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Congressional:
Discussion on ACA Premium Subsidies Continues
The House and Senate continue discussions this week on how to address the Affordable Care Act’s (ACA) expiring advanced premium tax credits (APTCs). On Monday, Senate Majority Leader John Thune (R-SD) said it was unlikely that a bipartisan health-care agreement would be ready by next week, noting, “My assumption is that by next week, [lawmakers] might not be far enough along on the bipartisan discussions.” Thune added that he remained committed to holding a vote regardless, explaining that this was part of the agreement with Democrats to end the recent government shutdown. Senate Democrats plan to bring a clean three-year extension of the APTCs to the Senate floor for a vote next week.
A bipartisan meeting took place on Wednesday that included Senator Bill Cassidy (R-LA) and Representatives Josh Gottheimer (D-NJ), Jen Kiggans (R-VA), and Kevin Kiley (R-CA). Representatives Gottheimer and Kiggans introduced a framework on Wednesday to reduce health premiums. The framework includes a one-year extension of APTC subsidies, with new guardrails to reduce fraud, and a menu of separate pay-for options, not in the form of subsidies, to keep health premiums low. No agreement was reached, however.
Several Republicans have expressed opposition to extending APTCs, including Ways and Means Committee Chairman Jason Smith (R-MO), Energy and Commerce Committee Chairman Brett Guthrie (R-KY), and Judiciary Committee Chairman Jim Jordan (R-OH). They cited concerns about waste, fraud, and abuse in the ACA marketplace plans, pointing to a newly released Government Accountability Office (GAO) report summarizing preliminary findings from its review of APTC fraud risk management. The report noted that results from ongoing GAO covert testing suggest continued fraud risks and identified weaknesses in the Centers for Medicare & Medicaid Services’ (CMS) fraud risk management practices.
Meanwhile, Speaker Johnson has indicated that House Republicans will try to coalesce around a Republican plan to address healthcare costs and possibly vote on a package later this month. A simple extension of APTCs is not expected, and instead, the package would likely focus on a mix of funding cost-sharing reductions (CSRs), Health Savings Accounts (HSAs), account expansions, and possibly pharmacy benefit manager (PBM) reforms. The package remains in flux and still needs to be presented to the GOP conference next week before any final decisions are made on a vote.
The White House has not released a health care proposal of its own, but the president has stated that he favors redirecting enhanced APTCs into health savings accounts (HSAs) that individuals can use to cover out-of-pocket costs.
Senate HELP Committee Holds Hearing on Making Health Care Affordable
On Wednesday, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on health care affordability, with the focus on the expiring Advanced Premium Tax Credit (APTCs). During the hearing, Chair Bill Cassidy (R-LA) acknowledged that a significant overhaul of the subsidies this late would be impossible, stating, "Now, we can push for big ideas, grandiose ideas on the right or the left, but we gotta have a solution for three weeks from now.” He added that he was hopeful to "find a bill that can get 60 votes that can fix the problem with these changes for Jan. 1, 2026." Cassidy stated that the Senate has three choices: accept that no deal is possible and let the APTC lapse with no other changes; conduct separate votes on partisan bills that both get rejected; or work together to pass something bipartisan in which both sides make concessions. Ranking Member Bernie Sanders (I-VT) agreed with Cassidy, in part. Sanders stated, "Yes, we need to create a new system, but unfortunately, we aren't going to do it in two weeks," and called for extending the subsidies for at least one to three years. Read Mehlman’s hearing summary here.
Trump Signs Opioid Response Reauthorization Bill Into Law
On Monday, President Donald Trump signed the SUPPORT for Patients and Communities Reauthorization Act of 2025 (H.R.2483) into law. The bill reauthorizes through FY 2030 and revises Department of Health and Human Services (HHS) programs that address substance use disorders, overdoses, and mental health. The House passed the bill in June by a 366-57 vote, and the Senate cleared it by unanimous consent in September. Read the bill here.
House Passes Pediatric Cancer, Hospital-At-Home Bills
On Monday, the House passed two health care bills by voice vote to accelerate pediatric cancer research and to expand access to acute hospital care at home. The Mikaela Naylon Give Kids a Chance Act (H.R. 1262) includes several bipartisan pediatric rare disease and cancer research provisions, including an extension of the Food and Drug Administration's (FDA) rare pediatric disease priority review voucher program, policies to address pediatric drug studies, and other policies designed to bring more treatments and medicines to patients. The legislation authorizes $25 million per year through fiscal year 2028 for pediatric drug and biological product research. The bill now heads to the Senate.
The Hospital Inpatient Services Modernization Act (H.R. 4313) would extend the Acute Hospital Care at Home Program under Medicare for five years and require an additional study regarding the program. The program, set to expire on January 30, allows patients to receive inpatient care from home through in-person doctor visits and telehealth. The Centers for Medicare and Medicaid Services (CMS) first established the waiver in November 2020. The bill now heads to the Senate.
House Ways and Means Health Subcommittee Holds Hearing on Organ Procurement Organizations
On Tuesday, the House Ways and Means Health Subcommittee held a hearing examining the accountability of organ procurement organizations (OPOs). During the hearing, witnesses and members expressed bipartisan concern and called for urgent reforms, including stricter oversight, closing regulatory loopholes, increasing transparency, protecting whistleblowers, and ensuring informed consent for families. Members from both parties also called for decertifying and replacing failing OPOs and prosecuting criminal behavior. Read Mehlman’s hearing summary here.
New Democrat Coalition Health Care Working Group Unveils Health Care Action Plan
On Wednesday, the New Democrat Coalition Health Care Working Group, led by Working Group Chair Terri Sewell (D-AL), Mental Health Task Force Chair Shontel Brown (D-OH), Substance Use Disorder Task Force Chair Madeleine Dean (D-PA), Access & Affordability Task Force Chair Julie Johnson (D-TX), and Reproductive Health Task Force Chair Kelly Morrison (D-MN), released the Coalition’s Health Care Action Plan. The Health Care Action Plan lays out the New Dems’ agenda to lower health care costs, expand access to high-quality care, and protect the Affordable Care Act, Medicaid, and Medicare. Read the press release and action plan here.
Notable Bills Introduced:
Senator Cassidy, Colleagues Reintroduce Legislation to Strengthen Cybersecurity in Health Care
On Thursday, Senators Bill Cassidy, M.D. (R-LA), chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, Maggie Hassan (D-NH), John Cornyn (R-TX), and Mark Warner (D-VA) reintroduced the Health Care Cybersecurity and Resilience Act. The legislation would bolster cybersecurity across the health care sector by funding system upgrades, providing training and best-practice guidance, including targeted support for rural providers, and improving coordination between HHS and CISA. It also modernizes HIPAA-related cybersecurity requirements and directs HHS to create a formal incident response plan. The legislation is a product of the senators’ bipartisan health care cybersecurity working group launched in 2023. Read the press release here and the bill here.
Senators Crapo, Wyden Introduce Bipartisan Pharmacy Benefit Manager Legislation
On Thursday, Senate Finance Committee Chairman Mike Crapo (R-ID) and Ranking Member Ron Wyden (D-OR) introduced the Pharmacy Benefit Manager (PBM) Price Transparency and Accountability Act. The bill would delink PBM compensation from their negotiated rebates, increase PBM reporting and audit requirements, protect independent pharmacies, require retail community pharmacies to participate in NADAC surveys, and ensure PBMs pass Medicaid payments directly to pharmacies. Read the press release here and the bill here.
Senators Wyden, Blunt Rochester Introduce Legislation to Protect Patients, Ensure More Americans Can Afford Health Care
On Thursday, Senators Ron Wyden (D-OR), ranking member of the Senate Finance Committee, and Lisa Blunt Rochester (D-DE), a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, introduced the Restoring Patient Protections and Affordability Act. The bill would renew the enhanced premium tax credits for 3 years, extend the 2026 Open Enrollment period, reduce paperwork for families, and lower out-of-pocket caps. Read the press release here and the bill here.
Senators Rosen, Curtis Introduce Bipartisan Bill to Lower Costs of Medications, Medical Devices
On Thursday, Senators Jacky Rosen (D-NV) and John Curtis (R-UT) introduced the Expanding Access to Affordable Prescription Drugs and Medical Devices Act to reduce prescription drug and medical device costs, prevent drug shortages, boost domestic production, and create more jobs. The legislation would create a pathway for nonprofit drug and medical device manufacturers to receive tax-exempt status. Read the press release here and the bill here.
Senators Booker, Paul, and Representatives Dean, Mace Introduce Bipartisan Legislation to Promote Access to Potential Life-Saving Drugs
On Thursday, Senators Cory Booker (D-NJ) and Rand Paul (R-KY) introduced the Freedom to Heal Act, legislation that would create a narrow, Drug Enforcement Administration (DEA) regulated system for physicians to administer Schedule I substances to patients with life-threatening conditions in accordance with the federal Right to Try law. Representatives Madeleine Dean (D-PA) and Nancy Mace (R-SC) introduced companion legislation in the House. Read the press release here and the bill here.
Senators Barrasso, Whitehouse Introduce Legislation to Expand Access to Quality-Driven Health Care
On Thursday, Senators John Barrasso (R-WY) and Sheldon Whitehouse (D-RI) introduced the ACO Assignment Improvement Act. The legislation would expand participation in Medicare’s coordinated-care programs by ensuring Medicare recognizes the care patients receive from nurse practitioners, physician assistants, and clinical nurse specialists when determining their participation in an Accountable Care Organization (ACO). Read the press release here and the bill here.
Senator Marshall Introduces Bill to Stop ACA Fraud
On Thursday, Senator Roger Marshall, M.D. (R-KS), introduced the ACA Marketplace Integrity Act, legislation to reduce fraud and restore accountability in the Affordable Care Act marketplace. The bill would require mandatory ID verification for enrollment, establishes a monthly minimum payment to ensure only real, active enrollees are counted, and codifies the Trump Administration’s 2025 Marketplace Integrity and Affordability Final Rule. Read the press release here and the bill here.
Senator Wyden Introduces Bill to Address Health Care Labor Shortage
On Thursday, Senator Ron Wyden (D-OR) introduced the Fast Track Apprenticeship Act that would help address the ongoing health care labor shortage by making it easier for health care employers to create new registered apprenticeship programs to train the next generation of health professionals. The bill would require federal and state labor agencies to make determinations on health care apprenticeship applications within 45 days of receipt and require the Department of Labor to digitize apprenticeship agreement forms, modernize the application process and enhance accessibility for applicants. Read the press release here and the bill here.
Senator Hawley Introduces ‘No Taxes on Healthcare’ Legislation to Lower Costs
On Thursday, Senator Josh Hawley (R-MO) introduced the No Taxes on Healthcare Act. The bill would allow taxpayers to deduct all out-of-pocket medical expenses up to $25,000 per individual or dependent, move the medical-expense deduction “above the line,” and allow out-of-pocket spending on healthcare premiums to be deducted from taxes. Read the press release here.
Senators Hickenlooper, Alsobrooks, Blumenthal, Blunt Rochester, Heinrich, Kim, Markey, Schiff, and Van Hollen Introduce Bill to Codify ACIP Structure & Practices
On Wednesday, Senators John Hickenlooper (D-CO), Angela Alsobrooks (D-MD), Richard Blumenthal (D-CT), Lisa Blunt Rochester (D-DE), Martin Heinrich (D-NM), Andy Kim (D-NJ), Ed Markey (D-MA), Adam Schiff (D-CA), and Chris Van Hollen (D-MD) introduced the Family Vaccine Protection Act. The legislation would codify the structure and practices of the Advisory Committee on Immunization Practices (ACIP) and strengthen transparency into how vaccine guidance is developed and adopted. Read the press release here and the bill here.
Senator Wicker, Colleagues Introduce Medical Foods and Formulas Access Act
On Wednesday, Senators Roger Wicker (R-MS), Amy Klobuchar (D-MN), Sheldon Whitehouse (D-RI), and Chuck Grassley (R-IA) introduced the Medical Foods and Formulas Access Act. The legislation would require Medicare, Medicaid, the Children’s Health Insurance Program, and the Federal Employee Health Benefit Program to cover specialized formulas, vitamins, individual amino acids, and other medically necessary foods prescribed by a physician for patients with specific gastrointestinal and inherited metabolic disorders. Representatives John Rutherford (R-FL), Debbie Dingell (D-MI), and Jim McGovern (D-MA) introduced the companion bill in the House. Read the press release here and the bill here.
Representative Kiggans, Krishnamoorthi Introduce Bill to Lower Prescription Costs for Seniors
On Wednesday, Representatives Jen Kiggans (R-VA) and Congressman Raja Krishnamoorthi (D-IL) introduced the bipartisan Increasing Medication Access for Seniors Act of 2025. The legislation would allow seniors on Medicare to spread out high-cost medications into 12 interest-free monthly payments. Read the press release here and the bill here.
Executive Branch:
ACIP Votes to Stop Recommending Birth Dose of Hepatitis B Vaccine
On Friday, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted 8-3 to change the recommendation for when children should get their first dose of the hepatitis B vaccine. Prior to today’s vote, ACIP guidance recommended a first dose within 24 hours of birth. Today, the panel voted to recommend delaying the first dose until a child is 2 months old, for children born to mothers who test negative for the virus. The panel recommends individual decision-making, in consultation with a health care provider, to determine when to give the first dose of hepatitis B. The vote now goes to the full CDC for endorsement.
HHS Repeals Federal Nursing Home Minimum Staffing Standards Rule
On Tuesday, the Department of Health and Human Services (HHS) repealed provisions of the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule, originally finalized by the Centers for Medicare & Medicaid Services (CMS). The 2024 rule had established a federal requirement that nursing homes participating in Medicare and Medicaid provide residents with a minimum total of 3.48 hours of nursing care per day, including at least 0.55 hours from a registered nurse per resident per day, and 2.45 hours from a nurse aide per resident per day, along with requirements that each facility have a registered nurse onsite 24/7. HHS stated that the Biden Administration final rule “disproportionately burdened facilities, especially those serving rural and Tribal communities, and jeopardized patients’ access to care.” Read the press release here and the interim final rule here.
HHS Unveils AI Strategy to Transform Agency Operations
On Thursday, the Department of Health and Human Services (HHS) released its AI Strategy, the next phase of the Department's initiative to make artificial intelligence (AI) available to the federal workforce, integrating it across internal operations, research, and public health. Led by the HHS Acting Chief Artificial Intelligence Officer, Clark Minor, the HHS AI Strategy delivers on the Trump Administration's AI Action Plan, AI-related Executive Orders, and guidance from the Office of Management and Budget (OMB). The five pillars of HHS’s AI strategy are to ensure governance and risk management for public trust, design infrastructure and platforms for user needs, promote workforce development and burden reduction for efficiency, foster health research and reproducibility through gold-standard science, and enable care and public health delivery modernization for better outcomes. Read the press release here.
U.S. and U.K. Reach Agreement in Principle on Drug Pricing and Tariffs
On Monday, the United States and the United Kingdom announced the Economic Prosperity Deal (EPD), a pharmaceutical pricing agreement. The EPD exempts U.K.-origin pharmaceuticals, pharmaceutical ingredients, and medical technology from Section 232 tariffs and protects U.K. pharmaceutical pricing practices from any future Section 301 investigation for the duration of President Trump’s term. In exchange, the U.K. will increase the net price it pays for new U.S medications by 25 percent. The agreement comes less than two months after the Trump administration announced the results of the most-favored-nation pharmaceutical drug pricing policy. Read the press release here.
FDA Announces Request for Information on Increasing Access to Nonprescription Drugs
On Tuesday, the Food and Drug Administration (FDA) announced a request for information (RFI) on how to increase access to nonprescription drugs. Specifically, the FDA is interested in perspectives on the scientific, regulatory, and practical considerations that shape non-prescription drug access. The FDA intends to use the information submitted to inform plans for a public meeting intended to be held in calendar year 2026. Comments must be submitted by February 2, 2026. See the RFI here.
CMS Proposes New Rule to Strengthen Quality, Access, and Competition in Medicare Advantage and Part D
Last week, on Tuesday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to the Medicare Advantage (MA) and Medicare Part D prescription drug programs. If finalized, the rule would implement changes to Part D that Congress enacted as part of the Inflation Reduction Act (IRA) under President Joe Biden, and update the methodology used to award insurers quality “star ratings” that determine bonuses and marketing privileges. The changes would take effect in 2027. The IRA eliminated Part D’s coverage gap as part of a broader overhaul of how the program is financed, which the CMS proposed implementing for 2027. The law’s $2,000 annual out-of-pocket cap for prescription drugs took effect this year. CMS also proposed eliminating star ratings measures that it said were based on “administrative processes” and not indicative of a plan’s quality. The agency is also proposing to forgo a change related to enrollees with social risk factors, and to add new measures focused on treating depression. The proposal would also allow Medicare Advantage members a special enrollment period when their doctor leaves their network. Additionally, CMS is soliciting feedback through a new Request for Information (RFI) on ways to improve competition and quality in Medicare Advantage, including the use of artificial intelligence (AI) and new data sources in risk adjustment. Read the press release here, the fact sheet here, and the proposed rule here.
Martin Kulldorff Appointed to Senior HHS Role
On Monday, the Department of Health and Human Services (HHS) announced the appointment of Martin Kulldorff, Ph.D., as chief science officer for the Office of the Assistant Secretary for Planning and Evaluation (ASPE). Kulldorff, a biostatistician and epidemiologist, recently chaired the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) and previously taught at Harvard Medical School. Kirk Milhoan, M.D., Ph.D., a pediatric cardiologist and former U.S. Air Force flight surgeon, now chairs ACIP. Robert Malone, M.D., serves as vice chair. Read the press release here.
Louisiana Surgeon General Appointed as CDC Principal Deputy Director
Late last week, Ralph Abraham, the Louisiana Surgeon General, was appointed as Principal Deputy Director at the Centers for Disease Control and Prevention (CDC). As Louisiana’s Surgeon General, Abraham has pursued policies closely aligned with those promoted by President Trump. Abraham is also a former House Representative, serving from 2015 to 2021. The Principal Deputy Director supports the CDC Director; currently, Deputy Health and Human Services Secretary Jim O’Neill is acting director.
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