While the men’s and women’s Final Four brackets are set, the Congressional budget is not at all locked up. Senate Majority Leader Thune (R-SD) is preparing to vote this week on a budget they’ve been negotiating with the House, while Speaker Johnson (R-LA) is hoping to add two members to his razor-thin majority by winning special elections in Florida. Will March Madness yield a “beautiful” budget in April?? Let’s see! Welcome to the Week Ahead!
The Administration
We are eagerly awaiting the final Medicare Advantage (MA) and Part D technical changes and rate announcement rules, as well as the proposed rules for the fiscal year payment systems. CMS Administrator-nominee Oz is waiting for his Senate floor vote, and he was not especially warm on MA during his confirmation hearing. We know the final MA rule will look different than the proposed rule released during the previous administration, but how much different? Will the rule come out on time – around April 7?
And how will the continued DOGE-ing complicate rule-making and public input? In case you were under a rock, you might have missed that the Department of Health and Human Services (HHS) announced plans to reduce its full-time workforce by 10,000 employees and consolidate the number of divisions from 28 to 15. The Department says this decision is about improving efficiency, saving taxpayer dollars, and better implementing the Trump administration’s focus on addressing chronic disease rates.
The Senate
The Senate aims to vote on the budget resolution this week they’ve been negotiating for the past few weeks with the House. While an agreement has yet to be shared publicly, rumors are the budget would set up a reconciliation bill that would require smaller cuts from Senate Committees (at least $3B) than from those in the House (at least $1.5T). Notably, the resolution may call for at least $1 billion in cuts from the Senate Health, Education, Labor, and Pensions Committee, which has jurisdiction over many HHS agencies.
Wait, what? How can they do that? Doesn’t the Senate and the House have to vote on the SAME budget?
Yes, they do, but the House and Senate do not have mirrored committees, so the Senate is really only voting on policies within the Senate’s committee structure, and the House is only voting on policies in the House’s structure.
The move here is essentially a way for Senators to delay making the tough decisions on policies like Medicaid, Medicare, and taxes later on in the process of budget reconciliation. Senators can vote for the budget this week and still vote against the final reconciliation bill if it doesn’t pass muster (ala the Sen. John McCain-style moment in 2017).
Senate Hearings This Week
- April 3: Senate Judiciary Committee meeting on April 3 on bills increasing transparency and promoting competition within the prescription drug industry
The House
The votes are tight – for everything in the House including the budget. Even with Democratic vacancies following the deaths of Reps. Sylvester Turner (D-TX) and Raul Grijalva (D-AZ), President Trump still felt the need to withdraw Rep. Elise Stefanik’s (R-NY) nomination to be UN Ambassador to boost his chances for a budget win. All eyes now turn to Florida, where Republicans hope to pick up two seats in special elections to replace former GOP Reps. Matt Gaetz and Michael Waltz on April 1.
These should be easy pickups for the GOP, but special elections should never be taken for granted. Republicans are growing anxious that Josh Weil, the Democratic candidate in the race to replace Rep. Waltz in Florida’s 6th congressional district, could pull off an upset against Republican Randy Fine. These races could either give Republicans more breathing room on forthcoming budget votes or make their lives even more difficult. Even if Republicans win both seats, they can still afford only 3 defections to reach the required 217 votes to pass a budget resolution and ultimately reconciliation.
House Hearings This Week
- April 1: House Energy and Commerce Health Subcommittee hearing on the regulation of over-the-counter monograph drugs
- April 1: House Energy and Commerce Oversight Subcommittee hearing on cybersecurity vulnerabilities in legacy medical devices
- April 1: House Veterans’ Affairs Committee oversight hearing on modernizing VA health care
- April 2: House Veterans’ Affairs Oversight Subcommittee hearing on the VA’s mental health policies
- April 2: House Education and Workforce Health, Employment, Labor, and Pensions Subcommittee hearing on employer-based health insurance
There You Have It
Speaking of March Madness, how are everyone’s brackets looking? Is your team still in it? Mixing hoops and vote-a-rama is a great way to watch the Senate floor. Let’s make it a great week!