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Appropriations Update

June 15, 2026

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Appropriations Update – The House Appropriations Committee favorably reported the fiscal year (FY) 2027 Labor-Health and Human Services spending bill to the full House of Representatives by a party line vote of 34-28 on Tuesday following a 12-hour markup. Under the legislation, the U.S. Department of Health and Human Services (HHS) would receive $110.8 billion in total funding, a 4% or roughly $4 billion cut. The National Institutes of Health (NIH) would receive a $100 million funding increase, with targeted increases directed toward research on cancer, Alzheimer’s disease, ALS, diabetes, women’s health, and rare diseases. The Centers for Disease Control and Prevention would see a $1 billion cut under the bill. There would be no direct appropriations changes for the Centers for Medicare and Medicaid Services (CMS). The package reduces funding for the Health Resources and Services Administration by $873 million, while the Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute (PCORI) would be eliminated entirely. Funding for the Substance Abuse and Mental Health Services Administration would be reduced by $145.3 million.

 

Similar to last year, the manager’s amendment adopted by appropriators would prohibit HHS from spending funds on the Wasteful and Inappropriate Service Reduction (WISeR) Model or any other model that would employ prior authorization in the traditional Medicare program. It also includes a request for a report from CMS on the impact of WISeR and how states were selected for participation in the model. The package also specifies that funds cannot be spent on administering federal student aid programs in a manner that does not designate advanced nursing programs as professional degree programs. This provision is in response to a recently finalized rule from the Department of Education implementing new caps on borrowing limits for graduate and professional degree programs, as established by the One Big Beautiful Bill Act. The rule excluded certain graduate level clinical programs – such as nursing, physician assistant, occupational therapy, and physical therapy – from the definition of professional degree. During the markup, the committee adopted a bipartisan amendment expressing concerns about delays in the availability of NIH grants. The amendment highlights that, as of June 2026, the amount of available competitive NIH awards is down 48%, and the value of all competitive awards is down 40% in FY 2026 as compared to FY 2024. All materials related to the bill, including the full committee mark, summary, and report language, can be found here.

 

Senate Appropriations Committee Chair Susan Collins (R-Maine) decided against marking up any FY 2027 spending bills last week. Appropriators in the Senate have yet to reach an agreement on topline defense and nondefense spending levels for the next fiscal year, and Democrats have said they are withholding their support for individual appropriations bills in the absence of such an agreement. Commerce-Justice-Science, Agriculture-Food and Drug Administration, Legislative Branch, Military Construction-Veterans Affairs, Interior-Environment, and Financial Services-General Government were the measures slated for possible consideration earlier this month.

 

GOP Passes Second Reconciliation Bill and Opens Talks on Third – Republicans in the House of Representatives passed a $70 billion budget reconciliation package on Tuesday to fund Immigration and Customs Enforcement and Border Patrol for three years. The bill, which contains no healthcare provisions, has been signed into law by the President. The GOP is now turning its focus to what could be the third reconciliation bill of the second Trump administration. The President himself has called for a third reconciliation bill to provide $350 million in funding for defense, while Senate Finance Committee Chair Mike Crapo (R-Idaho) has suggested inclusion of healthcare entitlement reforms that do not impact access to care as an option for inclusion in a third package. The House Republican Study Committee has begun holding meetings about deficit reduction options that could be included in the next bill, with addressing fraud in Medicare, Medicaid, and other safety-net programs, along with the funding of cost-sharing reduction payments for insurers, reportedly under consideration. Other Republicans have expressed caution about the inclusion of additional healthcare provisions in a new reconciliation bill, with Energy and Commerce Subcommittee on Health Chairman Morgan Griffith (R-Va.) asserting that any healthcare changes should be small to allow systems “to adjust to the changes we’ve already made.” Several Senators, including Senate Appropriations Defense Subcommittee Chairman Mitch McConnell (R-Ky.), have expressed reservations about a third reconciliation bill, with McConnell stating at a hearing this week that he thinks “it’s safe to conclude there will not be another reconciliation bill.”

 

Prior Authorization Bill Reaches 290 Cosponsors – The Improving Seniors’ Timely Access to Care Act (H.R. 3514) has hit 290 cosponsors in the House of Representatives. This milestone allows a motion to be filed to place the bill on the House consensus calendar, giving the primary committee of jurisdiction 25 days to advance the legislation before the bill is moved to the consensus calendar for a vote on the floor. The bipartisan legislation, introduced by Reps. Mike Kelly (R-Pa.) and Suzan DelBene (D-Wash.), aims to improve the Medicare Advantage prior authorization process for certain treatments and tests. Companion legislation (S. 1816), sponsored by Roger Marshall, MD (R-Kan.) and Mark Warner (D-Va.), has been introduced in the Senate and currently has 70 cosponsors.

 

FDA Approves New Sunscreen Ingredient – The Food and Drug Administration (FDA) has approved a new sunscreen ingredient for the first time in 20 years. Bemotrizinol is the first new active ingredient added to the over-the-counter sunscreen monograph since the late 1990s; it has been marketed as a sunscreen ingredient in Europe and other countries for decades. Bemotrizinol, which provides protection against both ultraviolet A and B rays and has low levels of absorption through the skin into the body, has been generally recognized as safe and effective for use in sunscreen by adults and children six months of age and older.

 

Judge Rules $100,000 H-1B Visa Fee Unlawful – A federal judge has blocked the Trump administration’s attempt to raise the one-time fee for new H-1B visa applications to $100,000. U.S. District Judge Richard Stearns ruled that the proposal, stemming from a September 2025 presidential proclamation, violates the Constitution’s separation of powers, characterizing the policy as an unauthorized tax that requires congressional approval.  H-1B work visas are used and typically paid for by employers looking to hire international workers for specialty jobs. H-1B visa holders are lawfully admitted to the U.S. but are not lawful permanent residents. The Trump administration was sued by 20 states citing the impact of the proposed fee on their ability to hire workers at public institutions like hospitals.

 

Medicare Trustees Annual Report – The Medicare Board of Trustees has released its latest forecast of when funding for the Medicare program will run dry. According to the Board’s annual report, the Hospital Insurance Trust Fund will run out in the second quarter of 2033 – a quarter earlier than last year’s projection. The change is due to a number of factors, including higher use of medical services and lower income tax revenue on Social Security benefits due to changes established by the One Big Beautiful Bill Act. “The projections in this year’s report continue to demonstrate the need for timely and effective action to address Medicare’s remaining financial challenges — including the HI trust fund’s projected depletion, this fund’s long-range financial imbalance, and the rapid growth in Medicare expenditures,” the trustees wrote.

 

Upcoming Congressional Hearings and Markups

Senate Health, Education, Labor, and Pensions Committee executive session to consider S. 1782 – Charlotte Woodward Organ Transplant Discrimination Protection Act; S. 3799 – Healthy Start Reauthorization Act of 2026; S. 4109 – Stem Cell Therapeutic and Research Reauthorization Act; S. 2339 – EARLY Act Reauthorization of 2025; S. 4472 – Accelerating Access to Critical Therapies for ALS Act of 2026; S. 2658 – Medication Affordability and Patent Integrity Act; S. 3014 – Ensuring Timely Access to Generics Act of 2025; S. 1954 – Biosimilar Red Tape Elimination Act; 10:00 a.m.; June 17

 

Senate Special Committee on Aging hearing “Counting the Cost: Communist China’s Toll on Older Americans’ Health, Finances, and Security;” 3:30 p.m.; June 17

 

Recently Introduced Health Legislation

H.Res.1355 — Supporting the designation of the week of June 14 through June 21, 2026, as “National Men’s Health Week”; Sponsor: Carter, Troy A. [Rep.-D-LA-2]; Committees: House – Oversight and Government Reform

 

H.R.9247 — To amend title 38, United States Code, to require the Secretary of Veterans Affairs to ensure that a suicide prevention coordinator is available at each medical center of the Department of Veterans Affairs, including outside the operating hours of such medical center, as needed, to accommodate a request for suicide prevention planning services, and for other purposes; Sponsor: Houchin, Erin [Rep.-R-IN-9]; Committees: House – Veterans’ Affairs

 

H.R.9251 — To amend the Public Health Service Act to provide funding for trained school personnel to administer drugs and devices for emergency treatment of known or suspected opioid overdose, and for other purposes; Sponsor: Morrison, Kelly [Rep.-D-MN-3]; Committees: House – Energy and Commerce

 

S.Res.765 — A resolution expressing support for the designation of July 2026 as “National Sarcoma Awareness Month”; Sponsor: Johnson, Ron [Sen.-R-WI]; Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent.

 

S.4717 — A bill to amend the Public Health Service Act to require the Director of the National Institutes of Health to develop a national strategy to address young adult cancers, and for other purposes; Sponsor: Markey, Edward J. [Sen.-D-MA]; Committees: Senate – Health, Education, Labor, and Pensions

 

H.R.9212 — To amend title 38, United States Code, to reimburse veterans for the cost of emergency medical transportation to a Federal facility, and for other purposes; Sponsor: Alford, Mark [Rep.-R-MO-4]; Committees: House – Veterans’ Affairs

 

H.R.9218 — To direct local educational agencies that receive certain Federal funds to require students in grades 9 through 12 to receive an electrocardiogram and an echocardiogram prior to participating in an athletic contest for the first time, and for other purposes; Sponsor: Gottheimer, Josh [Rep.-D-NJ-5]; Committees: House – Education and Workforce

 

H.R.9228 — To amend the Employee Retirement Income Security Act of 1974 to ensure plan fiduciaries have access to de-identified information relating to health claims, and for other purposes; Sponsor: Onder, Robert F. [Rep.-R-MO-3]; Committees: House – Education and Workforce

 

S.Res.756 — A resolution expressing support for the designation of June 5, 2026, as “National Gun Violence Awareness Day” and June 2026 as “National Gun Violence Awareness Month”; Sponsor: Durbin, Richard J. [Sen.-D-IL]; Committees: Senate – Judiciary

 

S.Res.758 — A resolution expressing support for the designation of the month of June 2026 as “National Post-Traumatic Stress Awareness Month” and June 27, 2026, as “National Post-Traumatic Stress Awareness Day”; Sponsor: Sullivan, Dan [Sen.-R-AK]; Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent.

 

S.4698 — A bill to amend the Federal Food, Drug, and Cosmetic Act to authorize the use of investigational individualized medical treatments by patients diagnosed with a life-threatening disease or condition or severely debilitating illness, and for other purposes; Sponsor: Johnson, Ron [Sen.-R-WI]; Committees: Senate – Health, Education, Labor, and Pensions

 

H.R.9186 — To amend the Controlled Substances Act to more closely align the Act with modern medical knowledge, terminology, and practices, and for other purposes; Sponsor: Cohen, Steve [Rep.-D-TN-9]; Committees: House – Energy and Commerce; Judiciary

 

H.R.9190 — To amend the Federal Food, Drug, and Cosmetic Act to authorize the use of investigational individualized medical treatments by patients diagnosed with a life-threatening disease or condition or severely debilitating illness, and for other purposes; Sponsor: Harshbarger, Diana [Rep.-R-TN-1]; Committees: House – Energy and Commerce

 

H.R.9192 — To amend the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to require health insurance coverage of drugs indicated for the treatment of autoimmune diseases and certain blood disorders; Sponsor: Johnson, Julie [Rep.-D-TX-32]; Committees: House – Energy and Commerce; Education and Workforce; Ways and Means

 

S.4694 — A bill to amend title 38, United States Code, to require the Secretary of Veterans Affairs to carry out a maternity care coordination program, and for other purposes; Sponsor: Duckworth, Tammy [Sen.-D-IL]; Committees: Senate – Veterans’ Affairs

 

S.4692 — A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to homeopathic drug products, and for other purposes; Sponsor: Tuberville, Tommy [Sen.-R-AL]; Committees: Senate – Health, Education, Labor, and Pensions

 

S.J.Res.196 — A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Education relating to “Reimagining and Improving Student Education-Federal Student Loan Program Final Regulations”; Sponsor: Merkley, Jeff [Sen.-D-OR]; Committees: Senate – Health, Education, Labor, and Pensions