Congress returns to Washington following weekend storms in the D.C. area. The forecast this week calls for potentially clearer skies and a busy week for both Congress and the White House. With that, let’s get into it. Welcome to the Week Ahead!
The Administration
Nearly a month after releasing its FY 26 skinny budget, the Department of Health and Human Services (HHS) has released its FY 26 Budget in Brief, which outlines a massive reorganization and shuttering of existing agencies to align with the administration’s “Make America Healthy Again” agenda.
As hard as issuing a budget request is, the real work is just beginning. Sec. Kennedy will now need to defend the full budget request against attacks from critics who argue that the reorganization is nothing more than a cut in disguise. Along with explaining the potentially bogus science in the recently published MAHA Report and plans to start publishing scientific research in-house, Sec. Kennedy has his work cut out for him.
The Senate
Senate Republicans return to Washington with only 13 legislative days to pass their version of the “One Big Beautiful Bill Act” before the self-imposed July 4 deadline. However, there are a lot of questions about how the Senate will move forward and what changes might be made to the bill. Some questions include:
- What will the Byrd Bath look like? The House-passed bill includes several provisions that may not pass the Senate’s Byrd Rule, which prohibits the inclusion of provisions unrelated to the federal budget. This could kill House provisions such as a moratorium on state regulations on artificial intelligence, a ban on courts enforcing certain injunctions, and language defunding Planned Parenthood.
- Will the Senate make changes to address concerns from fiscal hawks? The House bill would increase the debt limit by $4 trillion and extend borrowing authority beyond the 2026 midterms. That’s enough for Sen. Rand Paul (R-KY) to reject the bill. Additionally, Sen. Ron Johnson (R-WI) has called for more cuts if he is to support the bill. Other fiscal hawks may balk at the recent Congressional Budget Office estimate that the House bill’s tax changes would increase the deficit by $3.8 trillion.
- Will the Senate bump back Medicaid work requirements? To appease House Freedom Caucus members, the implementation date for Medicaid work requirements was moved forward from 2029 to 2026. However, concerns have been raised by some, including Sen. Lisa Murkowski (R-AK), that it will be challenging for some states, including hers, to meet the new timetable.
- Will the Senate remove Medicaid copays? Sen. Josh Hawley (R-MO) has criticized the House bill’s Medicaid copay provision as a “hidden tax on working poor people trying to get health care.” Other Republicans who supported Democratic amendments to protect Medicaid, like Murkowski and Sen. Susan Collins (R-ME), may share his concerns.
- Will the Senate change the Medicaid provider tax provision? The House bill prohibits states from putting in place new provider taxes and freezes existing provider taxes at current rates. However, some Republicans, such as Sen. Hawley, have expressed concerns about how that provision of the House bill will impact their states.
- Will we see committee markups? Initially, it sounded like the Senate might skip the committee process altogether. However, more recently, our intelligence from the Hill suggests committees such as the Senate Finance Committee might want to mark up the Senate bill. That opens the door for more proposed changes to the bill and slows things down for Republicans looking to get this bill passed.
- Will the SALT deduction be touched? House Republicans from high-tax states fought hard to increase the cap on how much their constituents can deduct from federal income taxes. Senate Republicans don’t have the same incentive to defend this provision, given that they generally represent lower-tax states.
Senate Health Care Hearings
- June 4: Senate HELP hearing on reauthorization of the over-the-counter monograph drug user fee program
The House
The House Appropriations Committee is kicking off the markup process for FY 26. First up are subcommittee markups for the funding bills for the Department of Veterans Affairs and the Food and Drug Administration on June 5.
Members of the House Appropriations Ag and FDA subcommittee won’t have much time to review the recently released FDA budget request before its June 5 markup. FDA highlights include:
- $3.2B in discretionary budget authority (11.4% decrease from FY 25). FDA justifies this by:
- Consolidating work to focus on core functions
- Reducing the number of full-time equivalents by 1,940
- $3.6B in user fees (4% increase over FY 25)
- $234.6M to support MAHA efforts related to chronic disease and food.
If the past is any gauge, we expect Republican members of the subcommittee to praise FDA’s efforts to address chronic disease rates by improving food quality and safety, and Democratic members to criticize planned reductions in force and funding cuts as a threat to public health.
Other House Health Care Hearings
- June 3: House Rules Committee meeting to consider the SUPPORT for Patients and Communities Reauthorization Act
- June 5: House Appropriations Interior and Environment Subcommittee hearing on FY 26 Indian Health Service Budget Request
There You Have It
It’s graduation season, so we wanted to take a moment to say congratulations to the class of 2025. Make it a great week!