The way health care is legislated in the U.S. is spread out between multiple committees in Congress. What this means is that getting comprehensive bills passed is a power chess game among the committees, requiring negotiation and knowledge.
As Congress considers legislative action to reform Medicaid, Medicare, and other health care priorities in this Congress, it’s important to understand a committee’s “jurisdiction.” The jurisdiction of each Senate committee is specified in Senate Rule XXV, while each House committee draws from House Rule X. Below you can find each congressional committee’s 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), 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: Leaders of the Senate Finance Committee are working on how, and even if they want, to address the $2.3 trillion dollars of spending cuts passed in the budget resolutions. There hasn’t been much time this year to address health care in the committee’s legislative agenda given the Committee has been busy with President Trump’s cabinet nominations and trade negotiations.
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, including user fees, and the Commissioner of Food and Drugs is subject to the committee’s nomination process.
Recent Activity: Almost all of the committee’s work so far this year has been regarding cabinet and agency-level nominations from the new Trump administration. However, they have been active in the reconciliation process, tasked with identifying $4 billion in spending cuts over ten years. Chairman Bill Cassidy (R-LA) and six Republican senators formed a working group to draft legislation aimed at restructuring the Center for Disease Control and Prevention to better respond to public health needs. The committee is also monitoring proposed changes to the CDC’s Advisory Committee on Immunization Practices (ACIP).
Senate Aging Committee
The committee conducts investigations into fraud, abuse, and exploitation targeting seniors; holds hearings on topics such as retirement security, Medicare, Social Security, elder justice, caregiving, and long-term care; and issues reports and recommendations to influence legislation considered by other committees.
Recent Activity: Recent hearings addressed topics like reducing chronic disease through community-based wellness programs, translating longevity research into actionable policy, and combating opioid use among seniors. The committee also supported legislation such as the SENIOR Act to address loneliness as a critical health issue under the Older Americans Act.
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 the 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 committee also oversees the visa programs on which many health care providers rely. 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 this year on nominations. But in the past few weeks, the committee has been focusing on the pharmaceutical benefit manager (PBMs) organizations and their role in health care costs. The committee passed a bill out on April 7th to pressure the FTC to continue with their investigation into PBM business practices.
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 Committees passed a Continuing Resolution (CR) to keep the government running until the end of September of this year. House and Senate Appropriations Committees are also working on drafting their spending bills Fiscal Year (FY) 2026.
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: Both committees have passed their budgets for fiscal year 2026, setting up for a health care policy heavy reconciliation bill. Note that the Budget Committees are in charge of reconciliation, and while the other committees will weigh in on health care policy changes, Budget can override these policies and make their own legislation.
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. Ways and Means is the only House committee that has jurisdiction over Medicare Part A because of the Social Security payroll tax. The committee does not have jurisdiction over Medicaid. The committee is considered particularly impactful among congressional members because of its authority on tax issues.
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 focusing on drugs lately in their hearings, illicit drugs, pharmacy benefit managers (PBMs). They have not yet marked up any health care bills, but they will be a key player in Medicaid reform this year.
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: The committee has held two health care hearings this year – one on the affordability of health care, another on employer-sponsored health plans. They have been mostly focusing on marking up bills to reform universities/colleges in the U.S.