All eyes are on the House, and not just for the UK’s King Charles III’s state visit. House Republicans are up to bat for consideration of a budget reconciliation resolution focused on immigration enforcement, and votes seem to be hard to find. So, let’s see what the week holds. Welcome to the Week Ahead!
The Administration
State Medicaid departments have been put on notice. The Centers for Medicare and Medicaid Services (CMS) sent letters to all 50 states on April 23 asking them to conduct a “swift revalidation” of high-risk providers. States have 10 business days from receiving the letter to notify CMS if they intend to carry out this revalidation and 30 days to deliver a broader revalidation strategy. Democratic leaders have accused the administration of targeting blue states in its war on fraud, but this action could show they are going after fraud wherever it exists. However, dramatically broadening the scope of its anti-fraud activities could cause CMS to make another error as the agency did in New York, where CMS miscalculated the number of residents receiving certain services.
Meanwhile, back in DC, Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. promised his agency would be bringing on 12,000 new employees during his recent marathon of congressional budget hearings. What will these employees be doing? We know from the hearings that RFK wants these new positions to focus on addressing chronic health challenges. We also know that the CMS budget justification document highlighted staffing for program integrity and technology positions as a priority. But after a year of reductions in force and staffing uncertainty, it’s hard to imagine that filling these positions will be easy.
The Senate
Senate Republican leaders are breathing a sigh of relief after passing a budget reconciliation resolution focused on immigration enforcement and avoiding efforts to amend the resolution to include other policy areas. Still, Senators discussed some health care amendments, providing insight into what members might want to include in a reconciliation 3.0.
President Trump’s MFN deals have been discussed as a potential item for inclusion in a reconciliation package. Sen. Sanders (I-VT) offered an amendment to adopt Most-Favored-Nation (MFN) drug pricing, which was supported by Republican Sens. Susan Collins (ME), Josh Hawley (MO), and Dan Sullivan (AK).
Sen. Josh Hawley (R-MO) also introduced an amendment to extend a ban on Medicaid funding for Planned Parenthood. While Sens. Lisa Murkowski (R-AK) and Susan Collins (R-ME) voted against the amendment, there is broad Republican support for this policy, boosting its chances for inclusion in a potential third reconciliation package.
Meanwhile, this week, Senate Democrats plan on releasing their health care plan, according to comments made by Minority Leader Chuck Schumer (D-NY) at the America Hospital Association annual meeting. The plan will focus on strengthening the Affordable Care Act, including reinstating premium subsidies; strengthening Medicare and Medicaid; lowering drug prices; investing in federal research; and reversing budget cuts. The plan gives us a window into how Senate Democratic candidates will talk about health care on the campaign trail and what Senate Democrats might do if they retake the majority in 2027.
Health Care Hearings This Week
- April 29: Senate Homeland Security Subcommittee on Investigations hearing on Biden-era COVID-19 policies
- April 29: Senate Veterans Affairs Committee legislative hearing
The House
All eyes are on the House, now that the Senate has passed its reconciliation resolution. Speaker of the House Mike Johnson (R-LA-4) will have his work cut out for him as he balances demands from moderate Republicans, who have felt burned by the One Big Beautiful Bill, with demands from conservatives who want the reconciliation bill to be broader than immigration enforcement funding. To ensure support from conservatives, House Republican leadership has made it clear they are willing to leave the door open for a third reconciliation package and are preparing to unveil a framework of what could be included in that package. With only 2 Republican votes to lose, Johnson is sure walking a perilous path. The first step in that path is the House Rules Committee meeting at 1pm on April 27.
In non-reconciliation news, health system CEOs are rounding out the House health care affordability hearings, as they appear before the Ways and Means Committee on April 28. The witness list includes representatives from HCA Healthcare, New York-Presbyterian – currently being sued by the Department of Justice for anticompetitive contracts, ECU Health, and CommonSpirit.
Other Health Care Hearings This Week:
- April 29: House Energy and Commerce Health Subcommittee hearing on regulation and oversight of food
- April 30: House Appropriations Interior Subcommittee hearing on the Indian Health Service
There You Have It
OpenAI has unveiled ChatGPT for Clinicians, designed to support clinical tasks like documentation and research. What are your thoughts about AI in health care? Let us know. Make it a great week!