The “Committees of Jurisdiction” That Shape Health Care Policy in Congress


Congressional committees help Congress with the important work of reviewing, debating, and passing legislation.  As Congress considers legislative action on drug pricing, paid leave, and other key health care policies, it’s important to understand a committee’s “jurisdiction,” or its area of responsibility.  The jurisdiction of each Senate committee is specified in Senate Rule XXV, while each House committee draws from House Rule X.  The following list contains each congressional committee that has  jurisdiction over health policy, along with a brief description of each committee’s role, issues that each committee covers, and the recent activities of each committee.

Senate Finance Committee

This committee, in addition to various issues related to taxation and trade, oversees health programs under the Social Security Act, such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), Temporary Assistance to Needy Families (TANF), and other programs financed by a certain tax or trust fund.  The committee also shares or has sole jurisdiction over numerous departments and agencies, including the Department of Health and Human Services (HHS), which includes the Centers for Medicare and Medicaid Services (CMS) and the Administration for Children and Families, and the Social Security Administration.  The committee is additionally tasked with reviewing nominations for the HHS Secretary, the CMS Administrator, and other high-ranking appointed positions with HHS and other departments under its jurisdiction.  Furthermore, the committee oversees employer-sponsored insurance per the Employee Retirement Income Security Act of 1974.

Recent Activity: Separately, leaders of the Senate Finance Committee are working on legislation to address drug prices.  In June, Chairman Ron Wyden (D-OR) released a set of principles on legislation to lower drug prices that includes allowing for government negotiation of drug prices and changes to the Medicare drug benefit design.  Additionally, Ranking Member Mike Crapo (R-ID) and Sen. Richard Burr (R-NC) recently reintroduced the Lower Costs, More Cures Act, which does not provide for government negotiation of  drug prices but also include benefit design.

Senate Health, Education, Labor, and Pensions Committee

Commonly abbreviated as “HELP,” this committee has wide jurisdiction over health care, education, labor and retirement policies, and public welfare.  Broadly speaking, the issues it deals with entail biomedical research and development, public health, and occupational health.  The HELP Committee also has jurisdiction over matters within the Food, Drug, and Cosmetics Act, and the Commissioner of Food and Drugs is subject to the committee’s nomination process.

Recent Activity: The HELP Committee has spent much of this year focusing on the response to the COVID-19 pandemic with regards to vaccinations, behavioral health, and preparing for the next public health crisis.   Its next hearing on the COVID-19 response is currently scheduled for July 20.

Senate and House Judiciary Committees

Broadly, these committees consider legislation related to the judicial system and play a critical role in providing oversight of the Department of Justice (DOJ) and the agencies under the Department’s jurisdiction, including the Federal Bureau of Investigation (FBI), and the Department of Homeland Security (DHS).  In particular, the Senate Judiciary Committee considers executive nominations for positions in the DOJ, FBI, and DHS.  The Senate committee also reviews all judiciary nominations, including Supreme Court, appellate court, and district court nominees.  Specific to health care, both committees review matters relating to antitrust law, such as the merger and acquisition of health providers.  The committees also review patent law issues as they apply to drug and medical device manufacturers.

Recent Activity: The Senate Judiciary Committee has focused much of its work in July on reviewing and voting on the Administration’s judicial nominees.  Other issues of note have focused on anti-competitive behavior among health care providers, particularly as it relates to drug pricing and hospital consolidation.  Meanwhile, the House Judiciary Committee recently advanced several antitrust bills and has held similar hearings on anti-competitive behavior in health care as well as voting rights and immigration.

Senate and House Appropriations Committees

These committees are responsible for the appropriation of revenue for the support of the government.  Appropriations is divided into 12 accounts, with two having the most influence on health care: Labor, Health and Human Service, Education, and Related Agencies (LHHS); and Agriculture, Rural Development, Food and Drug Administration, and Related Agencies (Ag-FDA).  LHHS dictates funding for all major components of HHS except for the Food and Drug Administration (FDA), which is covered under Ag-FDA.

Recent Activity: The House Appropriation subcommittees have kicked off the process of reviewing and marking up spending bills for Fiscal Year (FY) 2022, whereas the Senate Appropriation subcommittees have not started.  The full House Appropriations is scheduled to vote this week on spending bills for several accounts, which includes LHHS and Ag-FDA..  As government funding runs out in 78 days, lawmakers may have to pass a stopgap measure, known as a Continuing Resolution (CR) to keep the government running if both chambers cannot agree on top line numbers and pass a long-term spending bill for FY 2022.

Senate and House Budget Committees

These committees focus on the details of the federal budget, drafting of the budget resolution, and compiling and reconciling legislation for all areas including health care. These committees also oversee the Congressional Budget Office (CBO), which “scores” bills according to how much they would cost once enacted.  The Senate Budget Committee specifically reviews the nominee for the Director of the Office of Management and Budget.

Recent Activity: The Senate Budget Committee is working to finalize a budget resolution, which will include reconciliation instructions, to allow Democrats to advance a multitrillion-dollar package later this year.  Meanwhile, both the Senate and House Budget committees have held hearings to review the Administration’s FY 2022 budget request.

House Ways and Means Committee

This committee’s jurisdiction is very similar to that of the Senate Finance Committee in that it also oversees health programs under the Social Security Act, such as Medicare, Social Security, and TANF.  However, the committee does not have jurisdiction over Medicaid.  The committee is considered particularly impactful among congressional members because of its authority on tax issues.

Recent Activity: The Ways and Means Committee has recently conducted oversight hearings on improving access to housing and expanding access to education.

House Energy and Commerce Committee

In addition to being the oldest standing committee in the House of Representatives, this committee has the broadest jurisdiction of any House committee.  On health care, it oversees a variety of issues, including Medicare (except Medicare Part A), Medicaid, health insurance (except for employer-sponsored plans), biomedical research and development, drug and device safety, and public health issues.  The health-related departments and agencies it oversees are HHS, FDA, the Centers for Disease Control and Prevention, and the National Institutes of Health.

Recent Activity: The House Energy and Commerce Committee has been working on a number of areas within its health care jurisdiction to advance legislation on expanding access to health care coverage, improving maternal health, enhancing behavioral health, addressing social determinants of health, lowering drug costs, and addressing health equity.

House Education and Labor Committee

This committee has jurisdiction over education and labor issues.   This includes all employment-related health and retirement security issues, including employer-sponsored health plans.  The committee is also interested in health care workforce issues.

Recent Activity: Two subcommittees on the House Education and Labor Committee are set to review issues affecting the direct care workforce in a hearing on July 20.

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