Policy Updates: Hill Happenings and Administration Activities
Congress Passes One Big Beautiful Bill Act
On July 3, the Congressional Republican caucus passed the One Big Beautiful Bill Act (H.R.1), successfully leveraging their slim bicameral majority to advance a sweeping domestic policy and budget bill along party lines. The budget package includes major policy provisions central to the Trump Administration’s priorities, such as slashing federal health spending by curtailing access to safety-net coverage for Medicaid and Affordable Care Act (ACA) marketplace plans, empowering the White House Office of Management and Budget (OMB) to explore new opportunities to unilaterally impound Congressionally appropriated spending, and extending costly tax cuts for certain earners. A Congressional Budget Office report released on June 29 calculated that as many as 11.8 million people would lose health coverage if the bill became law.
FY2026 Appropriations
With the sprawling budget reconciliation package now in the rear-view mirror, appropriators are advancing Fiscal Year 2026 (FY2026) spending bills and preparing to consider President Trump’s rescission request to Congress. On June 6, Rep. Scalise (R-LA-01) introduced the Rescissions Act of 2025 (H.R. 4) to formally take up the White House’s rescission package, which aims to claw back Congressionally approved funding for several programs, including the HIV foreign assistance program, PEPFAR (President’s Emergency Plan for AIDS Relief). Congressional Republicans must approve the rescissions request by July 18.
On July 7, Senate Minority Leader Chuck Schumer (D-NY) called on his Democratic colleagues to reject the rescissions package and urged Republicans to uphold the bipartisan integrity of the Congressional appropriations process. Democratic appropriators fear that a FY2026 agreement might not materialize if the Executive branch can unilaterally adjust spending levels ex post facto. The House and Senate are advancing the first few spending bills for FY2026, but there is currently no bill text or committee markups scheduled for the Subcommittees on Labor, Health and Human Services, Education, and Related Agencies (LHHS) FY2026 bills.
Senate HELP Committee Schedules Key Vote on CDC Director Nomination
On July 9, the Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold an executive session to review the nomination of Susan Monarez to be Director of the Centers for Disease Control and Prevention (CDC). If the Committee votes in favor of Monarez, the nomination will head to the Senate floor for a full confirmation vote. Monarez, an immunologist by training, drew bipartisan scrutiny during a June 25 nomination hearing as Committee members assessed her commitment to the administration’s Make America Healthy Again (MAHA) initiative and her position on HHS Secretary Kennedy’s overhaul of the federal vaccine policy infrastructure, such as the removal of all members of the CDC Advisory Committee for Immunization Practices (ACIP). If confirmed, Monarez would play a critical role in federal vaccine policy development, including providing the final endorsement required to fully implement recommendations put forward by ACIP. Monarez is the first-ever nominee to undergo the Senate confirmation process for CDC Director, which became a Senate-confirmed role starting in 2025.
Administration Activities
HHS Issues Final Rule Modifying Certain Marketplace Exchange Policies
On June 25, the Department of Health and Human Services (HHS) published a final rule that updates policies and regulations governing Affordable Care Act (ACA) marketplace eligibility and enrollment. The final rule narrows consumer access to safety-net coverage by tightening eligibility and enrollment requirements and removing certain benefits, including shortening the duration of open enrollment periods, eliminating special enrollment periods for people with low incomes and implementing burdensome proof of income requirements, and authorizing the denial of coverage for individuals who owe past-due premiums. Public health advocates highlighted the risk of widespread insurance loss for millions of people as the administration implements the final rule and marketplaces operationalize provisions included in the One Big Beautiful Bill Act that curtail access to coverage.
Resources
NASTAD Resources: State Reporting Requirements for Negative HIV and HCV Test Results
NASTAD developed a series of four new jurisdictional resources analyzing the reporting requirements for negative HIV and hepatitis C virus (HCV) test results across the United States. While positive HIV and HCV test results are commonly reported, requirements for reporting negative test results vary by state and are often less clearly understood. These resources aim to close that gap by supporting health departments, laboratories, and healthcare providers in understanding their legal obligations related to public health reporting, while strengthening HIV and HCV surveillance systems nationwide.
News Bulletin
U.S. physician groups sue Kennedy over vaccine policy
“Several leading medical organizations filed a lawsuit against U.S. Health Secretary Robert F. Kennedy Jr. and the Department of Health and Human Services on Monday, arguing that current policies on Covid-19 vaccines pose an imminent threat to public health… The lawsuit accuses Kennedy of working ‘to dismantle the longstanding, Congressionally-authorized, science- and evidence-based vaccine infrastructure that has prevented the deaths of untold millions of Americans.’”
Judge temporarily blocks Planned Parenthood ‘defunding’ in Trump megabill
“A federal judge on Monday granted Planned Parenthood’s request to temporarily halt Medicaid funding cuts to the group’s health centers under a provision of Republicans’ new tax and spending package. U.S. District Judge Indira Talwani’s ruling marks the first known instance of a federal judge limiting enforcement of any part of the “big, beautiful” bill, which President Trump signed into law Friday.”
In a Nation Growing Hostile Toward Drugs and Homelessness, Los Angeles Tries Leniency
“As many Americans have grown increasingly intolerant of street homelessness, cities and states have returned to tough-on-crime approaches that penalize people for living outside and for substance use disorders. But the Skid Row facility shows Los Angeles County leaders’ embrace of the principle of harm reduction, a range of more lenient strategies that can include helping people more safely use drugs, as they contend with a homeless population estimated around 75,000 — among the largest of any county in the nation. Evidence shows the approach can help individuals enter treatment, gain sobriety, and end their homelessness, while addiction experts and county health officials note it has the added benefit of improving public health.”