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The Week Ahead

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

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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New Year…Same Speaker

The holidays may be over, but the weather in D.C. reminds us that winter is still here. Between the snowstorm and the funeral of Jimmy Carter, it might not seem like a lot will get done in Washington this week. However, with the start of a new Congress and the incoming Trump administration, there is still a lot to dig into. So, let’s start digging. Welcome to the Week Ahead!  

The Administration  

Former Center for Medicare and Medicaid Innovation (CMMI) Director Brad Smith has reportedly taken a leadership role within the next administration’s Department of Government Efficiency (DOGE) effort. CMMI has faced years of criticism that the center has failed to live up to its mandate to improve care quality and lower costs. Mr. Smith would be in a prime position to either protect the center he used to run, reform it, or help dismantle it in service of DOGE’s mission to find and eliminate spending it determines to be wasteful.  

Mr. Smith’s involvement in DOGE could also have other implications for health care policy. For example, Mr. Smith might use DOGE to look into other areas of health care, such as Medicare Advantage (MA).  MA has been under bipartisan attack in the last several years, and the timing couldn’t be more perfect given that the Centers for Medicare and Medicaid Services (CMS) is set to finalize the Contract Year 2026 MA and Part D rule in the spring of 2025. 

The Senate 

The 119th Congress officially began on January 3, and at least one confirmation hearing is currently scheduled by the Armed Services Committee on January 14 to consider Pete Hegseth to be Secretary of Defense.  We expect more noms hearings to be announced for next week as the Senate looks to get as many of President-elect Trump’s cabinet members as possible confirmed by January 20.  

We also now have a full picture of the committee assignments for Republican and Democratic Senators in the 119th Congress, including the following new members:  

  • Senate Finance Committee: Sens. Roger Marshall (R-KS), Bernie Sanders (I-VT), Tina Smith (D-MN), Raphael Warnock (D-GA), and Peter Welch (D-VT). 
  • Senate HELP Committee: Sens. Jim Banks (R-IN), Tim Scott (R-SC), Josh Hawley (R-MO), Mike Crapo (R-ID), Marsha Blackburn (R-TN), John Hickenlooper (D-CO), Andy Kim (D-NJ), Lisa Blunt Rochester (D-DE), and Angela Alsobrooks (D-MD). 
  • Senate Appropriations Committee: Sens. Markwayne Mullin (R-OK), Mike Rounds (R-SD), Kirsten Gillibrand (D-NY), and Jon Ossoff (D-GA). 

The House 

President-elect Trump gave Speaker Johnson a belated Christmas gift this year when he reached out on the Speaker’s behalf to swing two defectors to support Johnson in his successful bid to retain the speakership. Speaker Johnson and his leadership team still has very slim margins to work with, especially until the special elections fill vacant seats held by Republicans heading to the administration.  

Already, it’s been reported that Speaker Johnson told members of his caucus that President-elect Trump wants to see Congress pass “one big, beautiful bill” for reconciliation instead of the two-bill strategy that the House Freedom Caucus and others have previously endorsed. Trump weighing on House matters caused quite the  headache for the Speaker to complete a government funding patch in December, so expect to see more intraparty, inter-chamber squabbling this year.  

There You Have It 

Politics often gets compared with entertainment especially in an age where members of Congress have their own podcasts. But on January 5, we saw a different kind of entertainment with the 2025 Golden Globes. Did your favorites win? Which ones surprised you? Let us know. Make it a great week!  

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Week Ahead: Rocking Around the C.R. Tree

It’s the week before Christmas, and all over Capitol Hill, members are racing to reach a government funding deal.  And as 2025 approaches, we are also tracking activity of President-elect Trump’s nominees and advisors related to health care. So, let’s get into it; welcome to the Week Ahead!   

The Administration 

In a December 4 interview on CNBC, Vivek Ramaswamy shared his thoughts about his plans as a co-leader of the Department of Government Efficiency (DOGE). In that interview, Mr. Ramaswamy shared how getting rid of improper payments in Medicare and Medicaid could help save hundreds of billions of dollars.  

Both Republican and Democratic administrations have talked about saving Medicare and Medicaid dollars through various plans in the past. From changing how services are paid for under Medicare to how federal dollars are distributed to state Medicaid plans, there is no shortage of ideas. But the question is, will DOGE be different, and will the Trump administration take heat for proposing ideas that could be seen as cutting the programs?  

The Senate  

If you walk into any of the Senate office buildings these days, you will likely find more than mice stirring. You may even see some of President-elect Trump’s nominees, such as the nominee for Health and Human Services (HHS) RFK Jr. The pro-choice, former Democrat truly embodies the unconventional vibes we are already feeling from Team Trump 2.0.  

RFK Jr. is set to meet with Senators this week. Can he win the votes of certain GOP senators who reportedly have concerns, such as Sens. Collins (R-ME), Murkowski (R-AK), and Cassidy (R-LA)? (https://www.magiklights.com/) Might his views on the health of the nation’s food and skepticism towards big pharma sway any Democrats who have the same concerns?  We consistently see Republicans trying to get to “yes” with the President-elect’s nominees and Democrats holding the lines on their concerns. 

And don’t forget to watch Dr. Oz (and we aren’t talking about reruns). Even though much of the focus has been on cabinet-level nominees, Dr. Oz would have a lot of power if confirmed as the Centers for Medicare and Medicaid Services Administrator (especially if DOGE starts looking at Medicare and Medicaid).  

The House  

All of Washington is checking their inboxes with care, with hopes that news of the continuing resolution text will soon be there. House Republicans and Democrats are still working on getting that deal (and themselves) out the door, but they have made a deal on another important question: what the House committee ratios will be in the 119th Congress.  

According to a December 13 Dear Colleague letter from House Minority Leader Hakeem Jeffries (D-NY), that agreement will keep the ratios similar to the 118th Congress with some notable exceptions:  

  • Republicans and Democrats will both gain a seat on Appropriations, Energy and Commerce, Financial Services, Transportation and Infrastructure, and Ways and Means. 
  • Armed Services will decrease proportionally by 1 seat.  
  • Education and the Workforce will decrease proportionally by 4 seats.  

The Chairs announced the 4 Republican members joining Ways and Means and the 9 Republican members joining Energy and Commerce. Democrats will be looking for current members who previously served on that body to fill their 2 open seats on Ways and Means, according to Leader Jeffries. We are still waiting to hear about who will fill the 5 open Democratic seats on Energy and Commerce.  Democratic Members who have expressed interest so far include Reps. Deborah Ross (NC), Melanie Stansbury (NM), Kevin Mullin (CA), Jennifer McClellan (VA), and Gabe Amo (RI).  

Also happening this week: The House Veterans’ Affairs Health Subcommittee will hold a legislative hearing on several pieces of legislation at 2:30 PM EST on Tuesday, December 17.  

There You Have It 

With the holiday season in full swing, our team’s been talking about our families’ holiday traditions, and we want to hear about yours. So let us know, and make it a great week!  

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