News

Thune Confirms Narrowly-Focused Plan for Reconciliation

April 20, 2026

• Weekly Policy Briefing
• Administration
• Capitol Hill

Thune Confirms Narrowly-Focused Plan for Reconciliation – Senate Majority Leader John Thune (R-S.D.) has stated that Senate Republicans do not plan to include changes to the Medicare or Medicaid programs in the next budget reconciliation package. The reconciliation bill will instead focus on ending the partial government shutdown currently impacting the Department of Homeland Security (DHS). Sen. Thune confirmed that reconciliation instructions will not be sent to the Senate Finance Committee, the panel with Medicare/Medicaid spending jurisdiction.

 

House Appropriators Release FY 2027 Markup Schedule – The House Appropriations Committee has released a tentative schedule for fiscal year (FY) 2027 subcommittee and full committee markups. The panel aims to complete work on all 12 annual appropriations bills by the end of June. Health policy related markups include:

• April 23: Agriculture-Food and Drug Administration Subcommittee
• April 28-29: Agriculture-Food and Drug Administration Full Committee
• June 5: Labor-Health and Human Services-Education Subcommittee
• June 9: Labor-Health and Human Services-Education Full Committee

 

Cassidy Releases Money and Value for Patients Agenda – Senate Health, Education, Labor, and Pensions Committee Chair Bill Cassidy, MD (R-La.) unveiled a Money and Value for Patients (MVP) agenda last week with the aim of lowering costs and improving Americans’ health. The agenda calls for enacting the following policies: giving money in advance to individuals to cover out-of-pocket costs; taking power away from middlemen and giving it to patients, expanding TrumpRx and price transparency, stopping waste, fraud, and abuse, increasing access to safe and nutritious foods, and tackling chronic disease.

 

Democratic Health Leaders Continue to Request Information on Drug Pricing Agreements – Democratic health committee leadership have sent additional letters to those pharmaceutical companies that have entered formal drug pricing arrangements with the Trump administration. Sen. Ron Wyden (D-Ore.) and Reps. Frank Pallone (D-N.J.), Richard Neal (D-Mass.), and Bobby Scott (D-Va.) request details of the agreements in writing relating to the cost of certain medications. The lawmakers sent letters to the following companies and requested responses by April 27, 2026:

• AbbVie Inc.
• Amgen
• Bristol Myers Squibb
• Boehringer Ingelheim USA Corporation
• Genentech
• Gilead Sciences
• GSK
• Johnson & Johnson
• Merck & Co., Inc
• Novartis
• Sanofi

 

Scott, DeSaulnier Urge Expansion of EBSA Proposed Rule on PBMs – House Education and Workforce Committee Ranking Member Bobby Scott (D-Va.) and Subcommittee on Health, Employment, Labor, and Pensions Ranking Member Mark DeSaulnier (D-Calif.) have sent a letter urging the Employee Benefits Security Administration (EBSA) to strengthen its proposed rule related to pharmacy benefit managers (PBM). While the regulation would partially implement requirements for PBMs to disclose their direct and indirect compensation, the lawmakers argue that the rule should be expanded to include fully insured plans and to require transparency from other service providers, such as third-party administrators. “The proposed rule is a significant step forward that incorporates several ideas to increase transparency,” the letter states. The lawmakers go on to encourage the Department of Labor to “move forward with these aspects of the proposed rule, while taking additional action to further strengthen its provisions to lower costs for workers and their families.”

 

Dr. Erica Schwartz Nominated to Lead CDC – President Donald Trump has nominated Erica Schwartz, MD, JD, MPH to serve as the director of the Centers for Disease Control and Prevention (CDC). Schwartz is a career civil servant, having previously served as a U.S. deputy surgeon general and a rear admiral in the Commissioned Corps of the U.S. Public Health Service. If confirmed by the Senate, she would be the fourth leader of the CDC – with the role being filled by a permanent leader for only one month – during the President’s second term in office. The White House also announced that Sean Slovenski will serve as the CDC’s new chief operating officer, Jennifer Shuford will serve as its chief medical officer, and Sara Brenner will serve as U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy’s senior counselor for public health.

 

Congressional Resignations – Rep. Eric Swalwell (D-Calif.) resigned from the House of Representatives last week. The decision came one day after Swalwell withdrew from the California governor’s race amidst sexual assault and misconduct allegations. Swalwell was first elected to Congress in 2012, and was a member of the Homeland Security and Judiciary committees.

Rep. Tony Gonzalez (R-Texas) also resigned from the House last week, having admitted to having an affair with a staff member. Gonzalez had previously announced that he would not be running for reelection. Gonzalez has served in Congress since 2021, and was a member of the Appropriations Committee.

 

NIH Permanently Blocked from Implementing 15% Indirect Cost Rate Cap – The U.S. Department of Justice has declined to seek Supreme Court review in the litigation challenging a February 2025 guidance document from the National Institutes of Health (NIH), which sought to cap indirect cost reimbursement across all NIH grants. The guidance, issued on February 7, 2025, would have replaced longstanding negotiated indirect cost rates with a uniform 15% cap and has now been vacated. The First Circuit Court of Appeals previously upheld the district court’s ruling in favor of the plaintiffs, which included major research organizations and higher education associations. As a result, the district court’s permanent injunction remains in effect, and the NIH will continue to be barred from implementing the nationwide cap. With no further appeal forthcoming, the litigation is now concluded. However, the President’s FY 2027 budget request states that “In FY 2027, the budget will continue the policy to cap indirect cost rates at 15 percent, ensuring that funds support direct scientific research costs rather than administrative overhead.”

 

Kennedy Reiterates Plans to Overhaul USPSTF – HHS Secretary Robert F. Kennedy Jr. told the House Ways and Means Committee last week that he plans to make changes to the U.S. Preventive Services Task Force (USPSTF) in the near future. USPSTF is responsible for determining which preventive medical services are recommended and thus must be fully covered by insurers due to the Affordable Care Act. The HHS Secretary, who has been on Capitol Hill testifying about his department’s proposed budget for FY 2027, previewed plans to appoint new members to the task force and to reform the panel. While USPSTF usually meets three times a year, HHS has cancelled  three of its four scheduled meetings since the start of President Donald Trump’s second term.

 

White House Releases 2026 Economic Report – The White House has released the 2026 Economic Report of the President. The report is prepared annually by the Council of Economic Advisers and provides a review of the past year’s economic policies and their impact on current and future economic conditions. This year’s report is organized according to 14 topics related to the economy, including chapter 5, The Revolution of Artificial Intelligence, and chapter 11, Making America Healthy by Unleashing Competition in Physicians’ Markets.

 

Upcoming Congressional Hearings and Markups

House Energy and Commerce Subcommittee on Health hearing “The Fiscal Year 2027 Department of Health and Human Services Budget;” 10:00 a.m.; April 21

 

House Ways and Means Committee hearing “Protecting Patients and Taxpayers: Cracking Down on Medicare Fraud;” 10:00 a.m.; April 21

 

House Appropriations Committee markup of fiscal year (FY) 2027 Military Construction, Veterans Affairs, and Related Agencies bill; 11:00 a.m.; April 21

 

Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies hearing “A Review of the President’s Fiscal Year 2027 Budget Request for the Department of Health and Human Services;” 2:30 p.m.; April 21

 

Senate Finance Committee hearing “The President’s Fiscal Year 2027 Department of Health and Human Services Budget;” 10:00 a.m.; April 22

 

House Education & Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing “Profits Over Patients: The PBM Business Model Under Scrutiny;” 10:15 a.m.; April 22

 

Senate Health, Education, Labor, and Pensions Committee hearing “Fiscal Year 2027 Department of Health and Human Services Budget;” 2:00 p.m.; April 22

 

House Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration National Security, Department of State, and Related Programs markup of FY 2027 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies bill; 8:00 a.m.; April 23

 

House Appropriations Committee markup of FY 2027 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies bill; 11:00 a.m.; April 28

 

House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies markup of FY 2027 Labor, Health and Human Services, Education, and Related Agencies bill; 8:00 a.m.; June 5

 

House Appropriations Committee markup of FY 2027 Labor, Health and Human Services, Education, and Related Agencies bill; 11:00 a.m.; June 9

 

Recently Introduced Health Legislation

S.J.Res.159 — A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Consumer Financial Protection relating to the withdrawal of the rule relating to “Consumer Financial Protection Circular 2022-05: Debt Collection and Consumer Reporting Practices Involving Invalid Nursing Home Debts”; Sponsor: Padilla, Alex [Sen.-D-CA]; Committees: Senate – Banking, Housing, and Urban Affairs

 

S.Res.669 — 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.4283 — A bill to amend the Public Health Service Act to reauthorize a public health and bio-preparedness workforce loan repayment program; Sponsor: Baldwin, Tammy [Sen.-D-WI]; Committees: Senate – Health, Education, Labor, and Pensions

 

S.4291 — A bill to amend the Internal Revenue Code of 1986 to allow additional catch-up contributions for certain family caregivers; Sponsor: Collins, Susan M. [Sen.-R-ME]; Committees: Senate – Finance

 

S.4292 — A bill to amend the Internal Revenue Code of 1986 to allow certain family caregivers to contribute to a Roth IRA; Sponsor: Collins, Susan M. [Sen.-R-ME]; Committees: Senate – Finance

 

H.Res.1167 — Expressing support for the designation of the month of April 2026 as “Parkinson’s Awareness Month”; Sponsor: Bell, Wesley [Rep.-D-MO-1]; Committees: House – Energy and Commerce

 

H.R.8260 — To amend title XXVII of the Public Health Service Act and titles XVIII and XIX of the Social Security Act to require coverage of certain cardiovascular tests without cost sharing under group health plans, group and individual health insurance coverage, and the Medicare and Medicaid programs; Sponsor: Cherfilus-McCormick, Sheila [Rep.-D-FL-20]; Committees: House – Energy and Commerce; Ways and Means

 

H.R.8261 — To amend title XVIII of the Social Security Act to remove cost-sharing responsibilities for chronic care management services under the Medicare program; Sponsor: DelBene, Suzan K. [Rep.-D-WA-1]; Committees: House – Energy and Commerce; Ways and Means

 

H.R.8268 — To support biotechnology education for secondary school students, and for other purposes; Sponsor: McBride, Sarah [Rep.-D-DE-At Large]; Committees: House – Science, Space, and Technology

 

H.R.8269 — To amend the Federal Food, Drug, and Cosmetic Act to require drug labeling to include original manufacturer and supply chain information; Sponsor: McCormick, Richard [Rep.-R-GA-7]; Committees: House – Ways and Means; Energy and Commerce

 

H.R.8270 — To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require out-of-pocket expenditures for drugs to count towards an individual’s deductible and out-of-pocket maximum; Sponsor: Murphy, Gregory F. [Rep.-R-NC-3]; Committees: House – Energy and Commerce; Education and Workforce; Ways and Means

 

H.R.8271 — To amend title XVIII of the Social Security Act to require that hospitals report intensive care unit bed availability in real time as a condition of participation under the Medicare program; Sponsor: Obernolte, Jay [Rep.-R-CA-23]; Committees: House – Energy and Commerce; Ways and Means

 

H.R.8272 — To classify qualified locum tenens professionals and advanced care practitioners as independent contractors for the purposes of the Fair Labor Standards Act of 1938 and the National Labor Relations Act; Sponsor: Owens, Burgess [Rep.-R-UT-4]; Committees: House – Education and Workforce

 

H.R.8273 —To amend the Internal Revenue Code of 1986 to allow additional catch-up contributions for certain family caregivers; Sponsor: Pettersen, Brittany [Rep.-D-CO-7]; Committees: House – Ways and Means

 

H.R.8274 —To amend the Internal Revenue Code of 1986 to allow certain family caregivers to contribute to a Roth IRA; Sponsor: Pettersen, Brittany [Rep.-D-CO-7]; Committees: House – Ways and Means

 

H.R.8279 — To expand the definition of institution of higher education in the Higher Education Act of 1965 with respect to certain graduate medical schools located outside of the United States; Sponsor: Suozzi, Thomas R. [Rep.-D-NY-3]; Committees: House – Education and Workforce

 

S.4303 — A bill to amend the Tariff Act of 1930 to provide for escalating civil penalties for fraudulent or negligent importation of unauthorized electronic nicotine delivery systems; Sponsor: Cotton, Tom [Sen.-R-AR]; Committees: Senate – Finance

 

S.4304 — A bill to amend title 38, United States Code, to authorize the Secretary of Veterans Affairs to assign physicians of the Department of Veterans Affairs to temporarily serve as traveling physicians in the territories and possessions of the United States, and for other purposes; Sponsor: Sheehy, Tim [Sen.-R-MT]; Committees: Senate – Veterans’ Affairs

 

H.R.8293 — To abolish the Center for Medicare and Medicaid Innovation; Sponsor: Bean, Aaron [Rep.-R-FL-4]; Committees: House – Energy and Commerce; Ways and Means

 

H.R.8295 — To amend title 18, United States Code, to criminalize abuse with respect to assisted reproductive technology; Sponsor: Bice, Stephanie I. [Rep.-R-OK-5]; Committees: House – Judiciary

 

H.R.8310 — To establish protections for health care providers who raise concerns about the quality of health care services, and for other purposes; Sponsor: Scanlon, Mary Gay [Rep.-D-PA-5]; Committees: House – Energy and Commerce; Ways and Means; Judiciary

 

H.R.8317 — To amend the Public Health Service Act to authorize grants to evaluate, develop, and expand the use of technology-enabled collaborative learning and capacity building models to improve maternal health outcomes, and for other purposes; Sponsor: Williams, Nikema [Rep.-D-GA-5]; Committees: House – Energy and Commerce