Appropriations Update – The House of Representatives passed the $47.3 billion National Security, Department of State, and Related Programs Appropriations Act, 2027 (H.R. 8595) in a 217-209 vote on Wednesday. The spending bill represents a 6% reduction compared to FY 2026. It includes nearly $8.9 billion in global health funding, $532 million below currently enacted levels. The President’s Emergency Plan for AIDS Relief would receive $5.5 billion, while The Global Fund to Fight AIDS, Tuberculosis, and Malaria would receive $1.25 billion. The House rule for consideration of H.R. 8595 added the text of the SAVE America Act (S. 1383) upon passage.
On Friday, House Republicans released the text of a stopgap spending measure to extend government funding at current levels until after the November midterm elections. The continuing resolution would fund the government through December 4. The chamber is expected to consider the measure on the House floor this week. Congress faces a September 30 deadline to pass a funding bill and avoid a government shutdown at the end of the fiscal year.
House Passes Budget Resolution – Republicans on the House Budget Committee voted to approve a budget resolution along party lines on Thursday, completing the first step toward advancing the third budget reconciliation package of President Donald Trump’s second term in office. The $95 billion budget blueprint does not contain instructions for the Energy and Commerce or Ways and Means committees – the key panels with healthcare jurisdiction – meaning major health provisions or offsets will not be included in the eventual budget bill. The next reconciliation package is instead expected to focus on defense spending, aid to farmers, and voting integrity. Due to the narrow focus, House Majority Leader Steve Scalise (R-La.) said they are already “looking at reconciliation 4.0 to do the things that are left out of this one.”
Physician Lawmakers Introduce MACRA Reform Legislation – Reps. John Joyce, MD (R-Pa.), Greg Murphy, MD (R-N.C.), and Kim Schrier, MD (D-Wash.), with two dozen other members, have introduced a comprehensive bill to reform the Medicare Access and CHIP Reauthorization Act (MACRA). The bipartisan Patients First Act (H.R. 9693) would:
- Tie physician reimbursement to an inflationary measure.
- Establish a primary care hybrid payment pilot program that pays primary care providers a per-member-per-month payment along with regular services.
- Rebrand the Medicare Quality Payment Program and transition to the Patient Outcome Improvement National Tabulation System (POINTS), and establish a physician and clinician-led task force at the Centers for Medicare and Medicaid Services to develop quality metrics.
- Freeze advanced-alternative payment model participation thresholds for three years and create notice and comment periods for Center for Medicare and Medicaid Innovation mandatory models.
- Increase the budget neutrality threshold from $20 million to $57.64 million.
The bill text can be found here and a summary here.
Rep. Greg Murphy, MD Pens Op-Ed on Insurance Industry – In an op-ed published in The Hill on Monday, Rep. Greg Murphy, MD (R-N.C.) called on Congress to take action regarding the health insurance industry, highlighting that the seven largest for-profit insurers made nearly $1.7 trillion in total revenues – representing at least $54 billion in profits – last year. He specifically takes issue with the practice of stock buybacks, arguing that when insurance companies use excess profit to buy back their own stock“ it augments the upward spiral of patient financial distress as they try to pay for healthcare.” Rep. Murphy also acknowledges that increases in prior authorizations and claims denials make care more expensive and harder to access, while tying the “explosion of vertical integration, and its subsequent price tag” to the establishment of the Affordable Care Act’s health insurance marketplace.
House Committees Markup Health Bills – The House Ways and Means Committee favorably reported seven pieces of health legislation last week. Each of the bills, apart from H.R. 9645, was advanced unanimously.
- Essential Caregivers Act (H.R. 9641)
- Rural Patient Monitoring Access Act (H.R. 3108)
- Medicare Access to Rural Anesthesiology Act (H.R. 9642)
- Saving Today’s Acute-Care Resources Act (H.R. 9468)
- Improving Seniors’ Timely Access to Care Act (H.R. 3514)
- Medicare Advantage MLR Transparency Act (H.R. 9644)
- Health Care Price Certainty for All Americans Act (H.R. 9645), which passed in a 25-15 vote.
On Wednesday, the House Energy and Commerce Committee advanced three bills by voice vote aimed at addressing existing and emerging illicit drug threats.
- PRESS Act (H.R. 7184)
- Stop Pills That Kill Act (H.R. 8005)
- Fight Illicit Pill Presses Act (H.R. 5880)
Senate GOP Blocks WISeR Resolution – Senate Republicans voted down a Congressional Review Act resolution (S.J.Res. 198) on Thursday that would have prohibited implementation of the Centers for Medicare and Medicaid Services’ Wasteful and Inappropriate Service Reduction (WISeR) model. The resolution failed in a 46-50 vote. The WISeR pilot program, which launched on January 1 in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington, uses artificial intelligence to apply prior authorization for 13 medical services deemed low-value or vulnerable to misuse in the traditional Medicare program. The model is set to run for six years.
House Postpones Vote on Veteran Benefits Package – The House of Representatives postponed a planned vote last week on legislation (H.R. 9237) to overhaul disability, healthcare, and other benefits for veterans. The package included the text of more than 60 bills, many of which had bipartisan support. Some lawmakers on both sides of the aisle, however, expressed concern about the proposed offsets that would have reduced benefits for sleep apnea and tinnitus. House Speaker Mike Johnson (R-La.) has stated that Republicans will work further on the bill and bring it up again after the chamber’s August recess.
GAO Examines Unauthorized Actions in Marketplace Plans – The Government Accountability Office (GAO) released a report last week detailing the need for stronger controls to prevent unauthorized actions by agents and brokers in the federal insurance marketplace. The report finds that the Centers for Medicare and Medicaid Services’ (CMS) existing safeguards do not always protect consumers from unauthorized activity by unscrupulous agents and brokers, such as fraudulent enrollments or plan switching without the consumers’ knowledge or consent. The number of consumer complaints of unauthorized enrollments and plan switches increased from 66,548 in 2023 to 299,604 in 2025. GAO recommends that CMS design and implement stronger controls to verify consumer consent to agent and broker actions on consumer enrollments, restrict access to consumer information to the agent of record, and notify consumers of agent and broker activity on their federal marketplace enrollments.
Darline Graham Nordone Appointed to Fill Late Brother’s Senate Seat – South Carolina Governor Henry McMaster (R) has appointed Darline Graham Nordone, Lindsey Graham’s younger sister, to serve the remainder of the late senator’s term. She was sworn in on Tuesday afternoon. The special Republican primary to fill Graham’s seat must be held by August 11, and candidates can formally file to run between July 21 and July 28. While Darline Graham has not yet announced whether she will run for a full Senate term, she has already received the endorsement of President Donald Trump. The eventual Republican nominee will face Annie Andrews, MD, a pediatrician and professor at the University of South Carolina, who won the Democratic primary in June.
Upcoming Congressional Hearings and Markups
House Energy and Commerce Committee markup of 29 bills, including the Lower Costs, More Transparency Act (H.R. 9393), Improving Seniors’ Timely Access to Care Act (H.R. 3514), and Biosimilar Red Tape Elimination Act (H.R. 5526); 5:00 p.m.; July 20
Senate Health, Education, Labor, and Pensions (HELP) Committee markup of 13 health bills, including the EMPOWER for Health Act (H.R. 4110) and Title VIII Nursing Workforce Reauthorization Act (S. 1874); 10:00 a.m.; July 22
House Oversight and Government Reform Committee markup including the Pharmacists Fight Back in Federal Employee Health Benefit Plans Act (H.R. 6610); July 22
Senate Veterans’ Affairs Committee hearing “Advancing the Mission: Evaluating the Future of VA Research;” 4:00 p.m.; July 22
Senate HELP Committee executive session to consider the nominations of Sean Kaufman to be Assistant Secretary for Preparedness and Response for the Department of Health and Human Services, Erica Schwartz to be Director of the Centers for Disease Control and Prevention, and Keith Sonderling to be Secretary of Labor; 10:00 a.m.; July 23
Recently Introduced Health Legislation
H.R.9641 — To amend titles XVIII and XIX of the Social Security Act to require certain facilities to permit visits from an essential caregiver during certain periods; Sponsor: Tenney, Claudia [Rep.-R-NY-24]; Committees: House – Energy and Commerce; Ways and Means
H.R.9642 — To amend title XVIII of the Social Security Act to provide payment under part A of the Medicare program on a reasonable cost basis for anesthesia services furnished by an anesthesiologist in certain rural hospitals and critical access hospitals; Sponsor: Moolenaar, John R. [Rep.-R-MI-2]; Committees: House – Ways and Means
H.R.9644 — To amend title XVIII of the Social Security Act to promote transparency of Medicare Advantage plan information; Sponsor: Moran, Nathaniel [Rep.-R-TX-1]; Committees: House – Ways and Means; Energy and Commerce
H.R.9645 — To promote health care price transparency, and for other purposes; Sponsor: Smith, Jason [Rep.-R-MO-8]; Committees: House – Energy and Commerce; Ways and Means; Education and Workforce
H.R.9656 — To amend title XI of the Social Security Act to require hospitals participating in Federal health care programs to report certain information related to immigration status; Sponsor: Roy, Chip [Rep.-R-TX-21]; Committees: House – Energy and Commerce; Ways and Means
S.4963 — A bill to amend title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate – Finance
S.4972 — A bill to amend title 11, United States Code, to provide bankruptcy protections for medically distressed debtors, and for other purposes; Sponsor: Whitehouse, Sheldon [Sen.-D-RI]; Committees: Senate – Judiciary
H.R.9661 — To amend the Public Health Service Act to codify that the default expectation for licensure of biological products as biosimilar does not include clinical studies assessing pharmacodynamics or comparative clinical efficacy, and for other purposes; Sponsor: Langworthy, Nicholas A. [Rep.-R-NY-23]; Committees: House – Energy and Commerce
H.R.9666 — To direct the Secretary of Veterans Affairs to establish a pilot program to use four-dimensional functional lung imaging software product to identify respiratory disorders and lung disease in veterans, and for other purposes; Sponsor: Ciscomani, Juan [Rep.-R-AZ-6]; Committees: House – Veterans’ Affairs
H.R.9669 — To direct the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to establish a 5-year pilot program under which the Secretary will award grants to eligible entities for purposes of expanding forensic assertive community treatment team programs; Sponsor: Adams, Alma S. [Rep.-D-NC-12]; Committees: House – Energy and Commerce
H.R.9670 —To amend title 11, United States Code, to provide bankruptcy protections for medically distressed debtors, and for other purposes; Sponsor: Cohen, Steve [Rep.-D-TN-9]; Committees: House – Judiciary; Financial Services
H.R.9671 — To expand access for workers experiencing symptoms related to menopause and the menopause transition to reasonable accommodations that enable them to perform the essential functions of their job without risking their health or economic security; Sponsor: Dingell, Debbie [Rep.-D-MI-6]; Committees: House – Education and Workforce; House Administration; Oversight and Government Reform; Judiciary
H.R.9672 — To amend the Public Health Service Act to make updates to the Vaccine Injury Compensation Program, and for other purposes; Sponsor: Doggett, Lloyd [Rep.-D-TX-37]; Committees: House – Energy and Commerce; Ways and Means
H.R.9675 — To authorize the Assistant Secretary for Mental Health and Substance Use, acting through the Director of the Center for Substance Abuse Treatment, to award grants to States to expand access to clinically appropriate services for opioid abuse, dependence, or addiction; Sponsor: Foster, Bill [Rep.-D-IL-11]; Committees: House – Energy and Commerce
H.R.9676 — To direct the Comptroller General of the United States to evaluate and report on the inpatient and outpatient treatment capacity, availability, and needs of the United States with respect to opioid-use disorders, and for other purposes; Sponsor: Foster, Bill [Rep.-D-IL-11]; Committees: House – Energy and Commerce; Natural Resources
H.R.9682 — To require the Secretary of Health and Human Services to carry out activities to eliminate hepatitis C virus in the United States; Sponsor: Miller-Meeks, Mariannette [Rep.-R-IA-1]; Committees: House – Energy and Commerce; Judiciary; Natural Resources; Ways and Means
S.4986 — A bill to amend title XIX of the Social Security Act to provide coverage under the Medicaid program for services provided by doulas, midwives, and lactation support providers, and for other purposes; Sponsor: Warren, Elizabeth [Sen.-D-MA]; Committees: Senate – Finance
S.4987 — A bill to require the Federal Trade Commission to submit a report on foreign investment in the pharmaceutical industry of the United States, and for other purposes; Sponsor: Warren, Elizabeth [Sen.-D-MA]; Committees: Senate – Banking, Housing, and Urban Affairs
S.4989 — A bill to improve the quality, appropriateness, and effectiveness of diagnosis in health care, and for other purposes; Sponsor: Van Hollen, Chris [Sen.-D-MD]; Committees: Senate – Health, Education, Labor, and Pensions
S.4993 — A bill to direct the Secretary of Veterans Affairs to establish a precision oncology program for cancer of the prostate at the Department of Veterans Affairs, and for other purposes; Sponsor: Moran, Jerry [Sen.-R-KS]; Committees: Senate – Veterans’ Affairs
S.4994 — A bill to amend the Internal Revenue Code of 1986 to provide for credits against tax for domestic manufacturing of critical medical supplies and drugs; Sponsor: Blackburn, Marsha [Sen.-R-TN]; Committees: Senate – Finance
S.4997 — A bill to set forth requirements for the regulation by the Food and Drug Administration of nitrous oxide products, and for other purposes; Sponsor: Wyden, Ron [Sen.-D-OR]; Committees: Senate – Health, Education, Labor, and Pensions
S.5004 — A bill to amend the Employee Retirement Income Security Act of 1974 to require a group health plan (or health insurance coverage offered in connection with such a plan) to provide for cost-sharing for oral anticancer drugs on terms no less favorable than the cost-sharing provided for anticancer medications administered by a health care provider; Sponsor: Smith, Tina [Sen.-D-MN]; Committees: Senate – Health, Education, Labor, and Pensions
H.R.9693 — To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program; Sponsor: Joyce, John [Rep.-R-PA-13]; Committees: House – Energy and Commerce; Ways and Means
H.R.9696 — To improve the quality, appropriateness, and effectiveness of diagnosis in health care, and for other purposes; Sponsor: Beyer, Donald S. [Rep.-D-VA-8]; Committees: House – Energy and Commerce
H.R.9699 – To require the Department of Health and Human Services to release documents, communications, and other information relating to most favored nation pricing agreements and other private or confidential drug pricing deals struck with manufacturers, and for other purposes; Sponsor: Chu, Judy [Rep.-D-CA-28]; Committees: House – Energy and Commerce; Ways and Means; Budget
H.R.9702 — To establish a public health plan; Sponsor: Craig, Angie [Rep.-D-MN-2]; Committees: House – Energy and Commerce; Ways and Means; Judiciary
H.R.9703 — To require the Center for Medicare and Medicaid Innovation to test allowing blood transfusions to be paid separately from the Medicare hospice all-inclusive per diem payment; Sponsor: Dingell, Debbie [Rep.-D-MI-6]; Committees: House – Ways and Means
H.R.9709 — To amend title XVIII of the Social Security Act to adjust the applicability of the income related monthly adjustment amount to premiums under part B of Medicare; Sponsor: Kean, Thomas H. [Rep.-R-NJ-7]; Committees: House – Energy and Commerce; Ways and Means
H.R.9712 — To amend title XIX of the Social Security Act to provide coverage under the Medicaid program for services provided by doulas, midwives, and lactation support providers, and for other purposes; Sponsor: Moore, Gwen [Rep.-D-WI-4]; Committees: House – Energy and Commerce
S.5012 — A bill to authorize the Secretary of Health and Human Services to award grants for career support for a skilled, internationally educated health care workforce; Sponsor: Kaine, Tim [Sen.-D-VA]; Committees: Senate – Health, Education, Labor, and Pensions
S.5013 — A bill to require the Secretary of Veterans Affairs to carry out a pilot program to use amounts under the Veteran-Directed Care program to provide care to veterans with acquired brain injury, and for other purposes; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate – Veterans’ Affairs
S.5027 — A bill to amend title 38, United States Code, to ensure fair reimbursement rates for home and community-based services furnished by the Department of Veterans Affairs, and for other purposes; Sponsor: Heinrich, Martin [Sen.-D-NM]; Committees: Senate – Veterans’ Affairs
S.5030 — A bill to amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage that provide benefits for sex-rejecting procedures to provide benefits for items and services to address the harms caused by sex-rejecting procedures and to restore healthy human form and functioning, to the greatest extent possible; Sponsor: Marshall, Roger [Sen.-R-KS]; Committees: Senate – Health, Education, Labor, and Pensions
H.Res.1437 — Recognizing that equity, diversity, and inclusion in federally funded health research is necessary to enhance scientific excellence, and ensure equitable outcomes for patients in the United States; Sponsor: Dingell, Debbie [Rep.-D-MI-6]; Committees: House – Energy and Commerce
H.R.9734 — To amend title XVIII of the Social Security Act to establish requirements for the use of artificial intelligence in prior authorization denials by Medicare Advantage organizations; Sponsor: Conaway, Herbert C. [Rep.-D-NJ-3]; Committees: House – Ways and Means; Energy and Commerce
H.R.9743 — To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage that provide benefits for sex-rejecting procedures to provide benefits for items and services to address the harms caused by sex-rejecting procedures and to restore healthy human form and functioning, to the greatest extent practicable; Sponsor: Harshbarger, Diana [Rep.-R-TN-1]; Committees: House – Energy and Commerce; Education and Workforce; Ways and Means
H.R.9747 — To authorize the Secretary of Health and Human Services to award grants for career support for a skilled, internationally educated health care workforce; Sponsor: Krishnamoorthi, Raja [Rep.-D-IL-8]; Committees: House – Energy and Commerce
H.R.9752 —To amend title 38, United States Code, to ensure fair reimbursement rates for home and community-based services furnished by the Department of Veterans Affairs, and for other purposes; Sponsor: Leger Fernandez, Teresa [Rep.-D-NM-3]; Committees: House – Veterans’ Affairs
H.R.9753 — To amend the Internal Revenue Code of 1986 to exempt certain retirement plan distributions used to pay qualified fertility treatment expenses from the early withdrawal tax; Sponsor: Levin, Mike [Rep.-D-CA-49]; Committees: House – Ways and Means
H.R.9754 — To direct the Secretary of Labor to require group health plans include certain information on claim denials in annual reports, and for other purposes; Sponsor: McBath, Lucy [Rep.-D-GA-6]; Committees: House – Education and Workforce
H.R.9755 — To establishes a new position of Senior Biotechnology Official within the Department of State to enhance United States leadership in global biotechnology challenges by leading United States efforts in biotechnology diplomacy, security, and innovation, and for other purposes; Sponsor: McCormick, Richard [Rep.-R-GA-7]; Committees: House – Foreign Affairs
H.R.9756 — To direct the Director of the Bureau of Prisons to provide medication assisted treatment for opioid addiction to certain women; Sponsor: McGuire, John J. [Rep.-R-VA-5]; Committees: House – Judiciary
H.R.9759 — To provide funding for programs and activities under the SUPPORT for Patients and Communities Act; Sponsor: Pappas, Chris [Rep.-D-NH-1]; Committees: House – Energy and Commerce; Ways and Means; Judiciary; Oversight and Government Reform; Education and Workforce; Financial Services
