With Congress back, the long recess is giving way to high-stakes maneuvering. Congress returns with less than a month to hash out a continuing resolution (CR) before government funding lapses, and deadlines across health policy are stacking up. So, let’s get into it – welcome to the Week Ahead!
The Administration
The CDC is grappling with a sudden leadership vacuum after Director Susan Monarez was fired just weeks after her confirmation. Multiple senior officials resigned in protest, and protest actions erupted among CDC staff. For now, Deputy HHS Secretary Jim O’Neill has assumed the role of acting CDC director. Will the administration seek a new head that aligns with the vaccine policies of Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr., or hold for now? Don’t forget – the CDC director used to simply be appointed and not Senate confirmed.
September isn’t just back to school season; it’s also crunch time for the Rural Health Transformation Fund. States are eagerly waiting for the administration to start publish guidelines and next steps for applications. The clock is ticking toward the December 31, 2025 deadline, so once guidance is out, the scramble to put together strong proposals will begin.
Several states aren’t waiting around—no less than 20 states have already signaled their interest with early requests for information (Alaska, Georgia, Hawaii, Illinois, Indiana, Mississippi, Missouri, Montana, Nevada, North Carolina, North Dakota, Pennsylvania, Oklahoma, Oregon, South Carolina, South Dakota, Texas, Utah, Washington and Wisconsin). Their enthusiasm shows just how much demand there is for federal support to strengthen rural health care, whether through workforce investments, telehealth, or new models of care.
The Senate
Secretary RFK Jr. will be at the head of the classroom when he heads to the Senate Finance Committee on September 4 to walk through the President’s health agenda. Expect Senate Republicans to grade his progress on the Make America Healthy Again (MAHA) initiative, while Democrats are likely to raise their hands with tough questions on the new COVID-19 vaccine guidelines.
But Sec. Kennedy isn’t the only one getting homework this fall. Senate Majority Leader Chuck Schumer (D-NY) has been pushing Republicans to extend advanced premium tax credits (APTCs) that are set to expire at year’s end. Health plans, meanwhile, are sweating it trying to figure out how these changes might expand coverage and how to structure their plans for PY2026.
Where are Senate Republicans on this? At least five or six have openly discussed the importance of extending APTCs—but one question is whether Republicans will insist on paying for the tax credits with offsets or look to the study guide of the One Big, Beautiful bill which didn’t offset many of the Trump-era tax cuts. Either way, the debate this month could shape the contours of coverage and costs for years to come.
The House
The House is back in session with just 14 legislative days left before the continuing resolution (CR) expires. Think of it as the final exam no one can afford to fail. Their task is to keep the government funded with a swath of health extendersset to expire on September 30 as well.
With special elections happening in Virginia and Arizona – and what is expected to be a two-seat pick up for Democrats – and Rep. Kat Cammack (R-FL-3) going on maternity leave, House Republicans are facing what could soon be a one-seat margin. The real question: Can House Republican leaders keep their conference together long enough to turn in a passing grade by September 30? Remember the CR needs bipartisan Senate support to pass, and Senate Democrats are already upset at the President’s pocket recissions package announced on August 29.
House Health Hearings
- September 3: House Energy and Commerce Health Subcommittee hearing on advancing health care through AI
There You Have It
Back-to-school season is here! And that means MedPAC and MACPAC start their new sessions as well. Chamber Hill Strategies sends everyone best wishes for a healthy and successful year ahead.