget resolution on February 12 and February 13.  

Senate Majority Leader John Thune (R-SD) has filed for cloture on several cabinet nominees, including RFK Jr. to be Secretary of HHS. A vote on his nomination could come as soon as February 14.  Trump’s nominee to lead CMS, Dr. Mehmet Oz, is still working on getting his paperwork in order, but his committee hearing is in the offing.  Dr. Oz has recently met with Senate Finance Committee Chair Mike Crapo (R-ID) and Senate Health, Education, Labor, and Pensions Chair Bill Cassidy (R-LA), a critical step in the confirmation process.  

The House  

House Republicans had reportedly been close to unveiling a budget resolution for markup ahead of the Senate Budget Committee’s hearings on February 12 and 13. Accomplishing this would’ve been a nice win for House Speaker Mike Johnson (R-LA) and would’ve sent a message to his caucus that he can move on to the President’s agenda. However, Speaker Johnson called a time out at the Super Bowl last night when he said that markup may need to be postponed in order to get the details right.  

The House Ways and Means Health Subcommittee has scheduled the first hearing of the 119th Congress for February 11 to “examine ways to promote healthy living with more options, greater flexibility, and better incentives for patients.”  This hearing will focus on employer-sponsored health plans and chronic care, highlighting Buchanan’s recently introduced a bill to allow for employers who offer high-deductible health plans the option of including pre-deductible coverage for certain chronic disease treatments.  This bill has also been a priority for Senate Majority Leader Thune, boosting its chances of becoming law this session. 

There You Have It 

What was your favorite Super Bowl ad?  We are posting our favs on LinkedIn!  Let us know. Make it a great week!  

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Week Ahead: Reconciliation Waiting Game

Lawmakers return to D.C. following tragic plane crashes in Arlington, VA and Philadelphia, PA,  amid a number of questions regarding airline safety. Congress continues consideration of President Trump’s cabinet nominees as well as discussions on budget reconciliation and government funding. So, with that, let’s get into it. Welcome to the Week Ahead!  

The Administration 

The Centers for Medicare and Medicaid Services (CMS) issued a presser on January 29 commenting on the Biden administration’s recent release of the next 15 drugs to be included in the second cycle of Medicare prescription drug price negotiations. CMS intends to “provide opportunities for stakeholders to offer specific ideas to improve the Negotiation Program consistent with the goals of achieving greater value for beneficiaries and taxpayers and continuing to foster innovation.” 

Allowing the government direct negotiating power in the Medicare prescription drug program (Part D) was a signature achievement of the Inflation Reduction Act and has been a policy goal for Democrats going back to the creation of the Part D program.  President Trump’s position on Medicare drug price negotiations is murky at best.  While he hasn’t always held to traditional conservative positions on drug policy, Democratic Members of Congress aren’t taking any chances and are asking for Trump to reject any effort to undo the Medicare negotiation policy. 

The Senate  

The name of the game for the Senate continues to be confirming President Trump’s nominees. On February 4, the Senate Finance Committee will hold an Executive Session to vote on the nomination of RFK Jr. to be the Secretary of the Department of Health and Human Services (HHS). This vote follows hearings at both the Senate Finance Committee and the Senate Health, Education, Labor, and Pensions (HELP Committee) where RFK Jr. received widespread support from Republicans (although there were some grumblings from a few HELP GOP Members about Kennedy’s position on vaccine safety and efficacy). Since the Senate Finance Committee is the only committee that will vote on Kennedy’s nomination, the next step after the February 4 vote (assuming the committee advances the nomination) will be a vote on the Senate floor for confirmation.   

The Senate Finance Committee will also consider Jamieson Greer for U.S. Trade Representative on February 6. The U.S. Trade Representative can have a significant impact on health care policy as they work to implement the President’s trade agenda.  

In Trump’s case, that agenda includes the use of tariffs. Even though the Constitution gives Congress the authority to lay and collect duties on imported goods, Congress has given the President authority to change tariff rates if the administration can make the case that doing so is in response to specific national security or foreign policy interests.  

President Trump made use of these authorities during his first administration and has promised to impose tariffs on imported products including medical supplies and prescription drugs. The Trump Administration and other Republicans argue that these tariffs are necessary to protect American industry and reduce the nation’s dependence on foreign countries for critical supplies such as medicines. Opponents raise concerns that tariffs may lead to increased prices and more shortages of generic drugs. We expect tariffs to be a major topic of conversation at Greer’s hearing.  

The House  

Rep. Greg Murphy (R-NC) and a bipartisan group of lawmakers introduced the Medicare Patient Access and Practice Stabilization Act of 2025 on January 31. This bill would provide physicians with a 6.62% increase in Medicare reimbursement rates that would be retroactive to the start of 2025 when a 2.8% reimbursement rate reduction went into effect. Addressing concerns about the Medicare reimbursement rates for physicians has long been a priority for doctors. When Congress didn’t step in to mitigate the impact of the reimbursement rate reduction at the beginning of the year, physician groups were disappointed. But the introduction of this bill gives some hope that some relief from the payment cut that took effect on January could happen. That said, introducing the bill is just the first step in a year packed with government funding decisions and budget reconciliation.  

Speaking of budget reconciliation, it is unlikely that House Speaker Mike Johnson (R-LA) will be able to meet his optimistic goal of passing a budget resolution by February 27. This is especially true given reports of a phone call between members of the House Budget Committee that apparently failed to produce a date for marking up the resolution. Speaker Johnson is now reportedly pushing expectations back to May 2025, a timeline more in line with recent Congresses.  A later date is also an acknowledgment of the difficulty of passing a partisan resolution where just one or a few GOP defectors could be spoilers.  

Also Happening This Week 

  • 2/5: House Natural Resources Subcommittee on Indian and Insular Affairs legislative hearing on bills including H.R. 741, to elevate the Director of the Indian Health Service (IHS) to an Assistant Secretary position (Note: RFK Jr. has said he will elevate the IHS Director to an Assistant Secretary position if confirmed as HHS Secretary). 
  • 2/6: House Energy and Commerce Health Subcommittee hearing on the threat of illicit drugs.  

There You Have It 

The 2025 GRAMMYs were awarded on February 2, with a special effort to raise funds for those impacted by the L.A. wildfires. Did your favorites win? Let us know! Make it a great week!  

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Week Ahead: What a Week!  

The Philadelphia Eagles and the Kansas City Chiefs stamped their tickets to the Super Bowl in the NFC and AFC championship games. Not to be outdone, Washington D.C. continues to produce a lot of political gamesmanship. We have updates on the state of those political games, so let’s get into it. Welcome to the Week Ahead!  

The Administration 

Acting Health and Human Services (HHS) Secretary Dr. Dorothy Fink, issued an internal memo on January 21 directing staff to refrain from issuing communications until at least February 1 unless a presidential appointee has reviewed and approved it. There are exceptions for “mission critical” communications, but there are still concerns about the impact the pause could have on public health. As interested parties await the break in silence, they also hold their breaths as they look towards the nomination hearings of HHS leaders from RFK Jr. on down.  

However, a communications freeze does not mean the department is waiting to move on policy. Case in point: the Food and Drug Administration (FDA) officially withdrew the menthol ban that had been lingering at the Office of Management and Budget (OMB) since October 2023. President Trump has also taken several executive actions that directly or indirectly impact health care policy. These include: 

  • Scrapping plans for a Centers for Medicare and Medicaid Innovation (CMMI) model that would have limited out-of-pocket costs for generic drugs as part of a broader Executive Order rescinding several Biden era policies.  
  • Allowing Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) officers to enter hospitals to detain migrants..  
  • Beginning the process of withdrawing from the World Health Organization (WHO).  

The Senate  

RFK Jr. will have the chance to make his case before the Senate Finance Committee on January 29 and the Senate Committee on Health, Education, Labor, and Pensions on January 30. Only the Senate Finance Committee will have a vote on the nomination, but both hearings matter as they will give key senators on both sides of the aisle opportunities to have their say.  

RFK Jr. faces challenges from both the left and right. In the January 20 edition of the Week Ahead, we told you about an anti-RFK advertising campaign from the progressive group 314 Action. On January 22, the conservative group Advancing American Freedom announced its own advertising campaign to prevent RFK’s confirmation. Ultimately, it will be up to Senators to decide if the arguments from these strange bedfellows hold any weight.  

Also this week: The Senate Committee on Veterans Affairs (VA) will be holding a hearing on the VA’s Community Care Program on January 28. This follows a House VA Committee hearing on the same topic on January 22.  

The House  

The House is in recess, but members are meeting with Trump in Florida. We will be watching for any news from this meeting in the White House’s southern wing.  

Eyes will also be on Florida as primary elections are held for the seats left open by former Reps. Matt Gaetz (R-FL-1) and Michael Waltz (R-FL-6). These are especially important as Republicans in the House have a razor thin majority.  

There You Have It 

Super Bowl Sunday is coming up! Who are you rooting for? Let us know! Make it a great week!  

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Week Ahead: And Here We Go

At 12 PM on January 20, 2025, Donald Trump joins Grover Cleveland as the second President to serve two non-consecutive terms in office. As he returns to office, there is already a lot on his plate, as well as the plates of the Republican majorities in the House and Senate. All we can say is bon appétit and welcome to the Week Ahead!  

The Administration 

The incoming Trump administration is reportedly planning a major immigration enforcement action in Chicago. Cities such as Washington, D.C., Philadelphia, L.A., and Denver could also be sites for early immigration enforcement actions.  

Trump’s early actions on immigration will set the tone for his second term and could give us a hint into how he will act on matters where immigration and health care intersect. While much of the attention will be on deportations of those implicated in serious crimes, other executive actions in the coming days could provide insights as to how federal health care programs, such as Medicaid and the Affordable Care Act, might be utilized in the effort to combat illegal immigration. For example, Trump could revive his 2019 rule to include the use of Medicaid as a qualifying factor to declare someone as inadmissible to the United States as a “public charge.” In addition, the new administration could also try to tie Medicaid funding to states to cooperation with federal immigration officials.  

The Senate 

Although a hearing has yet to be announced, RFK Jr. has continued hitting the Hill and meeting with senators to build support for his nomination to run the Department of Health and Human Services (HHS). 

Kennedy’s push comes as some outside groups continue their campaigns to urge opposition to Kennedy’s confirmation. One group, 314 Action, announced the next phase of an advertising campaign targeting GOP senators that the group thinks could be key in determining if Kennedy can get across the finish line. The senators they are targeting include Mitch McConnell (R-KY), Lisa Murkowski (R-AK), Joni Ernst (R-IA), Bill Cassidy (R-LA), Susan Collins (R-ME), Thom Tillis (R-NC), John Curtis (R-UT), John Cornyn (R-TX), and Mike Rounds (R-SD).  

In addition to the nomination process, Sen. Bill Cassidy (R-LA) has scheduled the first meeting https://hearing/of the Senate Health, Education, Labor, and Pensions (HELP) in the 119th Congress on January 21. The executive session will be when the Committee adopts its rules for the 119th Congress. If you are looking for hints on what Sen. Bill Cassidy’s (R-LA) chairmanship of the Committee will look like, look no further than the press release which highlights, among other things, his work to pass pharmacy benefit manager (PBM) reform and reduce the cost of prescription drugs in the 118th Congress.  

The House 

The House continues to buzz with talk of budget reconciliation and what could be considered as a part of the one (or two) bill effort. A menu produced by the House Budget Committee outlines a litany of policy options that could be considered as part of reconciliation legislation. Health care policies on that list include: 

  • Revoking the eligibility of non-citizens without legal status to participate in federal health programs  
  • Medicare site neutrality  
  • Limiting Obamacare premium subsidies  

Keep in mind this list is meant to be a comprehensive list of possible options, so just because something is on this list does not mean it will be included in a reconciliation bill. However, it demonstrates the vast array of options that Republicans may consider as they plan to move forward with the reconciliation process. 

Of course, Representatives have other choices regarding what policies to pursue. We are hearing that Ways and Means Committee Chair Jason Smith (R-MO-8) is looking to keep up the Committee’s focus on rural health care after being disappointed in the number of rural health bills that the Committee considered but were not passed into law in the last Congress. This list includes legislation allowing critical access hospitals that have shut down to reopen as rural emergency hospitals and legislation to ensure more graduate medical students complete their residency in rural hospitals.  

Also, this week, the House Veterans’ Affairs Health Subcommittee will hold an oversight hearing on the Department of Veterans Affairs (VA) Community Care Program and Community Care Network on January 22.  

There You Have It 

The Washington Commanders defeated the Detroit Lions on January 18, earning them their first trip to the NFC Championship in 33  years. Only one more round until we get to the Super Bowl. (Diazepam)   Who do you want to head to the big game? Let us know! Make it a great week!  

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Full Steam Ahead

Congress returns for its second full week of work as Southern California battles wildfires. As Members of Congress respond to this issue, they also continue to discuss decisions that must be made about government funding, health care extenders, and confirmation hearings for President-elect Trump’s cabinet nominees. So, let’s get into it. Welcome to the Week Ahead!   

The Administration 

Biden’s Nicotine Ban  

President Biden is expected to propose limitations on nicotine in cigarettes before he leaves office on January 20. This move is in line with a long-standing goal of the administration, but it also comes after the Biden administration failed to move forward with a rule to ban menthol cigarettes.  

Presidents often push last-minute policies at the end of their time in office. However, that carries a risk, especially when the president’s party does not control the incoming administration and new Congress. That being said, it’s not a foregone conclusion that the second Trump administration will repeal this proposal. On the one hand, during the first Trump administration, the FDA restricted the sale of certain flavored e-cigarettes over concerns that they were being marketed in a way that appealed to minors.  He also signed legislation that increased the federal minimum age to purchase tobacco to 21 years of age. On the other hand, during the presidential campaign, Trump said he would “Save vaping again.” However, as President Biden prepares to leave office and President-elect Trump prepares to assume it, the future is as cloudy as a smoky room.  

ACA Deadline 

The January 15 deadline to enroll in an Affordable Care Act plan for 2025 is fast approaching. The Department of Health and Human Services is touting that 24 million people have already signed up for coverage, and that this is the fourth year of record enrollment. But once again, the future of this program depends on the actions of a very different administration and a Congress under complete Republican control. Even if Republicans are unlikely to push for a full-scale repeal and replace because of bad memories of the 2017 effort, Congress and the second Trump administration will have to decide on the expanded tax credits that expire at the year’s end.  

The Senate 

Confirmation hearings for President-elect Trump’s nominees begin in force with hearings for the Attorney General, Secretary of State, Secretary of Treasury, and several other nominations scheduled for the week of January 13. One hearing that hasn’t been scheduled? The hearing for Secretary of Health and Human Services nominee RFK Jr. Sen. Crapo (R-ID), who chairs the Senate Finance Committee, had stated he hoped to get this hearing scheduled for the week of January 13. However, as of the writing of this newsletter, the paperwork required to schedule the hearing has not been filed. In the meantime, RFK Jr. Continues talking with Republicans and Democrats to get his nomination across the finish line. But will it be enough, given the reticence from Senate Health, Education, Labor, and Pensions Committee chair Sen. Bill Cassidy (R-LA)? 

Another hearing you might have missed with all the confirmation excitement is the Senate Aging Committee hearing on Jan. 15 on improving senior wellness.  

The House  

Rep. Buddy Carter (R-GA), chair of the Energy and Commerce Health Subcommittee, told the press he is working with House leadership to pass a health care package that was at one point part of the end-of-the-year spending bill. Although the individual provisions (such as telehealth and reforms to pharmacy benefit managers) have bipartisan buy-in, there is not much of an incentive to negotiate if differences arise, and costs could complicate efforts. One thing that could help get Republicans on board is if Trump weighed in with support. Trump has criticized PBMs, so it’s not impossible. It will be interesting to watch to see how Carter moves forward on this.  

There You Have It  

Following the NFL’s Wild Card Weekend, nine teams remain in the hunt for a Super Bowl LIX appearance. For those who’ve made brackets, how is it going? Let us know. Make it a great week!  

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