HHS to Undergo Restructuring, Cutting 10,000 Employees – The U.S. Department of Health and Human Services (HHS) announced a plan for major restructuring last week that will result in $1.8 billion in savings and 10,000 job cuts across the department. The restructuring is in keeping with President Donald Trump’s executive order Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative. The plan will consolidate the 28 current HHS divisions into 15 new divisions, including a new Administration for a Healthy America (AHA), 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, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health. The Administration for Strategic Preparedness and Response will transfer to the Centers for Disease Control and Prevention (CDC). The Assistant Secretary for Planning and Evaluation will be merged with the Agency for Healthcare Research and Quality to create the new Office of Strategy. HHS regional offices will be reduced from 10 to 5. Workforce reductions will include the elimination of:
- 3,500 full time employees from the Food and Drug Administration, which HHS has said will not impact drug, medical device, or food reviewers or inspectors;
- 2,400 employees from the CDC;
- 1,200 employees from the National Institutes of Health; and
- 300 employees from the Centers for Medicare and Medicaid Services, mostly from the Office of Minority Health and the Office of Program Operations and Local Engagement according to the latest reports.
When combined with other efforts to reduce the size of the federal government made by the Trump administration earlier this year – including early retirement incentives and the “Fork in the Road” buyouts – the HHS workforce will be reduced from 82,000 to 62,000 full-time employees, a level the department has not seen since 2002. The reorganization is expected to take effect at the end of May. An administration fact sheet on the restructuring can be found here.
Senate Confirms, Advances Health Nominees – The Senate confirmed several of President Trump’s health nominees upon returning from its week-long recess last week. Jay Bhattacharya, MD was confirmed as director of the National Institutes of Health (NIH), and Marty Makary, MD was confirmed as commissioner of Food and Drugs. Dr. Bhattacharya was confirmed in a party line vote of 53-47, while Dr. Makary was confirmed in a 56-44 vote with the support of Democrats Maggie Hassan (N.H.), Jeanne Shaheen (N.H.), and Dick Durbin (Ill.). The chamber also confirmed Michael Kratsios to serve as director of the Office of Science and Technology Policy in a 74-25 vote. The Senate Finance Committee advanced the nomination of Mehmet Oz, MD to serve as administrator of the Centers for Medicare and Medicaid Services on Tuesday. His nomination was advanced in a 14-13 party line vote and the Senate is expected to take up the nomination soon.
White House Taps Acting CDC Director to Lead Agency – The White House has nominated Susan Monarez, PhD to serve as the next director of the Centers for Disease Control and Prevention (CDC). Monarez is currently acting director at the agency, a position she has held since January 23. Prior to joining CDC, she worked as the deputy director of the Advanced Research Projects Agency for Health, the biomedical innovation agency created during the Biden administration. Monarez has also held positions at the Health Resources and Services Administration, the Homeland Security Advanced Research Projects Agency, and the Biomedical Advanced Research Projects Authority during her career. The Trump administration recently withdrew the nomination of former congressman Dave Weldon, MD to lead the CDC when it became clear that Weldon did not have the votes to be confirmed by the Senate. Several Republican senators had raised concerns about Weldon’s views on vaccine safety and effectiveness. U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. defended Monarez’s nomination, stating in a social media post “I handpicked Susan for this job because she is a longtime champion of MAHA [Make America Healthy Again] values, and a caring, compassionate and brilliant microbiologist and a tech wizard who will reorient CDC towards public health and gold-standard science.” Other health nominations recently announced by the administration include Thomas March Bell, general counsel for House Republicans, to serve as HHS Inspector General; Brian Christine, MD, a urologist, to serve as HHS Assistant Secretary for Health; and Alex Adams, director of the Idaho Department of Health and Welfare, to serve as HHS Assistant Secretary for Family Support.
Fox News Contributor Selected to Lead Office of National Drug Control Policy – President Trump announced on Friday that Sara Carter, a journalist and Fox News contributor, will be nominated to lead the White House Office of National Drug Control Policy (ONDCP). If confirmed by the Senate, Carter will be the first woman to lead ONDCP, the office responsible for coordinating public health and law enforcement efforts to address opioid and substance use issues. Carter has never served in government but has written about and discussed illegal immigration and drug trafficking issues extensively.
U.S. Expected to Reach Debt Limit in August or September – The Congressional Budget Office (CBO) estimates that the nation will reach the debt limit in August or September 2025, a date known as the “X date” when the U.S. would default on its national debt. The 2023 suspension of the debt limit expired on January 1, but the Treasury Department is using so-called extraordinary measures to temporarily keep the government from defaulting on its debt. Congressional Republicans are expected to include a debt limit increase in a forthcoming budget reconciliation package. In response to CBO’s latest projection, House Budget Committee Chairman Jodey Arrington (R-Texas) highlighted that the House budget resolution raised the debt limit while “responsibly pairing it with meaningful fiscal reforms that will rein-in spending, reignite economic growth, and reduce our debt to GDP.” He urged the Senate to “move with urgency” to pass a budget resolution that aligns with the House version so that Congress can move forward with the reconciliation process. Reportedly, Senate Republicans hope to act on a budget resolution this week.
CBER Director Peter Marks to Resign – Peter Marks, MD, director of the Center for Biologics Evaluation and Research (CBER) at the Food and Drug Administration (FDA), announced his resignation last week. Marks cited U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr.’s “misinformation and lies” about the safety of vaccines as the reason for his departure. Marks was reportedly offered the choice of resigning or being fired by Kennedy. “It has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies,” Marks wrote in his letter of resignation. Marks first joined the FDA in 2012 and has served as head of CBER since 2016. He was a key figure in the establishment of Operation Warp Speed to develop a COVID-19 vaccine.
Upcoming Congressional Hearings and Markups
Senate Agriculture, Nutrition and Forestry Committee legislative hearing to review S. 222, the Whole Milk for Healthy Kids Act, and Improving Children’s Health;” 10:00 a.m.; April 1
House Veterans’ Affairs Committee hearing “Harnessing Biomedical Innovation: Modernizing VA Healthcare for the Future;” 10:15 a.m.; April 1
House Energy and Commerce Subcommittee on Health hearing “Examining the FDA’s Regulation of Over-the-Counter Monograph Drugs;” 10:15 a.m.; April 1
House Energy and Commerce Subcommittee on Oversight and Investigations hearing “Aging Technology, Emerging Threats: Examining Cybersecurity Vulnerabilities in Legacy Medical Devices;” 10:30 a.m.; April 1
House Veterans’ Affairs Subcommittee on Oversight and Investigations hearing “Answering the Call: Examining VA’s Mental Health Policies;” 2:00 p.m.; April 2
House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing “A Healthy Workforce: Expanding Access and Affordability in Employer-Sponsored Health Care;” 2:00 p.m.; April 2
Senate Judiciary Committee markup to consider S. 527, Prescription Pricing for the People Act; S. 1040, A bill to amend the Federal Trade Commission Act to prohibit product hopping; S. 1041, A bill to amend title 35, United States Code, to address the infringement of patents that claim biological products; S. 1097, Interagency Patent Coordination and Improvement Act; S. 1095, Stop STALLING Act; and S. 1096, Preserve Access to Affordable Generics and Biosimilars; 10:15 a.m. April 3
Recently Introduced Health Legislation
H.R.2268 — To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to recognize nurse registries for purposes of the Veterans Community Care Program, and for other purposes; Sponsor: Mast, Brian J. [Rep.-R-FL-21]; Committees: House – Veterans’ Affairs
H.R.2264 — To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to automatically pay dependency and indemnity compensation to a survivor of a veteran with a service-connected mental disorder who dies by suicide; Sponsor: Lawler, Michael [Rep.-R-NY-17]; Committees: House – Veterans’ Affairs
H.R.2263 — Telehealth Coverage Act – To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program, and for other purposes; Sponsor: Khanna, Ro [Rep.-D-CA-17]; Committees: House – Energy and Commerce; Ways and Means
H.R.2251 — To amend title 18, United States Code, to prohibit discrimination by abortion against an unborn child on the basis of Down syndrome; Sponsor: Estes, Ron [Rep.-R-KS-4]; Committees: House – Judiciary
H.R.2245 — To amend title 38, United States Code, to increase the amount paid by the Secretary of Veterans Affairs to veterans for improvements and structural alterations furnished as part of home health services; Sponsor: Bacon, Don [Rep.-R-NE-2]; Committees: House – Veterans’ Affairs
H.R.2244 — To amend title 38, United States Code, to establish presumptions of service connection for diseases associated with firefighting; Sponsor: Bacon, Don [Rep.-R-NE-2]; Committees: House – Veterans’ Affairs
H.Res.239 — Raising awareness of the racial disparities in the impact of colorectal cancer on the Black community; Sponsor: Watson Coleman, Bonnie [Rep.-D-NJ-12]; Committees: House – Energy and Commerce
H.Res.238 — Expressing the sense of the House of Representatives that every person has the basic right to emergency health care, including abortion care; Sponsor: Sykes, Emilia Strong [Rep.-D-OH-13]; Committees: House – Energy and Commerce
H.Res.236 — Expressing support for the goals of a “NICU Baby’s Bill of Rights”; Sponsor: Houchin, Erin [Rep.-R-IN-9]; Committees: House – Energy and Commerce
H.Res.235 — Recognizing the importance of sleep health and expressing support for the designation of the week of March 9 through March 15, 2025, as “Sleep Awareness Week”; Sponsor: Dean, Madeleine [Rep.-D-PA-4]; Committees: House – Energy and Commerce
S.1095 — A bill to enable the Federal Trade Commission to deter filing of sham citizen petitions to cover an attempt to interfere with approval of a competing generic drug or biosimilar, to foster competition, and facilitate the efficient review of petitions filed in good faith to raise legitimate public health concerns, and for other purposes; Sponsor: Klobuchar, Amy [Sen.-D-MN]; Committees: Senate – Judiciary
S.1096 — A bill to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable companies to delay the entry of biosimilar biological products and interchangeable biological products; Sponsor: Klobuchar, Amy [Sen.-D-MN]; Committees: Senate – Judiciary
S.1097 — A bill to amend title 35, United States Code, to establish an interagency task force between the United States Patent and Trademark Office and the Food and Drug Administration for purposes of sharing information and providing technical assistance with respect to patents, and for other purposes; Sponsor: Durbin, Richard J. [Sen.-D-IL]; Committees: Senate – Judiciary
S.1098 — A bill to amend the Omnibus Crime Control and Safe Streets Act of 1968 to enhance the Comprehensive Opioid Abuse Grant Program, and for other purposes; Sponsor: Cantwell, Maria [Sen.-D-WA]; Committees: Senate – Judiciary
H.Res.245 — Recognizing the significance of Sjögren’s disease as a serious and systemic autoimmune disease and expressing support for the designation of April 2025 as “Sjögren’s Awareness Month”; Sponsor: Morelle, Joseph D. [Rep.-D-NY-25]; Committees: House – Energy and Commerce
H.R.2283 — To direct the Secretary of Veterans Affairs to carry out a pilot program to provide grants to outpatient mental health facilities for the provision of culturally competent, evidence-based mental health care for veterans, and for other purposes; Sponsor: Bost, Mike [Rep.-R-IL-12]; Committees: House – Veterans’ Affairs
H.R.2309 — To amend title XIX of the Social Security Act to require certain additional provider screening under the Medicaid program; Sponsor: Peters, Scott H. [Rep.-D-CA-50]; Committees: House – Energy and Commerce
S.Res.138 — A resolution supporting the goals and ideals of “Deep Vein Thrombosis and Pulmonary Embolism Awareness Month”; Sponsor: Grassley, Chuck [Sen.-R-IA]; Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent.
S.1104 — A bill to amend section 495 of the Public Health Service Act to require inspections of foreign laboratories conducting biomedical and behavioral research to ensure compliance with applicable animal welfare requirements, and for other purposes; Sponsor: Schmitt, Eric [Sen.-R-MO]; Committees: Senate – Health, Education, Labor, and Pensions
S.1105 — A bill to amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate – Finance
S.1129 — Dietary Guidelines Reform Act of 2025 – A bill to amend the National Nutrition Monitoring and Related Research Act of 1990 to improve the dietary guidelines, and for other purposes; Sponsor: Marshall, Roger [Sen.-R-KS]; Committees: Senate – Agriculture, Nutrition, and Forestry
H.Res.253 — Expressing support for the designation of May 15, 2025, as “Prader-Willi Syndrome Awareness Day” to raise awareness of and promote research on the disorder; Sponsor: Tonko, Paul [Rep.-D-NY-20]; Committees: House – Energy and Commerce
H.R.2314 — To amend title XVIII of the Social Security Act to require hospitals with approved medical residency training programs to submit to the Secretary of Health and Human Services certain information regarding osteopathic and allopathic candidates for such programs; Sponsor: Harshbarger, Diana [Rep.-R-TN-1]; Committees: House – Ways and Means
H.R.2319 — To direct the Secretary of Health and Human Services to conduct a review to evaluate the status of research on lung cancer in women and underserved populations, and for other purposes; Sponsor: Boyle, Brendan F. [Rep.-D-PA-2]; Committees: House – Energy and Commerce
H.R.2320 — To amend the Internal Revenue Code of 1986 to establish a refundable credit for expenses incurred for mobility devices; Sponsor: Cohen, Steve [Rep.-D-TN-9]; Committees: House – Ways and Means
H.R.2326 — To amend the National Nutrition Monitoring and Related Research Act of 1990 to improve the dietary guidelines, and for other purposes; Sponsor: Jackson, Ronny [Rep.-R-TX-13]; Committees: House – Agriculture
H.R.2339 — To require the Office of Children’s Health Protection to be maintained within the Environmental Protection Agency, and for other purposes; Sponsor: Nadler, Jerrold [Rep.-D-NY-12]; Committees: House – Energy and Commerce
H.R.2340 — To amend title XVIII of the Social Security Act to provide for the automatic qualification of certain Medicaid beneficiaries for premium and cost-sharing subsidies under part D of the Medicare program, and for other purposes; Sponsor: Pappas, Chris [Rep.-D-NH-1]; Committees: House – Energy and Commerce; Ways and Means
H.R.2343 — To amend title XVIII of the Social Security Act to provide for coverage and payment of Alpha-1 Antitrypsin Deficiency Disorder treatment under part B of such title, and for other purposes; Sponsor: Salazar, Maria Elvira [Rep.-R-FL-27]; Committees: House – Energy and Commerce; Ways and Means
S.Res.143 — A resolution supporting the designation of May 29, 2025, as “Mental Health Awareness in Agriculture Day” to raise awareness around mental health in the agricultural industry and workforce and to continue to reduce stigma associated with mental illness; Sponsor: Fischer, Deb [Sen.-R-NE]; Committees: Senate – Judiciary
S.1132 — A bill to amend the Older Americans Act of 1965 to include peer supports as a supportive service within the National Family Caregiver Support Program, to require States to consider the unique needs of caregivers whose families have been impacted by substance use disorder, including opioid use disorder, in providing services under such program, and for other purposes; Sponsor: Budd, Ted [Sen.-R-NC]; Committees: Senate – Health, Education, Labor, and Pensions
S.1134 — A bill to amend title 38, United States Code, to improve the Office of Patient Advocacy of the Department of Veterans Affairs; Sponsor: Cramer, Kevin [Sen.-R-ND]; Committees: Senate – Veterans’ Affairs
S.1139 — A bill to amend the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019 to modify and reauthorize the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program of the Department of Veterans Affairs, and for other purposes; Sponsor: Moran, Jerry [Sen.-R-KS]; Committees: Senate – Veterans’ Affairs
S.1140 — A bill to amend title XI of the Social Security Act to lower barriers to increase patient access to health care; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate – Finance
S.1144 — A bill to amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care; Sponsor: Thune, John [Sen.-R-SD]; Committees: Senate – Finance
S.1147 — A bill to establish clear and consistent biological definitions of male and female; Sponsor: Marshall, Roger [Sen.-R-KS]; Committees: Senate – Judiciary
S.1157 — A bill to direct the Secretary of Health and Human Services to conduct a review to evaluate the status of research on lung cancer in women and underserved populations, and for other purposes; Sponsor: Smith, Tina [Sen.-D-MN]; Committees: Senate – Health, Education, Labor, and Pensions
H.Res.256 — Supporting the designation of March 2025 as Endometriosis Awareness Month; Sponsor: Scott, David [Rep.-D-GA-13]; Committees: House – Energy and Commerce
H.R.2363 — To prohibit the authorization of certain individuals to access certain systems containing individually identifiable health information; Sponsor: DeGette, Diana [Rep.-D-CO-1]; Committees: House – Energy and Commerce
H.R.2369 — Personal Health Investment Today (PHIT) Act – To amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care; Sponsor: Kelly, Mike [Rep.-R-PA-16]; Committees: House – Ways and Means
H.R.2372 — Disclosure; and Encouragement of Verification, Innovation, Cleaning, and Efficiency (DEVICE) Act – To amend the Federal Food, Drug, and Cosmetic Act to enhance medical device communications and ensure device cleanliness; Sponsor: Lieu, Ted [Rep.-D-CA-36]; Committees: House – Energy and Commerce
H.R.2378 — To establish clear and consistent biological definitions of male and female; Sponsor: Miller, Mary E. [Rep.-R-IL-15]; Committees: House – Judiciary
H.R.2381 — To amend the Public Health Service Act to reauthorize and improve the National Breast and Cervical Cancer Early Detection Program for fiscal years 2026 through 2030, and for other purposes; Sponsor: Morelle, Joseph D. [Rep.-D-NY-25]; Committees: House – Energy and Commerce
H.R.2382 — To amend the Internal Revenue Code of 1986 to provide that governmental pension plans may include certain firefighters, emergency medical technicians, and paramedics, and for other purposes; Sponsor: Murphy, Gregory F. [Rep.-R-NC-3]; Committees: House – Education and Workforce; Ways and Means
H.R.2383 — To amend the Public Health Service Act to authorize the use of Preventive Health and Health Services Block Grants to purchase life-saving opioid antagonists for schools and to provide related training and education to students and teachers, and for other purposes; Sponsor: Neguse, Joe [Rep.-D-CO-2]; Committees: House – Energy and Commerce
H.R.2385 — To establish the National Artificial Intelligence Research Resource, and for other purposes; Sponsor: Obernolte, Jay [Rep.-R-CA-23]; Committees: House – Science, Space, and Technology
H.R.2387 — To prohibit Federal funds from being used for sex-trait altering treatments for minors, and for other purposes; Sponsor: Onder, Robert [Rep.-R-MO-3]; Committees: House – Energy and Commerce; Judiciary; Education and Workforce; Ways and Means
S.1164 — A bill to allow additional individuals to enroll in standalone dental plans offered through Federal Exchanges; Sponsor: Hassan, Margaret Wood [Sen.-D-NH]; Committees: Senate – Health, Education, Labor, and Pensions
S.1168 — A bill to amend title XVIII of the Social Security Act to provide coverage of portable ultrasound transportation and set up services under the Medicare program; Sponsor: Cornyn, John [Sen.-R-TX]; Committees: Senate – Finance
S.1173 — A bill to amend title XVIII of the Social Security Act to clarify and preserve the breadth of the protections under the Medicare Secondary Payer Act; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate – Finance
S.1186 — A bill to amend title XVIII of the Social Security Act to apply prescription drug inflation rebates to drugs furnished in the commercial market and to change the base year for rebate calculations; Sponsor: Cortez Masto, Catherine [Sen.-D-NV]; Committees: Senate – Finance
H.R.2404 — To provide for a study on the effects of remote monitoring on individuals who are prescribed opioids; Sponsor: Balderson, Troy [Rep.-R-OH-12]; Committees: House – Energy and Commerce
H.R.2414 — To amend the Public Health Service Act to reauthorize a military and civilian partnership for trauma readiness grant program; Sponsor: Castor, Kathy [Rep.-D-FL-14]; Committees: House – Energy and Commerce
H.R.2419 — To amend the Internal Revenue Code of 1986 to allow all individuals to contribute to health savings accounts, and for other purposes; Sponsor: Davidson, Warren [Rep.-R-OH-8]; Committees: House – Ways and Means; Energy and Commerce
H.R.2426 — To require a study on the quality of care difference between mental health and addiction therapy care provided by health care providers of the Department of Veterans Affairs compared to non-Department providers, and for other purposes; Sponsor: Fallon, Pat [Rep.-R-TX-4]; Committees: House – Veterans’ Affairs
H.R.2433 — To ensure that prior authorization medical decisions under Medicare are determined by physicians; Sponsor: Green, Mark E. [Rep.-R-TN-7]; Committees: House – Ways and Means; Energy and Commerce
H.R.2436 — To amend the Internal Revenue Code of 1986 to treat distributions from health savings accounts for funeral expenses of the account beneficiary as qualified distributions; Sponsor: Hern, Kevin [Rep.-R-OK-1]; Committees: House – Ways and Means
H.R.2437 — To amend title XVIII of the Social Security Act to require hospitals to provide information on available hospice programs to certain individuals upon discharge under the Medicare program; Sponsor: Houchin, Erin [Rep.-R-IN-9]; Committees: House – Ways and Means
H.R.2445 — To prohibit implementation of the rule entitled “Medicaid Program; Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes”, and for other purposes; Sponsor: Kennedy, Mike [Rep.-R-UT-3]; Committees: House – Energy and Commerce
H.R.2450 — To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1984 to increase oversight of pharmacy benefit management services, and for other purposes; Sponsor: McDonald Rivet, Kristen [Rep.-D-MI-8]; Committees: House – Energy and Commerce; Education and Workforce; Ways and Means
H.R.2469 — To direct the Secretary of Health and Human Services to evaluate the benefits of abortion doula care and coverage; Sponsor: Strickland, Marilyn [Rep.-D-WA-10]; Committees: House – Energy and Commerce
H.R.2471 — To update the National Action Plan for Adverse Drug Event Prevention to consider advances in pharmacogenomic research and testing, to improve electronic health records for pharmacogenomic information, and for other purposes; Sponsor: Swalwell, Eric [Rep.-D-CA-14]; Committees: House – Energy and Commerce
H.R.2477 — To amend title XVIII of the Social Security Act to provide coverage of portable ultrasound transportation and set up services under the Medicare program; Sponsor: Van Duyne, Beth [Rep.-R-TX-24]; Committees: House – Energy and Commerce; Ways and Means