It’s crunch time in the House of Representatives, as Republican leadership has just a few days to pass their reconciliation bill before their self-imposed Memorial Day recess. It’s been a wild May here so far here in DC – so let’s get into it. Welcome to the Week Ahead!
The Administration
The Food and Drug Administration (FDA) is expected to unveil a new framework for vaccine regulation, which is making vaccine advocates nervous. Potential changes include requiring all vaccines to be tested against placebos and ending the use of the Vaccine Adverse Events Reporting System, which vaccine skeptics have long criticized as inadequate for addressing vaccine injury claims. Vaccine advocates are also raising concerns that Dr. Vinay Prasad, whom they count as a vaccine skeptic, will oversee this framework as the newly appointed director of the FDA’s Center for Biologics Evaluation and Research.
The Centers for Medicare and Medicaid Innovation (CMMI) is also undergoing a makeover to align with the Make America Healthy Again (MAHA) agenda. In a blog post, CMMI Director Abe Sutton unveiled a three-pronged strategy to achieve this by promoting evidence-based prevention, empowering individual health choices, and driving choice and competition. While light on specifics, the announcement is a sign that the Trump administration still sees a place for CMMI despite longstanding Republican concerns about the Center’s value and return on investment.
HHS is also rescinding guidance documents, including a 2001 guidance on opioids and a Biden administration guidance on buprenorphine for opioid addiction. Given how quickly the second Trump administration has moved on its deregulatory agenda, we expect more regulatory changes could be in the offing.
The Senate
As Americans prepare for Memorial Day cookouts, RFK Jr. is preparing for a different kind of grilling. The HHS Secretary will return to Capitol Hill on May 20 to testify before the Senate Appropriations Labor-HHS subcommittee about his department’s FY 26 budget request. This follows appearances by Secretary Kennedy before the House Appropriations Labor-HHS Subcommittee and the Senate Health, Education, Labor and Pensions (HELP) Committee. Much like the heated exchanges at last week’s hearings, we expect sparks to fly at the upcoming Senate subcommittee hearing, especially since Chair Susan Collins (R-ME) has already expressed concerns about HHS’s actions related to National Institutes of Health research and the impact of workforce reductions on implementing Alzheimer’s funding legislation.
We could also see action on the Senate floor this week on two HHS nominations that advanced out of the Senate Finance Committee on May 15, James O’Neill to be Deputy Secretary and Gary Andres to be an Assistant Secretary. It’s important to remember, though, that Senate Democrats are not completely powerless to stall President Trump’s nominees, as Minority Leader Schumer’s (D-NY) recent hold on Department of Justice nominees shows.
Other Senate Health Hearings
- May 21, Senate Homeland Security Subcommittee on Investigations hearing on adverse events following COVID-19 vaccination
- May 21, Senate VA Committee legislative hearing (includes bills related to health care)
The House
Following marathon markups at Energy and Commerce and Ways and Means, and a Sunday night reconvening of the House Budget Committee, the House Rules Committee is scheduled to meet on May 21 at 1 am to make any agreed-upon changes, and advance the bill to the House floor with just enough time to get it passed out of the chamber before Memorial Day recess.
But that’s a lot easier said than done. For everything to go according to plan, the final bill must be acceptable to both conservative Republicans, who have been demanding further spending cuts, and moderate Republicans, who are wary of how the cuts will be perceived both politically and practically. And then, of course, you have the contingent of blue-state Republicans who must be satisfied that the bill provides a high enough state and local tax (SALT) deduction cap for their constituents.
From what we are hearing both on and off Capitol Hill, there will be a move for the Rules Committee to consider amendments that would expedite the implementation of Medicaid work requirements, address concerns of the SALT caucus Republicans, and speed up the phasing out of energy tax credits, among other things. However, some House Conservatives are reviving the possibility of changes to the federal matching rate for Medicaid, but that would threaten moderate Republican support for the bill. It remains to be seen if Republican leadership can strike the right balance and send the big, beautiful bill to the Senate (where Republican Senators have also signaled their interest in changing the bill to their liking).
Beyond all the markups, the House Oversight Committee is also scheduled to hold a subcommittee hearing on May 20 that will consider the impact of the Inflation Reduction Act’s prescription drug provisions.
There You Have It
As we approach Memorial Day, Chamber Hill Strategies pauses to thank the brave men and women of our armed forces who have made the ultimate sacrifice in defense of our freedoms. Make it a great week!