Policy Updates: Hill Happenings and Administration Activities
FY2026 Appropriations
Appropriators are working to advance a bipartisan spending agreement for Fiscal Year 2026 (FY2026) before the start of FY2026 on October 1. On July 31, the Senate Appropriations Committee (SAC) approved a Labor, Health and Human Services, Education, and Related Agencies (LHHS) funding bill, teeing up a full floor vote on a spending package that rejects many of the spending cuts requested by the Trump Administration, including the elimination of Centers for Disease Control and Prevention (CDC) HIV prevention programming. The Senate proposal would maintain current funding levels for CDC programs, thus rejecting the consolidated block grant proposed by the President and does not appropriate funding to launch the Administration’s proposal for a new federal health agency, the Administration for a Healthy America. The SAC approved the following topline numbers:
- Centers for Disease Control and Prevention (CDC): $9.152 billion
- CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention: $9.152 billion
- Centers for Medicare and Medicaid Services (CMS): $3.669 billion
- Health Resources and Services Administration (HRSA): $8.862 billion
SAC Ranking Member Patty Murray (D-WA) praised the bipartisan approach to the bill, championing the important work of CDC and HIV programs.
The House Appropriations LHHS Subcommittee, however, faced delays advancing the lower chamber’s health funding package. The Subcommittee canceled a markup scheduled for July 21 and a full committee markup on July 24, tentatively rescheduling for the week after Labor Day. Like their Senate counterparts, House Republicans signaled that they might approve a spending bill that rejects some of the Administration’s proposed cuts in order to achieve the bipartisan quorum required to pass a spending package. Despite the initial progress, Democrats are wary of supporting a funding package that may be altered after the fact through the Executive impoundment of funds or a Congressionally-approved rescissions package, raising the potential for a government shutdown or a continuing resolution.
Senate Confirms Susan Monarez for Director of CDC
On July 29, the Senate voted to confirm (51-47) the nomination of Susan Monarez to serve as CDC Director. Monarez, a former public health official at Advanced Research Projects Agency for Health (ARPA-H) and Acting Director of CDC, is the first-ever agency leader to undergo the Senate confirmation process. HHS Secretary Kennedy swore in Monarez on July 31, championing her role in advancing the Make America Healthy Again agenda. Monarez will play a key role in the Trump Administration’s reshaping of the public health infrastructure, including federal investments in HIV, hepatitis, and overdose prevention programming and immunization policy.
Lawmakers Call on State Department to Utilize Remaining Mpox Stock
On July 22, Representatives Pocan (D-WI-02) and Jacobs (D-CA-51) sent a letter to the Department of State Secretary urging the Administration to ensure that mpox vaccines do not go to waste. Forty-eight House Democrats signed onto the letter, highlighting the dangers to global health, particularly in Uganda and Burundi, and the waste of taxpayer money if the doses do not get distributed. On June 17, a Politico article revealed that nearly 800,000 doses of the vaccine that were pledged to African nations might not be dispensed. The news follows the Trump Administration’s overhaul of federal programs, including steep cuts and even elimination of some federal programs and agencies, such as the United States Agency for International Development (USAID).
President Trump Issues Executive Order that Targets Homelessness, Harm Reduction
On July 24, President Trump issued an Executive Order (EO), Ending Crime and Disorder on America’s Streets, which aims to address homelessness and crimes often associated with poverty, drug use, and mental health disorders by facilitating involuntary civil commitment for people experiencing homelessness. Additionally, the EO alleges that homelessness is tied to drug use and blames housing first and harm reduction programs for enabling illegal drug use, despite an evidence base that demonstrates the public health benefits of these programs. Public health and harm reduction advocates criticized the EO for doubling down on punitive approaches that fail to meaningfully improve high rates of homelessness and substance use disorders.
President Issues Executive Order Intended to Align Federal Grantmaking with Administration Priorities
On August 7, President Trump issued an Executive Order (EO), Improving Oversight of Federal Grantmaking, which aims to strengthen oversight of federal programs and streamline grantmaking processes in order to align programmatic spending with the Administration’s priorities. The EO directs each agency to identify a federal appointee to review funding opportunity announcements and participate in the selection of grant recipients. The White House claims that increased scrutiny of federal programming and spending is necessary to ensure that federal resources are not used to support wasteful programs that are not in the public interest or in line with national priorities.
HHS Overhauls Members of Key CDC Committees
On July 31, an HHS spokesperson confirmed that the federal health agency would overhaul membership of the CDC Advisory committee to the Director (ACD). ACD members advise the Director on ways to advance the agency’s strategic priorities and are recruited from a range of health sectors, such as public health, global health, health disparities, and biomedical research. The ACD charter allows for up to 15 members, but the committee’s website currently only lists 4 appointees. The committee overhaul raised concerns from public health advocates, who questioned whether the ouster would stymie the independence of newly confirmed CDC Director Monarez.
Notably, the ACD changes follow Secretary Kennedy’s overhaul of the CDC Advisory Committee for Immunization Practices (ACIP), which provides recommendations to the CDC Director for adult and pediatric immunization practices that are adopted as federal health policy. On June 9, the HHS Secretary dismissed all 17 members of the Advisory Committee on Immunization Practices (ACIP) and appointed 8 new members, claiming that the reorganization was necessary to remove bias and restore public trust in federal immunization rules and regulations. In June, ACIP convened its first meeting since the overhaul and discussed early Committee priorities, which include reevaluating the safety of hepatitis B virus (HBV) vaccines and universal pediatric immunization recommendations.
White House Pressures Pharmaceutical Manufacturers to Adopt Most-Favored-Nation Prices for Certain Prescription Drugs
On July 31, the White House issued a fact sheet that outlines recent efforts to reduce the price of prescription drugs for Americans through the implementation of a most-favored-nation (MFN) drug pricing model. The White House sent letters to pharmaceutical manufacturers prompting them to adopt prices that match the lowest price offered in other developed nations, including offering MFN prices to all Medicaid patients. The letters warned manufacturers that the Administration would “deploy every tool in [its] arsenal” to lower drug prices if they do not voluntary comply within 60 days, ramping up the MFN campaign first launched on May 12 via an executive order.
HRSA Announces New 340B Rebate Model Pilot Program, Requests Public Comment
On July 31, the Health Resources and Services Administration (HRSA) announced that it is launching a pilot program to test a 340B Rebate Model for drugs placed on the Centers for Medicare and Medicaid Services (CMS) Medicare Drug Price Negotiation Selected Drug List for year 2026. HRSA is introducing the voluntary program to better understand the merits and challenges that qualifying manufacturers will face as the drug price negotiation mechanism becomes implemented. Additionally, HRSA is soliciting public comment on the new pilot program. Comments are due September 2, 2025.
CDC Recognizes World Hepatitis Day
“Viral hepatitis affects more than 300 million people worldwide and leads to more than 1 million deaths each year. In the United States, viral hepatitis is a serious public health threat and leading cause of liver cancer which affects more than 4 million people in the US and kills thousands of Americans annually. According to recent data, more than 85,000 new infections and 13,000 related deaths occurred in the U.S. in 2023. Despite the availability of effective vaccines, prevention strategies, and medications, deaths from hepatitis are increasing globally.
CDC recognizes World Hepatitis Day (WHD) on July 28 by raising awareness about viral hepatitis, the burdens people with viral hepatitis face, ongoing work to combat viral hepatitis across the globe, and actions people can take to prevent future transmission. This year’s WHD theme, “Hepatitis: Let’s Break it Down,” focuses on identifying and addressing the many financial, social, and systemic barriers—including stigma—that stand in the way of viral hepatitis elimination and liver cancer prevention.
World Hepatitis Day reminds us of the breadth of settings and populations affected by viral hepatitis. We have the tools to address viral hepatitis. Now it’s time to ‘break it down’ and eliminate barriers to accessing potentially life-saving testing and treatment. Working together, a hepatitis-free world is within reach.”
HepVu and NASTAD: 2023 Viral Hepatitis Surveillance Status Report
The 2023 Viral Hepatitis Surveillance Status Report offers an in-depth look at the state of viral hepatitis surveillance across U.S. jurisdictions. Now in its third year, this annual report provides essential insights into the evolving landscape of Hepatitis B and C surveillance efforts nationwide. In 2023, 88% of jurisdictions had at least one full-time employee (FTE) dedicated to viral hepatitis surveillance—a marked increase from previous years. However, jurisdictions reported needing an average of four FTEs to effectively meet surveillance demands, yet most only had one.
NASTAD: Pharmacist Authority to Provide Viral Hepatitis Prevention, Testing, and Treatment Services
The viral hepatitis epidemic in the United States represents a significant public health challenge, particularly in communities facing systemic barriers to healthcare. Addressing this epidemic will require expanded access to prevention and treatment services, and the integration of viral hepatitis services into locations that community members are already familiar with has been shown to further support interventions. Given their accessible hours and settings, trust within communities, and ability to provide healthcare services, pharmacists are well-positioned to potentially play a greater role in viral hepatitis prevention, screening, and treatment. Policies that authorize pharmacists to provide services may help to increase healthcare access and ensure that individuals at risk of viral hepatitis have paths to care.
CDC MMWR:
- Emergency Department Survey of Vaccination Knowledge, Vaccination Coverage, and Willingness to Receive Vaccines in an Emergency Department Among Underserved Populations
- “Among 3,285 emergency department (ED) patients in 8 U.S. cities, 86% reported they had not received at least one vaccine, 46% who were not up to date with recommended vaccines said they would accept one or more missing vaccines if offered during their ED visit, and 87% said they would accept all missing vaccines. EDs could be explored as settings to offer vaccination screening and to increase vaccination coverage among underserved populations.”
- Notes from the Field: Hepatitis B Virus Transmission Associated with Assisted Blood Glucose Monitoring in a Skilled Nursing Facility
- “A diabetic nursing home resident diagnosed with acute hepatitis B had received assisted blood glucose monitoring with a device that had also been used to test a different resident who had chronic hepatitis B. Whole-genome sequence analysis revealed that the viral strains infecting the two patients were genetically identical.”
US Fast-Track Cities 2025 Summit
Date: September 15-17, 2025
“Registration is now open for the US Fast-Track Cities 2025 Summit. Join your peers from across the United States on September 15-17, 2025, in New Orleans to continue the good fight for Ending the HIV Epidemic (EHE) by 2030.
The Summit will be hosted by the International Association of Providers of AIDS Care (IAPAC), in partnership with the Fast-Track Cities Institute (FTCI), National Association of County & City Health Officials (NACCHO), National Alliance of State and Territorial AIDS Directors (NASTAD), AIDS United, and National Minority AIDS Council (NMAC).
We invite mayors, county executives, public health professionals, healthcare providers, policymakers, researchers, and community leaders across the United States to join us for this important convening. The Summit will include a keynote address, plenary sessions, panel discussions, and abstract presentations, skills-building workshops, with dedicated sessions with topics such as:
- Strengthening integration of HIV services into primary care systems
- Enhancing local HIV response coordination through multisector partnerships
- Planning contingencies for HIV service continuity in dynamic funding landscapes
Click the registration link below! You do not want to miss this convening as we map a way forward for the US HIV response.
Register for US Fast-Track Cities 2025 Summit.“
NHRC, RTI International, NASEN: Improving Buprenorphine Access
“Life-saving Syringe Services Programs (SSPs) connect program participants with a range of care, support services, and medications, including buprenorphine. NHRC, in collaboration with our partners at RTI International and the North American Syringe Exchange Network (NASEN), have published fact sheets in Spanish and English that highlight the experiences 20 SSPs have had integrating buprenorphine into their work with program participants. The fact sheets include information about how SSPs can increase buprenorphine access for participants, the challenges and opportunities and more.”
Journal of Public Health Management Practices: Reorganizing HHS: Doing It the Right Way
Citation: Valdiserri RO. Undermining America's HIV Prevention Capacity: Wrong and Dangerous. AIDS Behav. 2025 Jul;29(7):2037-2038. doi: 10.1007/s10461-025-04770-3. Epub 2025 May 30. PMID: 40442557.
AIDS and Behavior: Undermining America's HIV Prevention Capacity: Wrong and Dangerous
Citation: Valdiserri RO. Undermining America's HIV Prevention Capacity: Wrong and Dangerous. AIDS Behav. 2025 Jul;29(7):2037-2038. doi: 10.1007/s10461-025-04770-3. Epub 2025 May 30. PMID: 40442557.
A proposed California bill aims to protect coverage for HIV prevention despite federal threats
“State lawmakers are considering a bill meant to protect access to HIV prevention drugs for insured Californians as threats from the federal government continue.
Assembly Bill 554 would require health plans and insurers to cover all antiretroviral drugs used for PrEP and PEP regimens. The drugs just have to be approved by the Food and Drug Administration, and would not require prior authorization. The bill would also prevent health plans from forcing patients to first try a less expensive drug before choosing a more expensive, specialty option.”
Confusion at NIH as administration halts, then releases, billions of dollars for scientific research
“Billions of dollars of National Institutes of Health research were stuck in limbo for hours, causing confusion after a memo from the Office of Management and Budget appeared to direct a halt to its funding…This back-and-forth comes after a string of large-scale cuts at the Health and Human Services Department, led by Secretary Robert F. Kennedy Jr., that has cast agencies such as NIH, the Food and Drug Administration and the Centers for Disease Control and Prevention into confusion as they execute directives from the top. Following reporting by several outlets, OMB reversed the decision publicly, with a spokesperson saying on Tuesday evening the money was ‘undergoing a programmatic review’ but ‘is being released.’”
CDC to disburse delayed funds for fighting fentanyl and more, staffers say
“The Centers for Disease Control and Prevention will be able to fully fund the Overdose Data to Action, or OD2A, program ahead of a key budget deadline, according to a CDC senior leader…NPR reported last month that the Trump administration was withholding $140 million from the OD2A program, which state and local public health departments rely on to lower overdose deaths from fentanyl, methamphetamines and other drugs across the U.S.”
We can’t win the fight to end HIV if we cut funding and access to medication
“The fight to end HIV in our lifetimes just received a game-changing innovation. In June, the FDA approved Yeztugo (lenacapavir), a groundbreaking HIV prevention treatment that requires just two injections per year — and scored 99 percent effectiveness in trials. This monumental scientific breakthrough is poised to transform the lives of people who have found it hard to keep up with daily oral pre-exposure prophylaxis, providing an option that fits better into their everyday lives. But as exciting as this development is, it could be undermined by the Trump administration’s proposal to cut nearly $1 billion from federal HIV prevention programs. Innovations like lenacapavir could be a key tool to ending the epidemic, but only if we have the resources and policy to deliver it directly to those who need them most. “
Hepatitis C is a silent epidemic in the U.S. -- one small clinic is changing that
“The CDC estimates up to 4 million Americans suffer from the chronic effects of Hepatitis C. It's a viral infection that attacks the liver. One small clinic in Buffalo, New York, is proving this doesn't have to be the case. Dr. Céline Gounder reports.”
Gunman in CDC shooting identified as staffers reel from attack on heavily scrutinized agency
“Employees at the top US public health agency, the Centers for Disease Control and Prevention, were winding down their Friday when bullets smashed through their office windows, whizzing just over their cubicle walls. Inside the buildings, CDC employees felt like “sitting ducks,” some would later say in a meeting. Across the street from the CDC campus, a gunman — possibly motivated by a hatred of vaccines — had opened fire on the agency’s buildings, bringing panic to the upscale Atlanta neighborhood and the sprawling, open-access campus of Emory University adjacent to it.”