GOP Divided on Subsidy Plan as Expiration Approaches – Lawmakers are returning from Thanksgiving recess without a plan to address the spike in health insurance premiums that is expected if the Affordable Care Act’s (ACA) enhanced advanced premium tax credits expire at the end of this year. President Donald Trump had been expected to unveil a proposal last week that would have extended the enhanced subsidies for two years while imposing new income limits; required every enrollee to pay at least a nominal monthly premium; and called on Congress to appropriate funding for cost-sharing reductions. It also included an option for enrollees to receive part of their tax credit in a tax-advantaged savings account. The announcement was cancelled at the last minute, however, reportedly because of GOP opposition to the plan.
Republicans on Capitol Hill remain divided over a path forward on health care costs. Some GOP members support allowing the subsidies to lapse, while others are weighing the introduction of their own health care reform legislation. Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Bill Cassidy, MD (R-La.), for example, has proposed funding for certain enrollees in the ACA marketplace, while Reps. Jen Kiggans (R-Va.) and Josh Gottheimer (D-N.J.) are leading a bipartisan effort to extend the subsidies while imposing a new income cap.
Senate Majority Leader John Thune (R-S.D.) has agreed to hold a vote on an extension no later than the second week of December. House Speaker Mike Johnson (R-La.) has declined to commit to such a vote, and has reportedly indicated that there is little interest amongst his caucus to extend the subsidies. Absent congressional action, premiums on the ACA market are projected to increase 114% on average next year. Congress is scheduled to be in session for just three more weeks during the remainder of 2025.
Health Leaders Pose Questions About New FDA Priority Review Program – Senate HELP Committee Ranking Member Bernie Sanders (I-Vt.) and House Energy and Commerce Committee Ranking Member Frank Pallone (D-N.J.) have written to the Food and Drug Administration (FDA) regarding the recently announced Commissioner’s National Priority Voucher pilot program. The pilot program, which aims to accelerate approvals for companies aligned with U.S. national health priorities, has promised to reduce certain drug and biological product application or efficacy supplement review times from 10-12 months to just 1-2 months. “We have significant concerns that this program will enable corruption by creating a new, lucrative gift for drugmakers and allies politically favored by President Trump,” the lawmakers state. “This program could undermine public confidence in FDA’s decisions and raise safety concerns, including rushed reviews by an agency whose staff have been decimated by this administration’s cuts.” They pose a series of questions about the program and request a response from Commissioner Marty Makary, MD, by December 11.
Negotiated Prices for Initial Price Applicability Year 2027 – The Centers for Medicare and Medicaid Services has announced the agreed upon prices for the 15 drugs under the second round of the Medicare Drug Price Negotiation Program. The administration estimates these prices, which will take effect starting in 2027, will result in $12 billion in federal savings. The selected drugs accounted for about $42.5 billion in total gross covered prescription drug costs under Medicare Part D, or about 15%, in 2024, and were used by approximately 5.3 million people with Medicare Part D coverage. The 15 drugs include weight management drugs Ozempic, Rybelsus, and Wegovy; cancer therapies Xtandi, Pomalyst, Ibrance, and Calquence; irritable bowel syndrome medicines Linzess and Xifaxan; asthma treatments Trelegy Ellipta and Breo Ellipta; and the plaque psoriasis/psoriatic arthritis treatment Otezla.
Upcoming Congressional Hearings and Markups
House Ways and Means Subcommittee on Oversight hearing “Lives at Stake: Holding Tax-Exempt Organ Procurement Organizations Accountable;” 10:00 a.m.; December 2
Senate Health, Education, Labor, and Pensions (HELP) Committee hearing “Making Health Care Affordable Again: Healing a Broken System;” 10:00 a.m.; December 3
House Veterans’ Affairs Committee legislative hearing on H.R: 6047, the Sharri Briley and Eric Edmundson Veterans Benefits Expansion Act of 2025, and H.R. 4077, the GUARD Veterans’ Health Care Act; 10:15 a.m.; December 3
Senate Veterans’ Affairs Committee hearing to examine medication management in VA healthcare; 4:00 p.m.; December 3
Senate HELP Committee hearing “Examining the Future of the U.S. Organ Procurement and Transplantation Network;” 10:00 a.m.; December 11
Recently Introduced Health Legislation
H.R.6288 — To amend title XXVII of the Public Health Service Act to limit cost sharing for prenatal services in certain circumstances; Sponsor: Vindman, Eugene Simon [Rep.-D-VA-7]; Committees: House – Energy and Commerce
H.R.6284 – To amend the Higher Education Act of 1965 to provide for a percentage of student loan forgiveness for public service employment, and for other purposes; Sponsor: Swalwell, Eric [Rep.-D-CA-14]; Committees: House – Education and Workforce
H.R.6283 — To amend the 21st Century Cures Act to support State and local agencies with responsibility for children services in their response to the opioid abuse crisis, and for other purposes; Sponsor: Strickland, Marilyn [Rep.-D-WA-10]; Committees: House – Energy and Commerce
H.R.6280 — To amend title XVIII of the Social Security Act to provide for expanded coverage of services furnished by genetic counselors under part B of the Medicare program, and for other purposes; Sponsor: Smith, Adrian [Rep.-R-NE-3]; Committees: House – Energy and Commerce; Ways and Means
H.R.6258 — To prevent a person who has been convicted of a misdemeanor hate crime, or received an enhanced sentence for a misdemeanor because of hate or bias in its commission, from obtaining a firearm; Sponsor: Escobar, Veronica [Rep.-D-TX-16]; Committees: House – Judiciary
H.R.6255 — To amend title XXVII of the Public Health Service Act, the Internal Revenue Code of 1986, and the Employee Retirement Income Security Act of 1974 to establish requirements with respect to cost-sharing for certain insulin products, and for other purposes; Sponsor: Craig, Angie [Rep.-D-MN-2]; Committees: House – Energy and Commerce; Ways and Means; Education and Workforce
H.R.6254 — To amend title XIX of the Social Security Act to allow States more flexibility with respect to using contractors to make eligibility determinations and redeterminations and conduct fair hearings on behalf of the State Medicaid plan, and for other purposes; Sponsor: Carter, Earl L. “Buddy” [Rep.-R-GA-1]; Committees: House – Energy and Commerce
H.R.6248 — To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care; Sponsor: Arrington, Jodey C. [Rep.-R-TX-19]; Committees: House – Energy and Commerce; Education and Workforce; Ways and Means
H.R.6246 — To amend the Internal Revenue Code of 1986 to extend certain provisions of the health insurance premium tax credit using tariff revenue; Sponsor: Thanedar, Shri [Rep.-D-MI-13]; Committees: House – Ways and Means
H.R.6316 — To amend the Internal Revenue Code of 1986 to extend the premium tax credit and provide for advance payment of the credit to taxpayers, and for other purposes; Sponsor: Van Drew, Jefferson [Rep.-R-NJ-2]; Committees: House – Ways and Means; Energy and Commerce
H.R.6314 — To require insurance coverage of annual lung cancer screenings for adults aged 50 to 80 at increased risk for lung cancer; Sponsor: Torres, Ritchie [Rep.-D-NY-15]; Committees: House – Energy and Commerce; Armed Services; Oversight and Government Reform; Veterans’ Affairs
H.R.6305 — To amend the Immigration and Nationality Act to expand availability of H1B nonimmgrant visas, and for other purposes; Sponsor: Krishnamoorthi, Raja [Rep.-D-IL-8]; Committees: House – Education and Workforce; Judiciary
H.R.6303 — To improve Federal efforts with respect to the prevention of maternal mortality, and for other purposes; Sponsor: Kelly, Robin L. [Rep.-D-IL-2]; Committees: House – Energy and Commerce; Education and Workforce; Ways and Means
H.R.6299 — To amend title XXVII of the Public Health Service Act to ensure the appropriate availability of short-term limited duration insurance; Sponsor: Fulcher, Russ [Rep.-R-ID-1]; Committees: House – Energy and Commerce
H.R.6296 — To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program; Sponsor: Dingell, Debbie [Rep.-D-MI-6]; Committees: House – Energy and Commerce; Ways and Means
H.R.6294 — To require health warning labeling of foods, and to impose restrictions on advertisements directed at children, for the purpose of reducing childhood diabetes, and for other purposes; Sponsor: Beyer, Donald S. [Rep.-D-VA-8]; Committees: House – Energy and Commerce