THIS WEEK’S DOSE
- Government Funding Deadline, Healthcare Program Expirations Approach. Congress has until March 14, 2025, to address government funding, and may also address healthcare extenders.
- Senate Finance, HELP Committee Ranking Members Hotline Bipartisan December 2024 Health Package. They seek to pass the bicameral, bipartisan health package negotiated in December 2024 via unanimous consent.
- Nomination Hearings Continue. Senate committees held hearings for President Trump’s nominees for Office of Management and Budget deputy director, US Food and Drug Administration commissioner, and National Institutes of Health director.
- President Trump Gives Joint Address to Congress. Healthcare was not a focus, but he mentioned Make America Healthy Again initiatives and gender-affirming care.
- DOJ Drops Idaho EMTALA Case. After the US Department of Justice (DOJ) dropped out of litigation related to the Emergency Medical Treatment and Active Labor Act (EMTALA), an Idaho health system that had also challenged the state law secured a temporary restraining order to prevent Idaho’s abortion ban from taking effect.
CONGRESS
Government Funding Deadline, Healthcare Program Expirations Approach. Following recent House and Senate passage of their competing budget resolutions, Congress’ attention has now turned to the March 14, 2025, government funding deadline. The most likely course of action is for Congress to pass another continuing resolution (CR), likely through the end of the fiscal year, September 30, 2025. While Republican and Democratic appropriators have been negotiating on final spending bills for 2025, matters have been complicated by the intense political climate that has marked the first months of the new Trump Administration. As a result, House Republicans are likely to bring the next CR to the floor without a formal agreement from Democrats, which may require Speaker Johnson to pass the bill with minimal (if any) Democratic support in the House. In the Senate, where Republicans hold a 53 – 47 majority, Democratic support will be necessary to clear the 60-vote threshold to overcome a filibuster. This situation is fluid, and a government shutdown of some duration cannot be ruled out, although neither party wants to appear responsible for such a shutdown.
The most recent CR also extended several healthcare programs, such as extending Medicare telehealth flexibilities, avoiding cuts to Medicaid disproportionate share hospital payments, and maintaining community health center funding, which are set to expire on March 31, 2025. Other programs expired at the end of 2024. The forthcoming CR is the most likely opportunity for Congress to temporarily extend or reinstate these programs, although the extension would likely be for a short period of time only, as most pay-fors are being saved for use in the budget reconciliation process.
Senate Finance, HELP Committee Ranking Members Hotline Health Package. In related news, Senate Finance Committee Ranking Member Wyden (D-OR) and Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Sanders (I-VT) introduced the bipartisan, bicameral health package negotiated in December 2024 (S. 891, the Bipartisan Health Care Act) and hotlined the bill (i.e., move via unanimous consent unless an objection is noted). This comprehensive package not only addresses the aforementioned health extenders, but also includes pharmacy benefit manager reforms, patent reforms, a limited Medicare site neutral policy, a five-year extension of the hospital at home program, Medicaid home- and community-based services policies, and an offset to the scheduled Medicare physician fee schedule reduction. The package was ultimately left out of the December 2024 CR because of Republican pushback about the overall bill’s size.
Nomination Hearings Continue. The Senate HELP Committee held its nomination hearing for National Institutes of Health (NIH) director nominee Jayanta Bhattacharya, MD, PhD. During the hearing, Democrats focused on how Bhattacharya would approach grant funding cuts, and Republicans’ conversation honed in on the culture at NIH. Bhattacharya emphasized the importance of transparency and NIH’s role in regaining the public’s trust. Chair Cassidy (R-LA) also facilitated discussion about the extent to which the government should encourage focus on research topics that have been extensively studied already, such as the link between vaccines and autism.
The Senate HELP Committee also held a hearing for US Food and Drug Administration (FDA) commissioner nominee Martin Makary, at which members underscored the importance of transparency in FDA processes and the need to rebuild public trust in health and science agencies. Democrats expressed concerns about the cancellation of the annual vaccine advisory committee meeting and emphasized the safety of mifepristone. Republicans stated their disagreement with the FDA’s decision to no longer enforce in-person dispensing for mifepristone. They also stressed the importance of addressing the impact of preservatives and chemicals in food on children’s health.
The Senate Budget Committee held the second nomination hearing for Dan Bishop to serve as deputy director of the Office of Management and Budget. Discussion predominately focused on the Impoundment Control Act, federal workforce cuts, and balancing the budget. Health-related topics included fraudulent payments and Medicaid cuts.
ADMINISTRATION
President Trump Gives Joint Address to Congress. Healthcare was not a focus of the speech; however, President Trump highlighted US Department of Health and Human Services (HHS) Secretary Kennedy’s efforts related to chronic conditions and called on him to determine the cause of the rise in autism cases. President Trump also discussed his executive order on limiting federal funding to institutions that provide gender-affirming care for individuals under 19 years of age and called on Congress to pass a bill criminalizing gender-affirming surgery for minors.
COURTS
DOJ Drops Idaho EMTALA Case. The DOJ announced that it will drop litigation first brought by former President Biden’s DOJ against Idaho’s abortion ban. The Biden administration argued that the ban violated EMTALA because it did not adequately protect the right to an abortion in a medical emergency. However, an Idaho-based health system that had also challenged the ban stepped up in DOJ’s place and secured a temporary restraining order barring the prosecution of providers who provide abortions in medical emergencies in Idaho.
QUICK HITS
- CMS Rescinds Guidance on Health Equity. The Centers for Medicare & Medicaid Services (CMS) released a short informational bulletin rescinding previous guidance on health-related social needs. The bulletin stated that CMS will continue to consider states’ applications to cover these services on a case-by-case basis.
- HHS Secretary Kennedy Writes Op-Ed on Measles. The op-ed encouraged parents to consult with their providers about the MMR vaccine and touted vitamin A as a treatment to reduce mortality. This comes as a measles outbreak sweeps through Texas and New Mexico, with 198 confirmed cases and two fatalities so far.
- CCSQ Releases Memo on Gender-Affirming Care. To further implement the sections of President Trump’s gender-affirming care executive order that remain in effect, the Center for Clinical Standards and Quality (CCSQ) released a memo alerting providers that CCSQ “may begin taking steps in the future to align policy . . . to protect children from harmful, often irreversible mutilation, including sterilization practices.”
- HRSA Memo on Gender-Affirming Care. The Health Resources and Services Administration (HRSA) sent a memo similar to the one from CCSQ to “Hospital Administrators, Colleagues and Grant Recipients” that specifically notes review of the Children’s Hospitals Graduate Medical Education Program funding.
- CBO Outlines Mandatory Spending, Excluding Medicare, in Energy & Commerce Committee Jurisdiction. In response to a Democratic inquiry, the Congressional Budget Office (CBO) issued a letter highlighting the predominance of Medicaid as a potential source of savings in reconciliation. While the inquiry specifically requested that CBO exclude Medicare from the analysis, the committee has jurisdiction over Medicare, and nothing prevents the committee from considering Medicare savings, including site neutral policies. That said, it makes the point that $880 billion in savings from the committee would most certainly include Medicaid cuts.
- Senators Send Letter to CMS About Agency Layoffs. Sens. Wyden (D-OR) and King (I-ME) requested that CMS Acting Administrator Carlton respond with information related to the job functions of laid-off workers.
- NIH Issues News Release on Grant Review Process Proposal. The release announces plans to centralize peer review of all applications for grants, cooperative agreements, and research and development contracts within the agency’s Center for Scientific Review. The proposal is now under review with implementation pending external review, which includes review by HHS and OMB, providing Congress with a 15-day notification period, and issuing a Federal Register notice.
- HRSA Opens Applications for OPTN Board of Directors. As part of the Organ Procurement and Transplantation Network (OPTN) modernization initiative, HRSA released the application for new members to join the OPTN Board of Directors. Applications are due April 4, 2025.
- JCT Clarifies Tax Scoring. There is an ongoing discussion among Congressional Republicans about using a “current policy baseline” for scoring tax cuts in reconciliation, which would mean that extending the 2017 Trump tax cuts would have no score. In a response to an inquiry from Sens. Warren (D-MA), Cortez Masto (D-NV), Warner (D-VA), Bennet (D-CO), and Welch (D-VT), the Joint Committee on Taxation (JCT) clarified that, if Congress utilizes this approach to bring down the score of extending the 2017 tax cuts to $0, then the cost of extending the Affordable Care Act’s advanced premium tax credits would be $0 as well.
- MedPAC Hosts March Public Meeting. The Medicare Payment Advisory Commission (MedPAC) agenda included sessions on physician fee schedule updates, beneficiary cost-sharing for outpatient services at critical access hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, Medicare Advantage utilization, and institutional special needs plans.
NEXT WEEK’S DIAGNOSIS
The House and Senate will be in session next week, and most of their attention will be on a government funding bill ahead of the March 14 deadline. The Senate will continue to advance President Trump’s nominees, including HELP Committee votes on the NIH and FDA nominees, and a HELP Committee hearing for Centers for Disease Control and Prevention director nominee Dave Weldon, MD. Several committees will hold other healthcare hearings, including a House Oversight and Government Reform Government Operations Subcommittee hearing on improper payments and fraud, a Senate Special Committee on Aging hearing on senior loneliness, and a House Ways and Means Health Subcommittee hearing on post-acute care.