Senate Republicans Release FY 2025 Budget Resolution – On Friday, Senate Budget Committee Chairman Lindsey Graham (R-S.C.) released the text of the Senate’s fiscal year 2025 budget resolution providing the blueprint for a reconciliation bill focused on border security, the military, and domestic energy production. To fully offset the $85.5 billion package, the resolution outlines minimum savings to be achieved by each congressional committee. The resolution requires that the Senate Finance Committee and the Senate Health, Education, Labor, and Pensions (HELP) Committee each report changes in law that reduce the deficit by at least $1 billion over the next ten years. The Senate Budget Committee plans to mark up the budget resolution on Wednesday and Thursday. The House Budget Committee, which did not meet last week to mark up a budget resolution as expected, has yet to officially start the budget reconciliation process.
Senate Vote on RFK Jr.’s Nomination Expected This Week – The Senate Finance Committee favorably reported the nomination of Robert F. Kennedy, Jr. to be Secretary of the U.S. Department of Health and Human Services in a 14-13 party line vote on February 4. Sen. Bill Cassidy, MD (R-La.) was the key vote in support of advancing the nomination. Cassidy, Chairman of the Senate HELP Committee, had repeatedly expressed reservations about Kennedy’s history of undermining confidence in vaccines. In his Senate floor speech later that day, Sen. Cassidy detailed his decision to vote yes stating that if confirmed, he and Mr. Kennedy would have “an unprecedently close collaborative working relationship,” and that the nominee committed to working within the current vaccine approval and safety monitoring systems. Kennedy also committed to Cassidy to provide a 30-day notice to the HELP Committee if the agency seeks to make changes to federal vaccine safety monitoring programs. The Senate voted 52-47 on Thursday on the motion to proceed to executive session to consider RFK’s nomination. Senate Majority Whip John Barrasso (R-Wyo.) has stated that the full chamber will vote on his confirmation this week.
Senate Confirms Doug Collins as VA Secretary – The Senate confirmed Doug Collins to serve as Secretary of Veterans Affairs by a vote of 77-23 last week. Collins is a former Georgia congressman who served in the House of Representatives from 2013 to 2021. Collins has stated that as VA Secretary he will focus on expanding access to community care for veterans as well as implementation of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act (Public Law No: 117-168).
Senate Confirms Russ Vought as OMB Director – Russ Vought will serve as Director of the Office of Management and Budget (OMB) – the same position he held during President Donald Trump’s first term in office – following his Senate confirmation by a vote of 53-47 last week. Vought previously worked for the Heritage Foundation as well the Republican Study Committee. He is also one of the architects of Project 2025, a conservative blueprint for Trump’s second term. Vought has expressed support for the idea that the Impoundment Control Act is unconstitutional and that the Executive Branch should have more control over spending appropriated by Congress.
House Passes Fentanyl Scheduling Bill – The House of Representatives passed the HALT Fentanyl Act (H.R. 27) by a vote of 312-108 last week. The legislation would permanently classify fentanyl-related substances as Schedule I substances and would modify registration processes for research activities involving controlled substances. Fentanyl’s temporary scheduling is set to expire on March 31. A similar fentanyl measure in the Republican-controlled Senate has enough Democratic cosponsors to overcome a filibuster.
Trump Administration’s Efforts to Downsize Federal Government – During the second week of his second term in office, President Donald Trump offered two million civilian full-time federal employees the opportunity to stop working and receive pay and benefits through September 30 in an attempt to cut the size of the federal government. The deferred resignation program was paused by a federal judge before it was set to expire at 11:59 p.m. on February 6; in response, the White House delayed the deadline until 11:59 p.m. on Monday, February 10. Reports indicate that the offer has been accepted by more than 50,000 people. The White House is reportedly aiming to cull the federal workforce by 2 to 5% in total.
Recent reports also indicate that the White House is working on an executive order (E.O.) related specifically to the workforce of the U.S. Department of Health and Human Services’ (HHS) according to multiple news outlets who cite people familiar with the matter. HHS currently employs over 83,000 people. Many of the rumors described below relate to probationary staff – an employment period that can extend one or two years into an individual’s federal service. While employees of probationary status include junior staff, they may also include long-time employees who recently took on new positions. The President issued a related memo on his first day in office ordering all federal agencies to report the names of employees in probationary periods to the Office of Personnel Management (OPM) by January 24. OPM issued a new memo last week asking federal agencies to report their poorest-performing employees by March 7.
- The White House has denied that it is drafting an E.O. to cut workers across federal health agencies (Reuters, Feb. 6).
- The E.O. could be signed as soon as the week of February 9 and would require health agencies to cut a certain percentage of employees. HHS officials have been told to prepare lists of probationary workers who have essential roles and must be retained and those who do not (Wall Street Journal, Feb. 6).
- HHS officials have been “urgently” instructed to rank thousands of their employees who are in probationary periods, with as much as 40% to be deemed “not mission critical.” Officials at the Centers for Disease Control and Prevention (CDC) have been told to rank 10% of their probationary staff as mission-critical, 50% as important, and 40% as not mission-critical. CDC’s rankings were due on February 6. Officials in other federal health agencies described similar requests to rank probationary employees and to justify why probationary employees should be retained. A CDC employee in the office of the chief operating officer said they expected employees identified as non-mission-critical to lose their jobs. About 135 people in the office are in probationary periods (The Washington Post, Feb. 6).
- An estimated 2,800 probationary and full-time CDC employees are at risk (Bloomberg, Feb. 6).
- An email sent to Food and Drug Administration staff on February 6 instructs officials to address “anything related to Covid” and contracts that would “be deemed wasteful by an average citizen if made public,” including General Services Administration contracts for services to support diversity, equity, inclusion and accessibility offices, telework, swag or advertising spending. HHS staff were asked to flag any contract that is inconsistent with the President’s recent E.O.s, including those focused on sustainability or “other environmental services not required by the law,” and contracts that support the Biden administration’s telework policies for federal employees (Bloomberg, Feb. 6).
CMS Latest Agency to Coordinate with DOGE – The Department of Government Efficiency (DOGE) recently visited the Centers for Medicare and Medicaid Services (CMS) to mine the agency’s data systems for fraud and waste. DOGE representatives gained access to CMS’ payment and contracting systems. The DOGE team has also been working to target any U.S. Department of Health and Human Services contracts related to diversity, equity, and inclusion for cancellation. CMS has two senior agency officials – one focused on policy and one focused on operations – who are leading the collaboration with DOGE, “including ensuring appropriate access to CMS systems and technology,” according to a statement from the agency. “We are taking a thoughtful approach to see where there may be opportunities for more effective and efficient use of resources in line with meeting the goals of President Trump.” DOGE’s visit to CMS follows similar on-site visits with the Treasury Department and U.S. Agency for International Development.
House Democrats Ask GAO to Monitor Medicare Drug Price Negotiation Program – Democratic health leaders in the House of Representatives have sent a letter to the Comptroller General asking that the Government Accountability Office (GAO) actively monitor the Trump administration’s operation of the Medicare Drug Price Negotiation Program. The Inflation Reduction Act directs the Comptroller General to conduct oversight of the law, and GAO has previously reviewed implementation of the program. “As the Medicare Drug Price Negotiation Program continues, new expertise will be developed and honed to improve the processes for successful negotiations in the future,” the letter states. “To build on this important work, we ask that GAO examine the ongoing implementation of the Medicare Drug Price Negotiation Program to ensure that it further reduces prescription drug prices, saves seniors money, and drives down federal spending.”
Upcoming Congressional Hearings and Markups
House Rules Committee hearing on H.R. 77, Midnight Rules Relief Act; 4:00 p.m.; February 10
House Ways and Means Subcommittee on Health hearing “Modernizing American Health Care: Creating Healthy Options and Better Incentives;” 2:00 p.m.; February 11
Senate Budget Committee markup of the Concurrent Resolution on the Budget for Fiscal Year 2025; 10:00 a.m.; February 12
House Veterans’ Affairs Subcommittee on Health hearing “Roles and Responsibilities: Evaluating VA Community Care;” 2:15 p.m.; February 12
Senate Special Committee on Aging hearing “Optimizing Longevity: From Research to Action;” 3:30 p.m.; February 12
House Foreign Affairs Committee hearing “The USAID Betrayal;” 8:30 a.m.; February 13
Senate Budget Committee continuation of markup of the Concurrent Resolution on the Budget for Fiscal Year 2025; 10:00 a.m.; February 13
Recently Introduced Health Legislation
H.R.903 — To amend the Clean Air Act to establish a grant program for supporting local communities in detecting, preparing for, communicating about, or mitigating the environmental and public health impacts of wildfire smoke and extreme heat, and for other purposes; Sponsor: Thompson, Mike [Rep.-D-CA-4]; Committees: House – Energy and Commerce; Science, Space, and Technology
H.R.895 —To amend title 18, United States Code, to require the Attorney General to investigate alleged violations of the partial birth abortion ban; Sponsor: Self, Keith [Rep.-R-TX-3]; Committees: House – Judiciary
H.R.894 — To authorize grants to implement school-community partnerships for preventing substance use and misuse among youth; Sponsor: Sánchez, Linda T. [Rep.-D-CA-38]; Committees: House – Energy and Commerce
H.R.890 — To amend title 35, United States Code, to prevent double patenting, and for other purposes; Sponsor: Ryan, Patrick [Rep.-D-NY-18]; Committees: House – Judiciary
H.R.879 —To amend title XVIII of the Social Security Act to increase support for physicians and other practitioners in adjusting to Medicare payment changes; Sponsor: Murphy, Gregory F. [Rep.-R-NC-3]; Committees: House – Energy and Commerce; Ways and Means
H.R.874 — To amend title 38, United States Code, to modify the rate of pay for care or services provided under the Community Care Program of the Department of Veterans Affairs based on the location at which such care or services were provided, and for other purposes; Sponsor: McCormick, Richard [Rep.-R-GA-7]; Committees: House – Veterans’ Affairs
H.R.873 — To amend title 10, United States Code, to modify the rate of pay for care or services provided under the TRICARE program based on the location at which such care or services were provided; Sponsor: McCormick, Richard [Rep.-R-GA-7]; Committees: House – Armed Services
H.R.870 —To amend title XVIII of the Social Security Act to make improvements to the redistribution of residency slots under the Medicare program after a hospital closes; Sponsor: Lee, Susie [Rep.-D-NV-3]; Committees: House – Ways and Means; Energy and Commerce
H.R.852 — To provide the Food and Drug Administration with authority to conduct microbial sampling on concentrated animal feeding operations as necessary to facilitate a foodborne illness outbreak investigation, determine the root cause of an outbreak of foodborne illness, or address other public health needs; Sponsor: DeLauro, Rosa L. [Rep.-D-CT-3]; Committees: House – Energy and Commerce
H.R.850 —To provide that silencers be treated the same as firearms accessories; Sponsor: Cloud, Michael [Rep.-R-TX-27]; Committees: House – Ways and Means; Judiciary
H.R.846 — To prohibit disinformation in the advertising of abortion services, and for other purposes; Sponsor: Bonamici, Suzanne [Rep.-D-OR-1]; Committees: House – Energy and Commerce
H.R.843 — To amend the Federal Food, Drug, and Cosmetic Act to provide for the prompt approval of drugs when safety information is added to labeling, and for other purposes; Sponsor: Barragán, Nanette Diaz [Rep.-D-CA-44]; Committees: House – Energy and Commerce
H.R.842 — To amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests; Sponsor: Arrington, Jodey C. [Rep.-R-TX-19]; Committees: House – Energy and Commerce; Ways and Means
H.R.830 — To amend the Controlled Substances Act with respect to fentanyl-related substances, and for other purposes; Sponsor: Pappas, Chris [Rep.-D-NH-1]; Committees: House – Energy and Commerce; Judiciary
H.Res.81 — Commending efforts to eradicate the wild poliovirus; Sponsor: Cohen, Steve [Rep.-D-TN-9]; Committees: House – Foreign Affairs
S.355 — A bill to require the Secretary of Health and Human Services, acting through the Commissioner of Food and Drugs, to publish a final rule relating to nonclinical testing methods; Sponsor: Booker, Cory A. [Sen.-D-NJ]; Committees: Senate – Health, Education, Labor, and Pensions
S.376 — A bill to provide the Food and Drug Administration with authority to conduct microbial sampling on concentrated animal feeding operations as necessary to facilitate a foodborne illness outbreak investigation, determine the root cause of an outbreak of foodborne illness, or address other public health needs; Sponsor: Booker, Cory A. [Sen.-D-NJ]; Committees: Senate – Health, Education, Labor, and Pensions
S.380 — A bill to improve obstetric emergency care; Sponsor: Hassan, Margaret Wood [Sen.-D-NH]; Committees: Senate – Health, Education, Labor, and Pensions
S.400 — A bill to amend the Internal Revenue Code of 1986 to enhance the paid family and medical leave credit, and for other purposes; Sponsor: Fischer, Deb [Sen.-R-NE]; Committees: Senate – Finance
H.Res.98 — Expressing support for the designation of February 4, 2025, as “National Cancer Prevention Day”; Sponsor: Dingell, Debbie [Rep.-D-MI-6]; Committees: House – Energy and Commerce
H.J.Res.34 — Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Environmental Protection Agency relating to “Trichloroethylene (TCE); Regulation Under the Toxic Substances Control Act (TSCA)”; Sponsor: Harshbarger, Diana [Rep.-R-TN-1]; Committees: House – Energy and Commerce
H.R.912 — To amend title V of the Public Health Service Act to secure the suicide prevention lifeline from cybersecurity incidents, and for other purposes; Sponsor: Obernolte, Jay [Rep.-R-CA-23]; Committees: House – Energy and Commerce
H.R.919 — To codify Internal Revenue Service guidance relating to treatment of certain services and items for chronic conditions as meeting the preventive care deductible safe harbor for purposes of high deductible health plans in connection with health savings accounts; Sponsor: Buchanan, Vern [Rep.-R-FL-16]; Committees: House – Ways and Means
H.R.920 — To amend the Controlled Substances Act to list fentanyl-related substances as schedule I controlled substances, and for other purposes; Sponsor: Buchanan, Vern [Rep.-R-FL-16]; Committees: House – Energy and Commerce; Judiciary
H.R.929 — To reauthorize the Dr. Lorna Breen Health Care Provider Protection Act, and for other purposes; Sponsor: Dingell, Debbie [Rep.-D-MI-6]; Committees: House – Energy and Commerce
H.R.935 — To amend the Public Health Service Act to provide for a health care workforce innovation program; Sponsor: Garbarino, Andrew R. [Rep.-R-NY-2]; Committees: House – Energy and Commerce
H.R.936 — To amend title XI of the Social Security Act to provide for State approval and implementation of specified waivers under the Medicaid program; Sponsor: Green, Mark E. [Rep.-R-TN-7]; Committees: House – Energy and Commerce
H.R.946 — To amend title XI of the Social Security Act to expand and clarify the exclusion for orphan drugs under the Drug Price Negotiation Program; Sponsor: Joyce, John [Rep.-R-PA-13]; Committees: House – Energy and Commerce; Ways and Means
H.R.950 — To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare part D; Sponsor: Landsman, Greg [Rep.-D-OH-1]; Committees: House – Energy and Commerce; Ways and Means
H.R.955 — To amend the Internal Revenue Code of 1986 to reform health provisions, and for other purposes; Sponsor: Moore, Blake D. [Rep.-R-UT-1]; Committees: House – Ways and Means
H.R.957 — To provide for civil monetary penalties for violations of mental health parity requirements; Sponsor: Norcross, Donald [Rep.-D-NJ-1]; Committees: House – Education and Workforce
H.R.958 — To amend the Public Health Service Act to reauthorize funding for grants and contracts for primary care training and enhancement, and for other purposes; Sponsor: Nunn, Zachary [Rep.-R-IA-3]; Committees: House – Energy and Commerce
H.R.961 — To direct the Secretary of Veterans Affairs to establish a pilot program to provide veteran health savings accounts to allow veterans to receive primary care furnished under non-Department direct primary care service arrangements, and for other purposes; Sponsor: Roy, Chip [Rep.-R-TX-21]; Committees: House – Veterans’ Affairs
H.R.966 — To prohibit the Secretary of Veterans Affairs from denying veteran benefits administered by the Secretary by reason of the veteran participating in a State-approved marijuana program, and for other purposes; Sponsor: Steube, W. Gregory [Rep.-R-FL-17]; Committees: House – Veterans’ Affairs
H.R.996 — To amend the Internal Revenue Code of 1986 to enhance the paid family and medical leave credit, and for other purposes; Sponsor: Feenstra, Randy [Rep.-R-IA-4]; Committees: House – Ways and Means
H.R.999 — To protect an individual’s ability to access contraceptives and to engage in contraception and to protect a health care providers ability to provide contraceptives, contraception, and information related to contraception; Sponsor: Fletcher, Lizzie [Rep.-D-TX-7]; Committees: House – Energy and Commerce
H.R.1014 — To amend title 10, United States Code, to direct the Secretary of Defense to include certain tests as part of the periodic health assessments provided to members of the Armed Forces; Sponsor: Luttrell, Morgan [Rep.-R-TX-8]; Committees: House – Armed Services
H.R.1015 — To amend title 18, United States Code, to provide for certain rules for housing or transportation based on gender and to provide for a limitation on gender-related medical treatment; Sponsor: Mace, Nancy [Rep.-R-SC-1]; Committees: House – Judiciary
H.R.1019 — To amend title XIX of the Social Security Act to ensure the reliability of address information provided under the Medicaid program; Sponsor: Miller-Meeks, Mariannette [Rep.-R-IA-1]; Committees: House – Energy and Commerce
H.R.1026 — To amend the Internal Revenue Code of 1986 to allow individuals with direct primary care service arrangements to remain eligible individuals for purposes of health savings accounts, and for other purposes; Sponsor: Smucker, Lloyd [Rep.-R-PA-11]; Committees: House – Ways and Means
H.R.1035 — To amend the Family and Medical Leave Act to expand employees eligible for leave and employers subject to leave requirements, and for other purposes; Sponsor: Underwood, Lauren [Rep.-D-IL-14]; Committees: House – Education and Workforce; House Administration; Oversight and Government Reform
S.Res.67 — A resolution declaring racism a public health crisis; Sponsor: Booker, Cory A. [Sen.-D-NJ]; Committees: Senate – Health, Education, Labor, and Pensions
S.447 — A bill to amend title XIX of the Social Security Act to implement a minimum work requirement for able-bodied adults enrolled in State Medicaid programs; Sponsor: Kennedy, John [Sen.-R-LA]; Committees: Senate – Finance
S.454 — A bill to authorize the Assistant Secretary for Mental Health and Substance Use to award formula grants to the States to address gambling addiction, and for other purposes; Sponsor: Blumenthal, Richard [Sen.-D-CT]; Committees: Senate – Health, Education, Labor, and Pensions
S.473 — A bill to amend the Older Americans Act of 1965 to include screening for loneliness and coordination of supportive services and health care to address the negative health effects of loneliness, to require a report on loneliness, and for other purposes; Sponsor: Scott, Rick [Sen.-R-FL]; Committees: Senate – Health, Education, Labor, and Pensions
S.474 — A bill to amend title XIX of the Social Security Act to establish a minimum Medicaid disproportionate share hospital allotment for States; Sponsor: Barrasso, John [Sen.-R-WY]; Committees: Senate – Finance
S.475 — A bill to amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program; Sponsor: Tillis, Thomas [Sen.-R-NC]; Committees: Senate – Finance
S.477 — A bill to amend the Controlled Substances Act and the Controlled Substances Import and Export Act to modify the offenses relating to fentanyl, and for other purposes; Sponsor: Kennedy, John [Sen.-R-LA]; Committees: Senate – Judiciary
S.483 — A bill to amend the Federal Food, Drug, and Cosmetic Act to restrict direct-to-consumer drug advertising; Sponsor: King, Angus S., Jr. [Sen.-I-ME]; Committees: Senate – Health, Education, Labor, and Pensions
H.Res.119 — Declaring racism a public health crisis; Sponsor: Hayes, Jahana [Rep.-D-CT-5]; Committees: House – Energy and Commerce; Judiciary
H.R.1051 — To amend the Federal Food, Drug, and Cosmetic Act to allow for the approval of an abbreviated new drug application submitted by a subsequent applicant in the case of a failure by a first applicant to commence commercial marketing within a certain period, and for other purposes; Sponsor: Budzinski, Nikki [Rep.-D-IL-13]; Committees: House – Energy and Commerce
H.R.1059 — To amend title XIX of the Social Security Act to implement a minimum work requirement for able-bodied adults enrolled in State Medicaid programs; Sponsor: Crenshaw, Dan [Rep.-R-TX-2]; Committees: House – Energy and Commerce
H.R.1060 — To amend the Federal Food, Drug, and Cosmetic Act to modernize the methods of authenticating controlled substances in the pharmaceutical distribution supply chain, and for other purposes; Sponsor: Davis, Donald G. [Rep.-D-NC-1]; Committees: House – Energy and Commerce
H.R.1064 — To amend the Controlled Substances Act to list fentanyl-related substances as schedule I controlled substances; Sponsor: Fitzgerald, Scott [Rep.-R-WI-5]; Committees: House – Energy and Commerce; Judiciary
H.R.1082 — To require the Secretary of Health and Human Services to conduct a national, evidence-based education campaign to increase public and health care provider awareness regarding the potential risks and benefits of human cell and tissue products transplants, and for other purposes; Sponsor: Moolenaar, John R. [Rep.-R-MI-2]; Committees: House – Energy and Commerce
H.R.1085 — To amend the Public Health Service Act to prohibit the National Institutes of Health from awarding any support for an activity or program that uses live animals in research unless the research occurs in the United States, and for other purposes; Sponsor: Nehls, Troy E. [Rep.-R-TX-22]; Committees: House – Energy and Commerce
H.R.1096 — To amend title XVIII of the Social Security Act to require coverage of 3 primary care visits without cost sharing each year under the Medicare program; Sponsor: Salinas, Andrea [Rep.-D-OR-6]; Committees: House – Energy and Commerce; Ways and Means
H.R.1100 — To amend the Controlled Substances Act to provide for the regulation of critical parts of tableting machines and encapsulating machines, and for other purposes; Sponsor: Stansbury, Melanie A. [Rep.-D-NM-1]; Committees: House – Energy and Commerce; Judiciary
H.R.1107 — To amend title 38, United States Code, to authorize certain heath care professionals employed by the Department of Veterans Affairs to deliver, distribute, or dispense to veterans certain controlled medications via telemedicine under certain conditions, and for other purposes; Sponsor: Womack, Steve [Rep.-R-AR-3]; Committees: House – Veterans’ Affairs