Lawmakers to Consider ACA Subsidy Extension Proposals This Week – Little progress has been made on negotiations related to the Affordable Care Act’s (ACA) enhanced advanced premium tax credits and the spike in health insurance premiums that is expected if the subsidies expire at the end of this year. House Speaker Mike Johnson (R-La.) said that he intends to present a health care plan focused on lowering costs during the GOP conference meeting on Tuesday, and to vote on the plan before the end of the year. The Senate will call up the Democrat’s proposed three-year extension of the subsidies for a floor vote on Thursday. It is expected to fail; Democrats would need the support of at least 13 Republicans to overcome the procedural 60-vote threshold. A number of GOP senators have expressed an openness to a two-year extension, but only in conjunction with new income caps and other eligibility requirements and restrictions. It remains to be seen whether Senate Republicans will offer a counterproposal. While efforts to reach a bipartisan agreement persist, talks have been complicated by the Republican push to expand prohibitions on the use of taxpayer dollars to pay for abortions.
Republican lawmakers who are opposed to extending the subsidies are touting a new report from the Government Accountability Office (GAO), which found evidence of fraud in ACA marketplace enrollment. The GAO set up 24 fictitious applicants during the 2024 and 2025 plan years; subsidized insurance was approved for nearly all the applicants, costing the government more than $10,000 per month in subsidies in 2025. Some of the fake applicants were approved for coverage without submitting documentation on citizenship, income, or other requirements.
Congress is currently scheduled to recess for the year on December 19. While the tax credits expire on December 31, some lawmakers have indicated that they consider January 30 – the current government funding deadline – as the next date to watch for movement of a health care package. This date would fall after premium increases have begun and the annual open enrollment period has closed.
House Passes Hospital at Home Extension, Give Kids a Chance Legislation – The House of Representatives passed two health-related measures last week. The Hospital Inpatient Services Modernization Act (H.R. 4313) was adopted via voice vote. The legislation will extend the Medicare Acute Hospital Care at Home waiver for five years. The program is currently set to expire on January 30. The Mikaela Naylon Give Kids a Chance Act (H.R. 1262) was also passed by voice vote. The bill would reauthorize the Food and Drug Administration’s (FDA) Rare Pediatric Disease Priority Review Voucher Program through September 30, 2029. It also authorizes the FDA to direct companies to study combinations of cancer drugs and therapies in pediatric trials. Both bills now head to the Senate to await further action.
Cassidy Presses AMA to Provide Requested Information – Senate Health, Education, Labor, and Pensions Committee Chair Bill Cassidy, MD (R-La.) has sent a letter to the American Medical Association (AMA) regarding the group’s role in generating and updating the Current Procedural Terminology (CPT) coding system. The letter expands upon a previous effort by Sen. Cassidy to investigate how the AMA assesses fees for its CPT coding system; Cassidy asserts that the AMA has refused to comply with that effort. “I am concerned that the status quo focuses on enriching the AMA at the expense of patients, while the organization subsequently uses the revenue to advance a political agenda that is not representative of the majority of the medical community,” writes Cassidy. “If you are unable to voluntarily reply in a fulsome and timely manner, the committee will consider other options to secure the information requested from the AMA.” He requests a response by December 15.
Texas Rep. Lloyd Doggett to Retire from Congress — Rep. Lloyd Doggett (D-Texas) announced that he will not seek reelection next year. His decision comes in the wake of a Supreme Court decision upholding the state’s new congressional map, which changed district boundaries in Republicans’ favor. Rep. Doggett has served in the House of Representatives since 1995. He currently sits on the Budget Committee and the Ways and Means Committee, where he serves as ranking member of the Health Subcommittee.
Tracy Beth Høeg Tapped to Lead CDER – Tracy Beth Høeg, MD, PhD has been selected to serve as acting director of the Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research. Veteran FDA scientist Richard Pazdur, MD, who accepted the role of director three weeks ago, has announced his decision to retire at this end of the month. Høeg is a sports medicine physician and epidemiologist. She has served as a special assistant to FDA Commissioner Marty Makary, MD since April.
Upcoming Congressional Hearings and Markups
House Oversight and Government Reform Subcommittees on Health Care and Financial Services and Economic Growth, Energy Policy, and Regulatory Affairs joint hearing “Lowering the Cost of Healthcare: Technology’s Role in Driving Affordability;” 10:00 a.m.; December 10
Senate Homeland Security and Governmental Affairs Permanent Subcommittee on Investigations hearing “Defining Our Healthcare Problem, and Principles We Should Follow to Solve it;” 2:00 p.m.; December 10
House Judiciary Subcommittees on Oversight and Administrative State, Regulatory Reform, and Antitrust joint hearing “Fighting Obamacare Subsidy Fraud: Is the Administrative Protective Act Working as Intended?” 2:00 p.m.; December 10
House Veterans’ Affairs Subcommittee on Health hearing “Putting Families First: Strengthening CHAMPVA for Survivors and Dependents;” 2:15 p.m.; December 10
Senate Health, Education, Labor, and Pensions Committee hearing “Examining the Future of the U.S. Organ Procurement and Transplantation Network;” 10:00 a.m.; December 11
House Energy and Commerce Committee Member Day hearing; 9:00 a.m.; December 12
Recently Introduced Health Legislation
H.R.6319 — To direct the Secretary of Health and Human Services to establish a Lung Cancer Task Force, and for other purposes; Sponsor: Gottheimer, Josh [Rep.-D-NJ-5]; Committees: House – Energy and Commerce
H.R.6320 — To amend title XIX of the Social Security Act to require coverage of lung cancer biomarker testing under the Medicaid program; Sponsor: Gottheimer, Josh [Rep.-D-NJ-5]; Committees: House – Energy and Commerce
H.R.6321 – To amend title XVIII of the Social Security Act to require coverage of lung cancer biomarker testing under the Medicare program; Sponsor: Gottheimer, Josh [Rep.-D-NJ-5]; Committees: House – Energy and Commerce; Ways and Means
S.3291 — A bill to require a declassification review for intelligence relating to the COVID-19 pandemic, and for other purposes; Sponsor: Young, Todd [Sen.-R-IN]; Committees: Senate – Intelligence (Select)
S.Res.522 — A resolution commemorating and supporting the goals of World AIDS Day; Sponsor: Booker, Cory A. [Sen.-D-NJ]; Committees: Senate – Foreign Relations
S.3296 — A bill to amend chapter 81 of title 5, United States Code, to cover, for purposes of workers’ compensation under such chapter, services by physician assistants and nurse practitioners provided to injured Federal workers, and for other purposes; Sponsor: Collins, Susan M. [Sen.-R-ME]; Committees: Senate – Homeland Security and Governmental Affairs
S.3298 — A bill to facilitate direct primary care arrangements under Medicaid; Sponsor: Blackburn, Marsha [Sen.-R-TN]; Committees: Senate – Finance
S.3299 — A bill to amend title XIX of the Social Security Act to provide a permanent disproportionate share hospital allotment to Tennessee for fiscal year 2026 and succeeding fiscal years, and for other purposes; Sponsor: Blackburn, Marsha [Sen.-R-TN]; Committees: Senate – Finance
S.3300 — A bill to amend title XIX of the Social Security Act to establish a State option to provide medical assistance to certain individuals with serious mental illness or substance use disorder; Sponsor: Blackburn, Marsha [Sen.-R-TN]; Committees: Senate – Finance
S.3302 — A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to molecularly targeted pediatric cancer investigations, and for other purposes; Sponsor: Mullin, Markwayne [Sen.-R-OK]; Committees: Senate – Health, Education, Labor, and Pensions
S.3303 — A bill to require the Secretary of Veterans Affairs to carry out a pilot program to establish or enhance a community integration platform for services for veterans, to require the collection from veterans of information related to social determinants of health, and for other purposes; Sponsor: Sullivan, Dan [Sen.-R-AK]; Committees: Senate – Veterans’ Affairs
S.3304 — A bill to provide for the coverage of medical food and vitamins and individual amino acids for digestive and inherited metabolic disorders under Federal health programs, to ensure State and Federal protection for existing coverage, and for other purposes; Sponsor: Wicker, Roger F. [Sen.-R-MS]; Committees: Senate – Finance
S.3311 — A bill to amend title 38, United States Code, to eliminate conflicts of interest in peer review for quality management of care conducted by the Veterans Health Administration, and for other purposes; Sponsor: Peters, Gary C. [Sen.-D-MI]; Committees: Senate – Veterans’ Affairs
S.3314 — A bill to direct the Secretary of Veterans Affairs to expand a directive of the Veterans Health Administration regarding informed consent to apply to certain types of medications; Sponsor: Sheehy, Tim [Sen.-R-MT]; Committees: Senate – Veterans’ Affairs
S.3315 — A bill to require the Secretary of Health and Human Services and the Director of the Cybersecurity and Infrastructure Security Agency to coordinate to improve cybersecurity in the health care and public health sectors, and for other purposes; Sponsor: Cassidy, Bill [Sen.-R-LA]; Committees: Senate – Health, Education, Labor, and Pensions
H.Res.919 — Commemorating and supporting the goals of World AIDS Day; Sponsor: Pocan, Mark [Rep.-D-WI-2]; Committees: House – Energy and Commerce; Foreign Affairs
H.R.6360 — GENESIS Act; Sponsor: Kennedy, Mike [Rep.-R-UT-3]; Committees: House – Science, Space, and Technology
H.R.6361 — Ban AI Denials in Medicare Act; Sponsor: Landsman, Greg [Rep.-D-OH-1]; Committees: House – Ways and Means; Energy and Commerce
H.R.6364 — To amend titles XI, XIX, and XXI of the Social Security Act with respect to screening for childhood onset fluency disorders, and to require coverage of certain speech therapy services under Medicaid and CHIP; Sponsor: McDowell, Addison P. [Rep.-R-NC-6]; Committees: House – Energy and Commerce
S.3337 — A bill to amend the Older Americans Act of 1965 to require the Assistant Secretary for Aging to award grants to States, Indian tribes, and tribal organizations to create or implement Multisector Plans for Aging and Aging with a Disability, and for other purposes; Sponsor: Gillibrand, Kirsten E. [Sen.-D-NY]; Committees: Senate – Health, Education, Labor, and Pensions
S.3334 — A bill to prohibit reductions in the workforce at the Drug Enforcement Administration, and for other purposes; Sponsor: Shaheen, Jeanne [Sen.-D-NH]; Committees: Senate – Judiciary
S.3325 — A bill to amend the Internal Revenue Code of 1986 to provide rules for determining the tax-exempt status of organizations that manufacture and distribute drugs and medical devices to meet public health needs, and for other purposes; Sponsor: Rosen, Jacky [Sen.-D-NV]; Committees: Senate – Finance
S.3323 — A bill to amend the Public Health Service Act to codify the Advisory Committee on Immunization Practices, and for other purposes; Sponsor: Hickenlooper, John W. [Sen.-D-CO]; Committees: Senate – Health, Education, Labor, and Pensions
H.R.6370 — To amend the Public Health Service Act to require certain health centers to equip restrooms with baby changing tables, and for other purposes; Sponsor: Underwood, Lauren [Rep.-D-IL-14]; Committees: House – Energy and Commerce
H.R.6376 — To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to provide health care for family members and other individuals who resided at or worked at locations where there is a presumption of service-connection for certain illnesses and conditions, and for other purposes; Sponsor: Brownley, Julia [Rep.-D-CA-26]; Committees: House – Veterans’ Affairs
H.R.6383 — To direct the Secretary of Defense to develop a strategic plan to address mental health of members of the Armed Forces; Sponsor: Cisneros, Gilbert Ray [Rep.-D-CA-31]; Committees: House – Armed Services
H.R.6394 — To address maternity care shortages and promote optimal maternity outcomes by expanding educational opportunities for midwives, and for other purposes; Sponsor: Hinson, Ashley [Rep.-R-IA-2]; Committees: House – Energy and Commerce
H.R.6400 — To amend title 10, United States Code, to improve access to certain medications under the TRICARE program, and for other purposes; Sponsor: Kiggans, Jennifer A. [Rep.-R-VA-2]; Committees: House – Armed Services
H.R.6401 — To require the Secretary of Health and Human Services to submit to Congress a report on the option to elect to pay cost-sharing under a prescription drug plan or MA-PD plan in monthly capped amounts; Sponsor: Kiggans, Jennifer A. [Rep.-R-VA-2]; Committees: House – Energy and Commerce; Ways and Means
H.R.6402 — To require the National Academy of Sciences to establish a grant program to develop safe AI models and safe AI research, and for other purposes; Sponsor: Kiley, Kevin [Rep.-R-CA-3]; Committees: House – Science, Space, and Technology
H.R.6407 — To amend the Public Health Service Act to maintain the Rural Communities Opioid Response Program, and for other purposes; Sponsor: Miller, Carol D. [Rep.-R-WV-1]; Committees: House – Energy and Commerce
H.R.6408 — To amend title XIX of the Social Security Act to establish a State option to provide medical assistance to certain individuals with serious mental illness or substance use disorder; Sponsor: Pfluger, August [Rep.-R-TX-11]; Committees: House – Energy and Commerce
S.3345 — A bill to amend titles XVIII and XIX of the Social Security Act to ensure accurate payments to pharmacies under Medicaid and prevent the use of abusive spread pricing in Medicaid, and to assure pharmacy access and choice for Medicare beneficiaries and modernize and ensure PBM accountability under Medicare; Sponsor: Crapo, Mike [Sen.-R-ID]; Committees: Senate – Finance
S.3346 — A bill to establish a special registration under the Controlled Substances Act for schedule I eligible investigational drugs under the Federal Right to Try law; Sponsor: Booker, Cory A. [Sen.-D-NJ]; Committees: Senate – Judiciary
S.3349 — A bill to clarify the requirement to disclose direct and indirect compensation from entities providing pharmacy benefit management services or third party administration services; Sponsor: Marshall, Roger [Sen.-R-KS]; Committees: Senate – Health, Education, Labor, and Pensions
S.3350 — A bill to amend title XVIII of the Social Security Act to improve the way beneficiaries are assigned under the Medicare shared savings program by also basing such assignment on primary care services furnished by nurse practitioners, physician assistants, and clinical nurse specialists; Sponsor: Barrasso, John [Sen.-R-WY]; Committees: Senate – Finance
S.3362 — A bill to amend the Internal Revenue Code of 1986 to increase the limitations on contributions to health savings accounts, and for other purposes; Sponsor: Paul, Rand [Sen.-R-KY]; Committees: Senate – Finance
S.3364 — A bill to clarify the time period for registering health care apprenticeships under the Act of August 16, 1937 (commonly known as the “National Apprenticeship Act”) and require the digitization of apprenticeship agreement forms under such Act, and for other purposes; Sponsor: Wyden, Ron [Sen.-D-OR]; Committees: Senate – Health, Education, Labor, and Pensions
S.3368 — A bill to improve patient protections and affordability under the Patient Protection and Affordable Care Act, and for other purposes; Sponsor: Blunt Rochester, Lisa [Sen.-D-DE]; Committees: Senate – Finance
S.3369 — A bill to establish a public health plan; Sponsor: Bennet, Michael F. [Sen.-D-CO]; Committees: Senate – Finance
S.3380 — A bill to provide for a minimum monthly premium payment amount for individuals receiving premium tax credits, and to require additional enrollment verification procedures prior to enrollment in qualified health plans; Sponsor: Marshall, Roger [Sen.-R-KS]; Committees: Senate – Finance
H.Res.928 — Affirming support for most-favored-Nation drug pricing for United States patients; Sponsor: Dingell, Debbie [Rep.-D-MI-6]; Committees: House – Energy and Commerce
H.R.6420 —To amend title XXVII of the Public Health Service Act to define short-term limited duration insurance; Sponsor: Miller, Max L. [Rep.-R-OH-7]; Committees: House – Energy and Commerce
H.R.6421 —To amend the Patient Protection and Affordable Care Act to expand eligibility for catastrophic plans; Sponsor: Miller, Max L. [Rep.-R-OH-7]; Committees: House – Energy and Commerce
H.R.6423 —To amend title XXVII of the Public Health Service Act to apply financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes; Sponsor: Kean, Thomas H. [Rep.-R-NJ-7]; Committees: House – Energy and Commerce; Ways and Means
H.R.6434 —To establish a special registration under the Controlled Substances Act for schedule I eligible investigational drugs under the Federal Right to Try law; Sponsor: Dean, Madeleine [Rep.-D-PA-4]; Committees: House – Energy and Commerce; Judiciary
H.R.6442 — To amend title IV of the Social Security Act to establish requirements for biological fathers to pay child support for medical expenses incurred during pregnancy and delivery; Sponsor: Hinson, Ashley [Rep.-R-IA-2]; Committees: House – Ways and Means
H.R.6445 — To clarify the time period for registering health care apprenticeships under the Act of August 16, 1937 (commonly known as the “National Apprenticeship Act”) and require the digitization of apprenticeship agreement forms under such Act, and for other purposes; Sponsor: Johnson, Julie [Rep.-D-TX-32]; Committees: House – Education and Workforce
H.R.6454 — To direct the Secretary of Veterans Affairs to establish the Zero Suicide Initiative pilot program of the Department of Veterans Affairs; Sponsor: Lee, Susie [Rep.-D-NV-3]; Committees: House – Veterans’ Affairs
H.R.6455 —To amend the Internal Revenue Code of 1986 to take certain Medicare premiums of household members into account in determining the health care insurance premiums tax credit; Sponsor: Levin, Mike [Rep.-D-CA-49]; Committees: House – Ways and Means
H.R.6461 — To direct the National Institute of Standards and Technology to develop best practices and technical guidance on artificial intelligence model documentation, and for other purposes; Sponsor: McBride, Sarah [Rep.-D-DE-At Large]; Committees: House – Science, Space, and Technology
H.R.6466 — To amend title 18, United States Code, to establish Federal penalties for the knowing and intentional administration of any abortion-inducing drug to a woman without her informed consent, if the abortion-inducing drug has been shipped or transported in interstate commerce, and for other purposes; Sponsor: Messmer, Mark B. [Rep.-R-IN-8]; Committees: House – Judiciary
H.R.6468 —To amend the Public Health Service Act to authorize rural residency planning and development grant programs, and for other purposes; Sponsor: Miller, Carol D. [Rep.-R-WV-1]; Committees: House – Energy and Commerce
H.R.6479 —To amend the Patient Protection and Affordable Care Act to require the establishment of an Exchange in Puerto Rico, and for other purposes; Sponsor: Soto, Darren [Rep.-D-FL-9]; Committees: House – Energy and Commerce; Ways and Means