Policy Updates: Hill Happenings and Administration Activities

Hill Happenings

FY2026 Appropriations & Budget Reconciliation 

After returning to Capitol Hill from Easter recess, House committees are beginning to advance portions of a spending package through the budget reconciliation process. On April 10, the House of Representatives approved a Senate-backed budget resolution that unlocked budget reconciliation as a legislative vehicle to pass a landmark domestic policy and spending bill via a simple majority if Republicans can build consensus for a single, identical bill in both chambers. House Speaker Mike Johnson (R-LA-04) is aiming to complete the lower chamber’s version of the bill by Memorial Day, but internal disagreements on spending and policy priorities may delay the Speaker’s timeline. Additionally, competing priorities between Senate and House Republicans that were sidestepped during budget resolution negotiations may be an obstacle for Congress to approve the final package. Democrats will have limited opportunities to block the reconciliation package if the Republican caucus can successfully leverage their bicameral majority to advance the mega-bill.

HHS Secretary to Testify at Senate HELP Committee Hearing 

On April 24, a Department of Health and Human Services (HHS) spokesperson confirmed that HHS Secretary Robert F. Kennedy Jr. will testify at a hearing before the Senate Committee on Health, Education, Labor and Pensions (HELP) during the month of May. On April 1, HELP Committee Chair Senator Cassidy (R-LA) invited the Secretary to testify on the reduction in force and reorganization plans that were implemented across HHS agencies and operating divisions, but Kennedy did not issue a formal response to the invitation. Although the Secretary’s agreement to participate ends speculation over whether he would renege on a commitment made during the Senate confirmation process to appear before the Committee on a regular basis, the HHS spokesperson clarified that RFK would not discuss the Administration’s recent changes to HHS. Instead, Kennedy’s upcoming testimony was framed as a standard part of the yearly federal budget process, where he will provide justification for the health portions of the Administration’s executive budget request to Congress. The Trump-Vance budget request for Fiscal Year 2026 (FY2026) is expected to be released in early May and will likely mirror a leaked Office of Management and Budget (OMB) document that outlined the Administration’s intent to pursue more funding cuts for health programs across HHS including elimination of the Centers for Disease Control and Prevention (CDC) Division of HIV Prevention, scale down the programmatic scope of CDC, and create a new HHS entity, the Administration for a Healthy America (AHA).

Senate HELP Chair Calls on Congress to Take On 340B Program Reform  

On April 24, Senate HELP Committee Chair Senator Bill Cassidy (R-LA) released a report that outlines the results of an investigation into the flow of revenue generated by a variety of entities participating in the 340B Drug Pricing Program. Senator Cassidy requested information from drug manufacturers and 340B covered entities to determine whether current programmatic guidance ensures that 340B discounts are used to benefit low-income and uninsured patients. The report argues that some covered entities lacked transparency into the use of program savings and that the utilization of administrative fees and dispensing through contract pharmacies negatively impacted the 340B Program’s ability to pass savings directly to the consumer. In light of the findings, Senator Cassidy called on Congress to take steps to reform the 340B Program, including expanding reporting requirements for covered entities, excluding certain entities from participating in the program, and updating program definitions to narrow patient eligibility.

NASTAD Calls on Appropriators to Reject Proposed Budget Cuts for HHS Programs 

On April 25, NASTAD and over 530 health and research organizations urged top appropriators to reject a FY2026 budget proposal that would enact sweeping budget cuts across HHS agencies and centers. The coalition letter, spearheaded by the Coalition for Health Funding, highlights the broad range of programs that would be impacted by the proposal, including health research, development and approval of new treatments and diagnostics, disease surveillance and prevention, and mental and behavioral health. As drafted, the proposed budget would cut about one-third of the agency’s discretionary spending and effectively devastate our nation’s research, scientific, and public health infrastructure.

Administration Activities

SCOTUS Hears Oral Arguments on Kennedy v. Braidwood Management 

On April 21, the Supreme Court of the United States (SCOTUS) heard oral arguments in Kennedy v. Braidwood Management, a legal challenge to the constitutionality of the Affordable Care Act’s (ACA) preventive services mandate that will reshape how federal coverage guidelines for preventive care are set. The case hinges upon whether the US Preventive Services Task Force (USPSTF), an independent body convened by the federal government that determines which preventive services must be covered without consumer cost-sharing, violates the U.S. Constitution’s Appointments Clause. On April 25, SCOTUS directed both parties to submit new briefs that address the HHS Secretary’s authority or lack thereof to appoint USPSTF members. On February 25, NASTAD joined Lambda Legal, GLAD Law and Mintz, and other leading HIV, LGBTQ+, and healthcare organizations to submit an amicus brief urging the Court to uphold no-cost access to pre-exposure prophylaxis (PrEP) and other critical preventive healthcare services. 

NFPRHA Files Lawsuit Challenging Trump Administration’s Withholding of FY2025 Title X Grant Awards 

On April 24, the National Family Planning & Reproductive Health Association (NFPRHA), represented by the American Civil Liberties Union (ACLU) and the ACLU of the District of Columbia, filed a lawsuit challenging the Trump Administration’s withholding of $65.8 million in Fiscal Year 2025 (FY2025) Title X family planning program grants. The lawsuit, National Family Planning and Reproductive Health Association v. Kennedy, et al., was filed on behalf of NFPRHA members, which include 14 of the 16 Title X grantees who were subject to withholding of program grants due to alleged “possible violations” of the terms and conditions of their grant awards. In total, the Administration refused to disperse 22 Title X grants, impacting 25% of the national Title X-funded network.

Resources

JAIDS: "State of US HIV Implementation Science: Progress and Priorities to End the Epidemic by 2030" 

The Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing published an open-access supplemental issue (volume 98, supplement 5) in the Journal of Acquired Immune Deficiency Syndromes (JAIDS) that summarizes shared HIV implementation knowledge from 120 Ending the HIV Epidemic in the US (EHE) projects across 40 priority jurisdictions in the US where HIV diagnoses are highest. The supplemental issue combines the combines the EHE projects into 24 collaborative papers (including the selected highlights below) that address a wide array of interventions, settings, target populations, and implementation strategies, serving as a potential model for speeding up research synthesis in any health domain or context.

• Lessons Learned From Engaging Healthcare Providers in Research on Implementation of HIV Preexposure Prophylaxis
• Rapid ART, Rapid PrEP, and Status Neutral Implementation in Ryan White–Funded Clinics: Results From a Multisite Survey
• Innovation in Providing Equitable Pre‐exposure Prophylaxis Services in the United States: Expanding Access in Nontraditional Settings
• Pre-Exposure Prophylaxis Awareness and Demand Creation: Overlooked Populations and Opportunities to Move Forward
• Policymaker Perspectives on Implementation Determinants of Rapid ART and Same-Day PrEP in Seven Priority Jurisdictions for Ending the HIV Epidemic: A Multisite Qualitative Study 

LinkedIn Pulse (Brett Giroir): Preserve, Protect and Defend the 2019 Ending HIV in America Initiative 

“The goal of ending the HIV epidemic in America is being realized, saving tens of thousands of lives and tens of billions of dollars. And with new advancements like the drug lenacapavir -- which can be administered twice yearly (and perhaps once yearly) and prevents 100% of new HIV infections -- ending HIV in America is now ever more realistic. This is the legacy of Trump ’45. But that legacy is now threatened by changes currently proposed or already implemented, including eliminating the Office of Infectious Disease and HIV Policy (which I proudly created) that leads the EHE effort; eliminating 150 staff in the Office of HIV prevention at CDC; reassigning key leaders in HIV to other programs; and the elimination of about $750 million in HIV targeted NIH grants.” 

KFF: What Does the Future Hold for the Ending the HIV Epidemic Initiative (EHE)? 

“While there has been no formal announcement, a leaked document detailing budget and restructuring plans for the Department of Health and Human Services (HHS) suggests there will be significant changes to the federal HIV response, including eliminating the EHE. The leaked document is not official policy and not a final budget request. While Congress could still theoretically fund the initiative, it appears the Trump Administration is not currently planning to champion the effort. This analysis examines what EHE has done to date and what its future might look like under the new administration.” 

KFF: Ending the HIV Epidemic (EHE) Funding Tracker 

“This tracker provides up-to-date data on federal EHE funding, including an overview of funding mechanisms by year, agency, grant mechanism, and jurisdiction. It will be updated over time.” 

Global AIDS Policy Partnership (GAPP): What does PEPFAR funding do?

The President’s Emergency Plan for AIDS Relief (PEPFAR) is a one-of-a-kind American investment. It is an extremely efficient, cost-effective program that yields astonishing returns. Through innovative, targeted, and science-based HIV prevention and treatment programming, PEPFAR has saved over 25 million lives, helped stabilize nations through health infrastructure investments, and fundamentally changed the course of the HIV pandemic. 

Advocates for Youth: Youth Activist Network Application 2025 

Deadline: May 1 

“Join our Youth Activist Network (YAN) to be one of over 100 youth activists aged 14-24 who receive training, support, and stipends to organize for bodily autonomy, reproductive justice, and sexual health & rights in your community! Those accepted will receive in-depth training at our all-expenses-paid Youth Activist Institute in Washington D.C. from Thursday, September 4th - Sunday, September 7th, 2025.” 

Job Postings

Executive Director of Programs – New York City, NY 

The New York City Health Department is seeking an Executive Director of Programs to join its Bureau of Hepatitis, HIV, and STIs (BHHS). The Executive Director of Programs will provide day-to-day oversight and operational support to BHHS’s HIV Care and Treatment Program, HIV Epidemiology Program, HIV Prevention Program, STI Program, and Viral Hepatitis Program, which comprise the majority of the bureau’s staff. The Executive Director of Programs will report to BHHS’s Assistant Commissioner and work alongside the Assistant Commissioner and BHHS leadership to ensure these Programs are supported to function optimally and collaboratively, and that BHHS is well-positioned to implement its strategic priorities and achieve its mission to improve the lives of New Yorkers by ending transmission, illness, stigma, and inequities related to viral hepatitis, HIV, and STIs. For more information or to apply for the position, visit the job posting on NYC Jobs, here. 

Communicable Disease Epidemiologist – Cheyenne, Wyoming 

This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program.  Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, analyzing exposure data utilizing epidemiological and statistical methods. 

News Bulletin

Oversight Democrat questions how CDC can provide public records without staffers 

“Rep. Gerry Connolly (D-Va.), ranking member of the House Oversight and Government Reform Committee, is demanding to know how the Centers for Disease Control and Prevention (CDC) plans to comply with Freedom of Information Act (FOIA) requests when the relevant staff have been put on administrative leave. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. laid off or eliminated HHS staffers in charge of handling FOIA requests at the CDC, Food and Drug Administration and the National Institutes of Health, according to reporting earlier this month. The move raised alarm among lawmakers and health care stakeholders as Kennedy had vowed to usher in an era of “radical transparency” at federal health agencies.” 

With CDC injury prevention team gutted, 'we will not know what is killing us' 

“Before they were fired, staff at the Centers for Disease Control and Prevention were about to launch a new data system to improve how the U.S. tracks concussions… All of this came to a halt when health secretary Robert F. Kennedy Jr. directed sweeping layoffs to the Department of Health and Human Services this month… Much of the federal workforce focused on injury and violence prevention was cut, according to researchers, advocates and five former employees whose jobs were eliminated… And while some areas, such as the division of overdose prevention and a branch that focuses on suicide, were largely spared, they now lack technical support to carry out some of their work.” 

As Republicans push work requirements in Medicaid, Arkansas offers a cautionary tale 

“The debate over the future of Medicaid continues to rage among Republicans. A House budget proposal released in February would slash up to $880 billion in spending over the next decade from the public health insurance program that 80 million low-income Americans rely on — including children, seniors, and people with disabilities. Last week, moderate House Republicans joined several GOP senators and governors in publicly opposing deep Medicaid cuts. But nearly all Republican elected officials seem to agree on one big policy change: Start requiring most adults enrolled in Medicaid to work.”