THIS WEEK’S DOSE
- Senate Confirms FDA, NIH Nominations, Advances CMS Nomination. The Senate confirmed US Food and Drug Administration (FDA) Commissioner Martin Makary and National Institutes of Health (NIH) Director Jayanta Bhattacharya, and the Senate Finance Committee advanced Mehmet Oz’s nomination as Centers for Medicare & Medicaid Services (CMS) administrator to the full Senate.
- House Oversight Committee Discusses Government Reform Legislation. The committee advanced three bills related to government reorganization, the Federal Employees Health Benefits Program, and pandemic response.
- CBO Projects US Will Reach Debt Limit in August or September 2025. The Congressional Budget Office (CBO) estimate will factor into the timing of a budget reconciliation package, as Republican leaders appear to be in agreement to include a debt limit increase in that forthcoming package.
- HHS Announces Reorganization. The US Department of Health and Human Services (HHS) plans to eliminate 10,000 employees and consolidate multiple agencies.
- President Trump Makes Additional Healthcare Nominations. Nominated positions include CDC director, HHS inspector general, HHS assistant secretary for health, and HHS assistant secretary for the Administration for Children and Families.
CONGRESS
Senate Confirms FDA, NIH Nominations, Advances CMS Nomination. On March 25, 2025, the Senate confirmed Martin Makary, MD, as the next FDA commissioner by a 56 – 44 vote. Sens. Durbin (D-IL), Hassan (D-NH), and Shaheen (D-NH) were the sole Democrats to vote yes, along with all Republicans. Jayanta Bhattacharya, MD, was also confirmed as the next NIH director by a 53 – 47 party line vote. The Senate Finance Committee advanced the nomination of Mehmet Oz, MD, to be CMS administrator by a 14 – 13 party line vote. Oz’s full Senate confirmation vote could be as early as next week, and he is expected to be confirmed.
House Oversight Committee Discusses Government Reform Legislation. The markup included discussion of nine bills, three of which pertained to healthcare and the federal workforce and advanced out of the committee:
- H.R. 1295, the Reorganizing Government Act of 2025, would renew and extend through December 2026 the president’s authority to propose a government reorganization plan that Congress must consider via an up or down vote on a joint resolution of approval within 90 calendar days.
- Passed 23 – 20 along party lines, with Republicans voting in support.
- H.R. 2193, the FEHB Protection Act of 2025, would require federal agencies to verify that an employee is eligible to add a family member to their Federal Employees Health Benefits (FEHB) Program plan.
- Passed 29 – 15, with support from Republicans as well as Reps. Connolly (D-VA), Lynch (D-MA), Brown (D-OH), Min (D-CA), Norton (D-DC), and Subramanyam (D-VA).
- H.R. 2277, the Federal Accountability Committee for Transparency Act of 2025, would extend the Pandemic Response Accountability Committee through December 2026 and rename it the Fraud Prevention and Accountability Committee.
- Passed unanimously, 44 – 0.
Links to all bills discussed during the markup can be found here.
CBO Projects US Will Reach Debt Limit in August or September 2025. The CBO “X date” projection is that the United States will default on its debt in August or September 2025 if the debt limit remains unchanged. If the government’s borrowing needs are greater than CBO projections, the debt limit could be reached as early as May or June 2025. Republicans aim to raise the debt limit as part of the reconciliation process in the coming months, but if a reconciliation package is not enacted by the X date, separate legislation may be required to raise the debt limit. Legislation outside the reconciliation process would require support from Democrats to pass. The US Department of the Treasury is expected to release its own X date estimate in May 2025.
ADMINISTRATION
HHS Announces Reorganization. In response to the executive order on the Department of Government Efficiency (DOGE) Workforce Optimization Initiative, HHS announced a “dramatic restructuring” that includes the elimination of 10,000 employees. This follows the voluntary departure of 10,000 employees that has already occurred. Taken together, these two workforce reductions will shrink HHS by 25% to 62,000 employees. The agency projects that the reorganization will save $1.8 billion and make the agency more efficient.
Major actions of the restructuring plan include:
- Consolidating 28 divisions into 15, eliminating five of the 10 regional offices, and centralizing core administrative functions.
- Eliminating 10,000 workers, including 3,500 employees from the FDA; 2,400 employees from the Centers for Disease Control and Prevention (CDC); 1,200 employees from the NIH; and 300 employees from CMS.
- Creating a new Administration for a Healthy America subdivision, which will combine the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration (SAMHSA), the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health.
- Moving programs for older adults from the Administration for Community Living to other agencies, including CMS, the Assistant Secretary for Planning and Evaluation, and the Administration for Children and Families (ACF).
Read the press release here, and the fact sheet here.
President Trump Makes Additional Healthcare Nominations. After the White House abruptly withdrew Dave Weldon’s nomination for CDC director, President Trump nominated acting CDC director Susan Monarez, PhD, to be the permanent director. She previously worked as deputy director of the Advanced Research Projects Agency for Health. Additional HHS nominations include:
- HHS inspector general: Thomas March Bell, general counsel for House Republicans.
- HHS assistant secretary for health: Brian Christine, MD, urologist.
- HHS assistant secretary for ACF: Alex Adams, director of the Idaho Department of Health and Welfare.
QUICK HITS
- Senate Finance Democrats Release Report on MA Marketing Tactics. The report found that Medicare Advantage (MA) plans are increasingly using marketing strategies to enroll beneficiaries, and includes eight recommendations to increase oversight of these actions.
- Senate Democrats Hold Forum on NIH Research Cuts. The forum, hosted by Sens. Baldwin (D-WI) and Welch (D-VT), featured a panel of researchers, patients, and former NIH Director Monica Bertagnolli, MD. Discussion focused on how cuts or delays of NIH research could harm cancer and Alzheimer’s research.
- HHS Cancels $12 Billion in State Infectious Disease, Substance Use Grants. Congress appropriated the now-cancelled CDC and SAMHSA state grants through September 2025 during the COVID-19 pandemic. The grants focused on infectious disease tracking, mental health services, and substance use disorder treatment. House Appropriations Committee Ranking Member DeLauro (D-CT) criticized the cancellations.
- Department of Justice Launches Anticompetitive Regulations Task Force. As part of the president’s deregulatory initiative, the task force aims to eliminate anticompetitive state and federal laws and regulations, including in the healthcare sector. Public comments to support the task force’s efforts are due May 26, 2025.
BIPARTISAN LEGISLATION SPOTLIGHT
| The Bipartisan Senate 340B Working Group announced the addition of Sens. Kaine (D-VA), Mullin (R-OK), and Hickenlooper (D-CO). They join Sens. Moran (R-KS), Baldwin (D-WI), and Capito (R-WV). The new additions replace former Sens. Stabenow (D-MI) and Cardin (D-MD), who retired, and Sen. Thune (R-SD), who stepped back from the working group when he became Senate majority leader. Last Congress, the working group released a conceptual discussion draft and request for information on proposed changes to the 340B program. It is now completing its review of stakeholder feedback with the intention of releasing a formal legislative draft. |
NEXT WEEK’S DIAGNOSIS
The House and Senate are both in session next week. Republicans will continue conversations on a reconciliation strategy, as they aim to strike a deal on a unified budget resolution before the Easter recess in mid-April. A Senate vote on a unified budget resolution could occur as early as next week, and Senate nomination hearings and confirmation votes are expected to continue. The Senate Judiciary Committee will discuss drug patent legislation. The House Energy and Commerce Committee has a busy week with a Health Subcommittee hearing on over-the-counter monograph drugs, an Oversight and Investigations Subcommittee hearing on cybersecurity vulnerabilities in legacy medical devices, and an expected full committee markup. Both the Inpatient Prospective Payment System (IPPS) proposed rule and the final rate notice for MA and Part D plans are expected in early April 2025. Read our previews for the IPPS proposed rule here and the final rate notice here.