Policy Updates: Hill Happenings and Administration Activities
FY2026 Appropriations
Appropriators will soon return from August recess and have less than a month to pass a spending package for Fiscal Year 2026 (FY2026) by the September 30 deadline. The House Appropriations Committee (HAC) Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS) will markup its bill on September 4, resuming efforts to advance a bipartisan package after a July markup was postponed until after the recess. On July 31, the Senate Appropriations Committee (SAC) approved the upper chamber’s 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.
Like their Senate counterparts, House Republicans may opt to support a bipartisan approach to avoid a government shutdown on October 1. However, House Republicans may be more willing to leverage a partisan strategy and force Democrats into a shutdown standoff—an option that may be increasingly appealing to Democrats, who are wary of ceding their votes to support a funding package that may be altered after the fact through the Executive impoundment of funds or a Congressionally-approved rescissions package.
Senate HELP Committee Advances Trump Administration’s Nominee for HHS Assistant Secretary for Health
On July 24, the Senate Committee on Health, Education, Labor, and Pensions (HELP) voted to advance the nomination of Brian Christine for Department of Health and Human Services (HHS) Assistant Secretary for Health (ASH). The ASH is the primary advisor to the Secretary and works to coordinate programming across HHS agencies and operating divisions, including overseeing the US Public Health Service Commissioned Corps. Christine is a physician based in Alabama who garnered the political spotlight after an unsuccessful run for the Alabama State Senate and for promoting controversial views on gender and reproductive health. During the HELP Committee nomination hearing, Christine touted his credentials as a physician and grassroots experience navigating health systems with his patients. Christine’s nomination will now head to the Senate floor for a full vote.
Rep. Ansari Introduces HIV Medication Act to Expand Access
On July 23, Representative Ansari (D-AZ-03) introduced the HIV Medication Act to Expand Access to amend the Foreign Assistance Act of 1961 (H.R.4627), a bill that would protect access to PrEP for HIV through global assistance programs at the Department of State. House Democrats introduced the bill in response to the Administration’s efforts to withhold funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) and the programmatic challenges that resulted form the dismantling of the US Agency for International Development (USAID) and subsequent transfer of PEPFAR operations to the State Department. The bill would amend the Foreign Assistance Act of 1961 to clarify that PrEP is a core component of life-saving humanitarian assistance. NASTAD applauds the House of Representatives for introducing the important bill and endorsed the legislation upon its introduction.
House Energy & Commerce Committee Democrats Urge Insurers to Protect Affordable Access to Immunizations
On July 17, top Democrats on the House Energy & Commerce (E&C) Committee sent a letter to ten of the largest health insurers urging them to protect affordable access to immunizations in response to Secretary Kennedy’s overhaul of CDC Advisory Committee for Immunization Practices (ACIP) membership. The lawmakers requested information from health payors on how they would preserve evidence-based decision making when updating coverage for services in their health plans and urged them to preserve coverage for immunizations regardless of the Administration’s position on vaccine safety and efficacy. Additionally, the lawmakers pressed insurers to clarify whether they would continue to cover all routine immunizations without cost-sharing if the Administration stops endorsing the current vaccine schedule.
Ranking Member on Senate HELP Committee Launches Investigation of HHS Secretary’s Overhaul of Key CDC Vaccine Advisory Committee
On July 29, Democrats on the Senate HELP Committee launched an investigation into the HHS Secretary’s overhaul of CDC ACIP. On June 9, Secretary Kennedy ousted all 17 members on the influential committee, who provide recommendations for pediatric and adult immunization practices that are later adopted as federal policy by the CDC Director. HHS stated that it plans to select appoint new members that are aligned with the Make America Healthy Again (MAHA) movement, but only 7 new members have been appointed. Secretary Kennedy maintains that the overhaul is necessary to remove industry bias and restore trust in federal vaccine policy. Democrats panned the membership ouster, characterizing the move as a partisan attack on objective science. The Committee requested a response from the Administration by August 12 that justifies initiating the overhaul and explains how the new members were vetted.
SCOTUS Rules in Favor of Trump Administration, Lifting Temporary Restraining Order that Halted NIH’s Purge of “DEI” Grants and Programs
On August 21, the Supreme Court of the United States (SCOTUS) reversed a lower court of appeal’s ruling that temporarily halted the White House’s efforts to cancel any National Institutes of Health (NIH) research grants and programs that it associates with diversity, equity, and inclusion (DEI). SCOTUS held that district courts lack authority to hear challenges to grants determinations or to order relief enforcing monetary obligations tied to those grants.
On January 20, 2025, President Trump issued an Executive Order directing federal agencies to root out all DEI “mandates, policies, programs, preferences, and activities,” alleging that DEI frameworks are discriminatory and misuse taxpayer dollars. On May 30, NIH began to implement the sweeping censorship of its impactful biomedical research portfolios, including a focus on eliminating HIV research programming, but was required to halt its efforts on June 16 after a U.S. District Judge ruled that the DEI purge was not legally enforceable and ordered the reinstatement of nearly $1 billion in research funding. Notably, as a result of SCOTUS ruling, continued advancements in biomedical knowledge of HIV and public health practice are once again in jeopardy, including progress made towards discovering new treatment options for HIV, developing new long-acting and drug device formulations for PrEP, and a potential breakthrough in the creation of a vaccine for HIV.
Federal Judge Rules in Favor of Trump Administration’s Reduction in Force Plans
On August 13, a federal court of appeals judge narrowed a ruling that protected CDC employees from the Administration’s sweeping reduction in force plans. On July 1, Judge Melissa DuBose initially ruled that the layoffs violated federal law and directed the Administration to reverse all of the mass firings. The updated ruling narrowed down the total number of agencies that are exempt from the reduction in force plans to six. Notably, the Court determined that the National Center for HIV, Hepatitis, STD, and TB (NCHHSTP) was exempt from the Administration’s overhaul of the federal health workforce, protecting Center staff from termination while the case continues to make its way through the courts.
HHS Announces Reinstatement of Task Force on Safer Childhood Vaccines
On August 14, HHS announced that it would reinstate the Task Force on Safer Childhood Vaccines, an HHS advisory entity comprised of Food and Drug Administration (FDA), National Institutes of Health (NIH), and CDC experts and officials. The Task Force was authorized by Congress through the National Childhood Vaccine Injury Act of 1986 but was disbanded in 1998. The Task Force will support the Administration’s efforts to advance the MAHA agenda, which features vaccine skepticism that public health experts argue is not rooted in evidence, including promoting misinformation over the safety and efficacy of the HBV pediatric immunization. FDA Administrator Bhattacharya will lead the Task Force and work closely with the Advisory Commission on Childhood Vaccines to develop recommendations for the development, promotion, and refinement of childhood vaccines.
NASTAD Calls on Secretary Kennedy to Protect USPSTF as HHS Prepares to Overhaul its Membership
On August 11, NASTAD joined over 200 organizations and called on HHS Secretary Kennedy to defend the mission of the United States Preventive Services Task Force (USPSTF). In July, media reports revealed that Secretary Kennedy planned to remove all 16 members serving on the committee, which issues recommendations for preventive care that inform which types of services are offered at no cost to the consumer, like screening for HIV and viral hepatitis. The committee overhaul would follow a June 27 Supreme Court ruling that rejected a legal challenge to the Committee’s membership structure and recommendations, preserving accessible preventive care for millions of people, but concurrently ruled that the HHS Secretary has the authority to reshape committee membership and the discretion to accept or reject its recommendations. The coalition urged the Secretary to preserve the current structure, membership, and processes of USPSTF to ensure that its recommendations are unbiased and evidence-based. Secretary Kennedy used a similar tactic to reshape ACIP, a key vaccine policy committee at CDC, ousting its 17 members and replacing them with a 8 hand-picked appointees who are more receptive to the Administration’s anti-vaccine views.
HRSA Updates 340B Program Registration and Recertification Policies for Covered Entities
On August 7, Health Resources and Services Administration (HRSA) published a notice and request for public comment soliciting stakeholder input on updates to 340B program registration and re-certification policies and procedures for health programs seeking to participate in the 340B Drug Pricing Program. The 340B Program, administered by the HRSA Office of Pharmacy Affairs (OPA), supports consumer access to outpatient drugs by capping drug acquisition costs incurred by 340B covered entities, which include safety-net providers like Federally Qualified Health Centers and AIDS Drug Assistance Programs (ADAPs), who can subsequently leverage the savings to offer affordable treatment and care options to their clients. The policy notice outlines new guidelines that increase the administrative data and programmatic information required from health programs during the initial registration process to become a 340B covered entity or when re-certifying their eligibility, including information on shipping and billing arrangements, participation in Medicaid programs, verification of federal grant or subgrantee status, and the submission of STD and TB subgrantee agreements that specify the terms and conditions of support. HRSA claims that these modifications will streamline eligibility-related processes and uphold the transparency and integrity of the 340B Program by ensuring the ongoing eligibility of covered entities and preventing duplicate drug discounts. However, grantees and subgrantees with limited staff capacity may experience undue administrative burden as a result of the new requirements. HRSA will accept comments until October 6, 2025.
CMS to Implement Claims-Based Methodology for Medicare Part D Drug Inflation Rebates for Drugs Dispensed at 340B Prices
On July 16, Centers for Medicare and Medicaid Services (CMS) published a proposed rule introducing methodology to be used to exclude 340B-discounted drugs from those subject to Medicare Part D inflation rebates. The physician fee schedule regulation is part of yearly rulemaking efforts that CMS promulgates to align payment and coverage policies across its health plans with the economic, legal, and programmatic changes that occurred in the year prior. For calendar year 2026, CMS is proposing to finalize provisions that codified the Medicare Part D Drug Inflation Rebate Program, which was authorized by the Inflation Reduction Act and Consolidated Appropriations Act, 2023. CMS is proposing a new Provider-Pharmacy methodology to exclude 340B claims by pairing prescriber and contract pharmacy information associated with Part D claims. Notably, CMS acknowledges that many 340B-eligible ADAPs may experience administrative and operational challenges under the new methodology due to their status as a secondary payor for cost-sharing requirements and 340B dispensing arrangements that collect discounts through established rebate mechanisms and not at the point-of-sale. NASTAD will be providing comments detailing an alternative methodology for both ADAPs with rebate mechanims and those with direct purchase mechanims generating program income on dispenses for Medicare beneficiaries. Additionally, CMS will establish a repository to collect Part D 340B claims data voluntarily submitted by covered entities that will inform future rulemaking and program maintenance. CMS will accept public comment through September 12, 2025.
HRSA Announces New 340B Rebate Model Pilot Program, Requests Public Comment
On July 31, HRSA announced the launch of a pilot program to test the administrative, operational, and financial workflows that 340B eligible manufacturers and covered entities will navigate as new rebate models, including the Medicare drug price negotiation mechanism, are implemented. HRSA will leverage the pilot to test a new 340B rebate model with qualified manufacturers using a limited number of drugs placed on the CMS Medicare Drug Price Negotiation Selected Drug List for year 2026 over the period of at least one year. Notably, the pilot model includes provisions that could introduce cash flow, vendor contract, and administrative challenges for safety-net providers participating in the 340B program, such as requirements for covered entities to purchase eligible drugs at the wholesale acquisition cost, which may prove to be cost-prohibitive and unsustainable for covered entities with limited funds, such as ADAPs, HIV prevention programs, and viral hepatitis programs. HRSA will accept public comment on the new pilot program through September 2, 2025.
Federal Judge Pauses HHS Plan to Share Medicaid Beneficiary Information with Immigration and Customs Enforcement; CMS Announces Oversight Initiative of Medicaid and CHIP
On August 12, a federal judge issued a preliminary injunction that pauses the Administration’s plans to collect immigration-related data from Medicaid recipients. The Court determined that the Administration’s plan to transfer sensitive health information from CMS databases to the Department of Homeland Security (DHS) Immigration and Customs Enforcement (ICE) likely violates the Administrative Procedure Act. The Administration claims that the data transfer is necessary to root out waste, fraud, and abuse in federal health programs and plans to use the data to facilitate the identification of undocumented immigrants for detention and removal proceedings, but public health and human rights advocates panned the proposal and urged the Administration to protect sensitive health information.
Additionally, on August 19, CMS launched an oversight initiative to purge Medicaid and Children’s Health Insurance Program (CHIP) rolls of beneficiaries that did not provide proof of satisfactory immigration status upon enrollment or redetermination. CMS will provide states with a monthly enrollment report that identifies beneficiaries whose citizenship status could not be confirmed. CMS advised states that it will monitor progress made to cull state Medicaid and CHIP programs of ineligible enrollees.
CDC, APHL to Host HCV Diagnostics Convening
CDC, in partnership with the Association of Public Health Laboratories (APHL), will host a two-day convening on September 16-17 to discuss opportunities for hepatitis stakeholders to increase HCV testing rates across multiple health settings utilizing same-day test to treat and viral-first testing strategies. The Convening will bring together key stakeholders and leaders in public health, laboratory, medical, academic, and industry sectors. On September 16, participants will discuss opportunities to scale up same-day HCV diagnosis and rapid treatment initiation utilizing point-of-care diagnostic testing technologies. On September 17, the group will discuss the role of viral-first testing strategies for effective identification of people living with HCV. Although the stakeholders will not produce recommendations or official advice for CDC, the convening will culminate in a report summarizing both the discussion that took place at the convening and the public comments that were submitted to CDC to use for future reference. CDC will accept public comment through September 24. To register for this virtual meeting on the public line (listen-only access), please use the following link: https://webster.eventsair.com/hepatitis-2025-meeting/hcvattendee/Site/Register
NASTAD Blog: World Hepatitis Day 2025: Advancing a Cure to Protect the Next Generation
Each year on July 28, we come together to recognize World Hepatitis Day, a global moment to raise awareness, celebrate progress, and renew our commitment to eliminating viral hepatitis. At NASTAD, we are proud to work alongside advocates, policymakers, and public health leaders to advance equitable access for solutions to the hepatitis B and C viruses (HBV and HCV.) This year marks a major policy milestone in the United States: the Cure Hepatitis C Act of 2025, a bipartisan effort introduced by Senators Bill Cassidy (R-LA) and Chris Van Hollen (D-MD). The Cure Hepatitis C Act of 2025 offers a comprehensive strategy that includes expanding hepatitis C access to testing and treatment, strengthening public health infrastructure at the state and local levels, and implementing a cost-saving subscription model to purchase hepatitis C medications through registered pharmacies, correctional systems, and the Indian Health Services. NASTAD played a key role in supporting the development of this legislation and continues to advocate for its passage to help ensure everyone with HCV has access to timely, life-saving care.
The AIDS Institute: Deep Cuts to Medicaid and ACA Coverage Threaten Progress Against HIV
“H.R.1 (also known as the One Big Beautiful Bill Act or OBBA), was signed into law by President Trump on July 4th, 2025. It includes significant reductions in federal funding for programs that provide food and health care to low-income and vulnerable people – including hundreds of thousands of people with HIV…These changes represent the largest rollback of federal health care support in U.S. history, threatening access to care and public health outcomes, especially for vulnerable populations. It is estimated that 15 million people will lose health insurance as a result of this law. People living with and vulnerable to HIV, HIV service providers, and community-based organizations should be prepared for the changes that will come as a result of H.R. 1.”
Springboard HealthLab: Pitch Day
Deadline: Apply by September 17
“Springboard HealthLab is excited to announce our inaugural Pitch Day — an opportunity to surface bold, innovative public health ideas and provide the support needed to help them thrive. Do you have a public health project that could improve health outcomes for communities? Pitch Day is your gateway to a 12-month incubation program designed to provide long-term, hands-on support to build the foundation for lasting, impactful solutions. We’re seeking individuals and small teams with creative, systems-minded ideas aimed at reimagining how health, prevention, or support reaches communities, especially those historically excluded or underserved. Whether your idea involves tech-driven health solutions, reimagining HIV prevention, scaling a community-rooted program, or launching something entirely new, we want to hear from you! A select group of applicants will be invited to pitch live on October 29. Winning proposals will be offered spots in Springboard’s 12-month Incubation Program.”
CDC MMWR:
- Vaccination Coverage Among Adolescents Aged 13–17 Years — National Immunization Survey-Teen, United States, 2024
- “In 2024, among adolescents aged 13–17 years, Tdap, meningococcal conjugate, MMR, and hepatitis B vaccination coverage increased, highlighting progress in efforts to improve vaccination. HPV vaccination coverage did not change, and for the previous 9 years, HPV vaccination coverage has remained lower among adolescents in mostly rural areas compared with those in mostly urban areas. Health care providers can support adolescent health by discussing and recommending vaccines, and by reviewing patient records to determine if adolescents are up to date with recommended vaccinations.”
- Notes from the Field: Hepatitis B Virus Transmission Associated with Assisted Blood Glucose Monitoring in a Skilled Nursing Facility — North Carolina, 2024
- “During 2008–2019, 15 hepatitis B outbreaks associated with assisted blood glucose monitoring were reported in long-term care facilities. CDC recommends assigning blood glucose monitors (glucometers) to one person…Sharing glucometers presents a risk for HBV transmission that can be reduced by routine HBV vaccination of persons with diabetes and dedicating individual glucometers to a single resident.”
- CDC Laboratory Recommendations for Syphilis Testing, United States, 2024
- “This report provides new CDC recommendations for tests that can support a diagnosis of syphilis, including serologic testing and methods for the identification of the causative agent Treponema pallidum. These comprehensive recommendations are the first published by CDC on laboratory testing for syphilis, which has traditionally been based on serologic algorithms to detect a humoral immune response to T. pallidum.”
GU O’Neill Institute: Sustaining Momentum and Increasing Access to PrEP in Uncertain Times
“The Centers for Disease Control and Prevention (CDC) has recently updated its estimates of the size of the U.S. population that can benefit from PrEP estimating that there are 2.2 million potential users. While PrEP use has increased — with nearly 600,000 people using it in 2024, according to AIDSVu — overall uptake remains limited. Persistent use is low among the populations with the greatest need, and significant inequities in access still exist. Moreover, many of the policies put in place to support PrEP access and use are under threat and there would be significant consequences if they were eliminated. Threats to HIV prevention funding and policies to increase and support persistent PrEP use demand urgent action from stakeholders at all levels.”
International Association of Providers of AIDS Care (IAPAC): Disrupt to Deliver: Reimagining PrEP
“Scientific innovation has delivered unprecedented prevention tools – from oral pre-exposure prophylaxis (PrEP) to long-acting injectable options – but access to these tools remains grossly unequal. Fewer than one in four individuals globally who could benefit from PrEP are currently able to access this critical prevention tool. The vast majority are those systematically marginalized: young people, key populations, and communities living in low- and middle-income countries (LMICs), many of whom face additional legal, social, and structural barriers to care. This sobering reality long in the making is not just a failure of policy or logistics… What is required now is disruption – strategic, intentional, and unapologetically bold.”
Robert Wood Johnson Foundation: Call for Proposals - Reinvesting in Racial and Indigenous Health Equity Research
Apply by: October 1 at 3:00 p.m. ET
“The purpose of this call for proposals is to meet the current moment by supporting timely, actionable health equity research that has been interrupted by shifts in federal funding. Rapid Response Research funding is exclusively available to applicants who have already received federal funding (e.g., from the NIH, CDC, NSF) for their health equity research, but have since had their funding partially or fully rescinded due to federal administrative actions.”
CDC funding changes inject ‘chaos’ into local health programs
“The Trump administration has delayed or blocked millions of dollars in federal grants from the Centers for Disease Control and Prevention (CDC), leaving state and local health departments in the dark, uncertain when or even if they will get money that’s already been appropriated by Congress for key public health initiatives. With little communication from the White House, CDC staff are trying to expedite getting grants out the door, and public health officials are scrambling to spend the money they have before it expires Sept. 30…Raynard Washington, director of the Mecklenburg County Public Health Department in North Carolina, said his agency laid off six workers — including half its disease investigators — after grants for HIV prevention and surveillance programs expired at the end of May with no information about future funding.”
Trump Budget Office Is Withholding H.I.V. Funds That Congress Appropriated
“The Trump administration is ignoring a directive from Congress and refusing to fully fund a landmark H.I.V. program that is widely credited with saving millions of lives over the past two decades. The Office of Management and Budget, headed by Russell T. Vought, has apportioned only $2.9 billion of $6 billion appropriated by Congress for the President’s Emergency Plan for AIDS Relief in the 2025 fiscal year spending bill, according to budget documents and members of the program’s staff… The decision not to release the PEPFAR funds is in keeping with Mr. Vought’s stated belief that the executive branch can use the budget office forcibly to shrink the size of government. He has so far faced limited resistance from Congress although some members have accused him of impoundment.”
‘Makes No Sense': Experts Push Back On RFK Jr.’s Doubts About Hepatitis B Vaccine
“Public health experts are pushing back against doubts and criticisms about the hepatitis B vaccine spread by HHS Secretary Robert F. Kennedy Jr. and his allies. Since overhauling the CDC's Advisory Committee on Immunization Practices (ACIP), Kennedy and his supporters have questioned the vaccine's safety and the need for a birth dose. Those assertions could erode public confidence in a vaccine credited with virtually eliminating childhood transmission of the virus in the U.S., health professionals told MedPage Today.”
Harm reduction techniques being phased out under Trump
“The Trump administration is escalating its push against what has become a key part of the way states, localities and communities respond to the overdose epidemic: harm reduction. A public health approach aimed at mitigating the negative health effects associated with drug use, harm reduction aims to prevent overdoses and infectious disease transmission. Methods can involve the use of opioid overdose reversal medications such as naloxone, providing sterile needles to limit the transmission of infectious diseases, test strips that detect fentanyl in drugs, and “safe consumption sites,” where people can use drugs under supervision in case they need intervention.”
RFK Jr. Is Slashing mRNA Funding as HIV Vaccine Approaches Possible Breakthrough
“A potential breakthrough in the ongoing AIDS crisis could be deprioritized due to the decisions of noted vaccine skeptic Robert F. Kennedy, Jr. In his capacity as the Secretary of Health and Human Services, Robert F. Kennedy, Jr., announced on August 5 that the federal agency would begin a “coordinated wind-down” of mRNA vaccine development. The announcement came mere days after researchers announced promising results from an early-stage clinical trial using mRNA technology to develop an HIV vaccine.”