Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2026 Appropriations and Budget Reconciliation
Senators are working to advance their version of fiscal year 2026 (FY2026) budget and spending bills following progress in the House of Representatives. On May 22, the House passed the One Big Beautiful Bill Act (H.R. 1), a landmark domestic budget and policy bill that Republicans are attempting to pass through the budget reconciliation process. A bipartisan group of Senators expressed disapproval of controversial cost-cutting provisions included in the House bill, such as an $800 billion cut to core Medicaid and ACA funding, new eligibility requirements for some programs that would restrict access to coverage for millions, and provisions that would strip access to care for vulnerable populations. President Trump has called on Congress to pass the budget package by the Independence Day holiday, but lingering disagreements between the Senate and House caucuses may complicate prompt passage of the bill.
Additionally, the Senate Appropriations Committee released guidance for outside witness testimony on the Labor, Health and Human Services, Education, and Related Agencies (LHHS) Subcommittee spending bill, setting a deadline of June 13. NASTAD submitted testimony for the record that uplifts the importance of HIV and hepatitis programs at state and local health departments and the critical coordinating role of the Centers for Disease Control and Prevention (CDC) Division of HIV Prevention and Division of Viral Hepatitis.
Bipartisan Legislation Introduced to Support the Elimination of Hepatitis C In the United States
On June 4, Senators Bill Cassidy (R-LA) and Chris Van Hollen (D-MD) introduced bipartisan legislation, the Cure Hepatitis C Act of 2025, to support the elimination of hepatitis C in the United States. The legislation would expand access to testing and treatment, strengthen public health infrastructure, and reach at-need populations through innovative care delivery models. NASTAD worked closely with community and Congressional partners to draft the bill and reach introduction. Notably, the legislation would implement a purchasing model to reduce the cost of treatment and increase access to hepatitis C medications, includes funding provisions for state and local health departments, and would also empower state and local public health systems, community health centers, opioid treatment programs, and correctional facilities to build lasting infrastructure, scale up existing prevention programs, and integrate hepatitis C services into their work. Additionally, on June 10, the bill authors held a briefing to raise awareness of the bill and invited community stakeholders to share how the bill could usher in a watershed opportunity to eliminate HCV in the US.
NASTAD Calls on Congress to Reject Anti-LGBTQ+ Policy Riders in FY2026 Package
On June 6, NASTAD joined a coalition of 85 organizations and called on Congress to reject policy riders in the FY2026 spending package that introduce anti-LGBTQ+ provisions. The policy riders, which historically have included provisions such as restrictions on gender-affirming care and loosening of nondiscrimination protections for gender and sexual minorities, seek to entrench exclusionary policies into federal law. In FY2025, 55 anti-LGBTQ+ riders were introduced, but none were able to make it into the final spending package.
Congress Passes HALT Fentanyl Act
On June 12, the House of Representatives passed the HALT Fentanyl Act (S.331), establishing final Congressional approval for legislation to permanently schedule fentanyl and related substances (FRS) under Schedule I. Additionally, the HALT Fentanyl Act would establish new mandatory minimum sentencing for criminal charges that involve FRS. The HALT Fentanyl Act secured bipartisan support despite pushback from public health advocates, who warned that permanent scheduling of FRS will stymie research into novel opioid overdose reversal agents and worsen racial sentencing disparities for criminal drug offenses. The House passed the HALT Fentanyl Act in February of 2025, but had to execute a procedural vote to resolve differences between the Senate’s version of the bill that was passed in March. The bill now heads to the White House for the President to sign the legislation into law.
Administration Activities
CDC to Reinstate Over 400 Employees Laid off as part of the Administration’s HHS Reduction In Force Plans
On June 11, the Centers for Disease Control and Prevention (CDC) announced that it would reinstate over 400 employees that it laid off as part of the reduction in force (RIF) efforts across the Department of Health and Human Services (HHS) agencies and operating divisions. Notably, nearly half of the rehired employees work within the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP), which was heavily impacted by the RIF plan, including the elimination of half of the branches in the Division of HIV Prevention and the Division of Viral Hepatitis Laboratory Branch.
FDA Approves Expanded Label for AbbVie’s MAVYRET
On June 11, pharmaceutical manufacturer AbbVie announced that the US Food & Drug Administration (FDA) approved a label expansion for Mavyret, its direct-acting antiviral (DAA) to treat hepatitis C virus (HCV) infection. The label expansion reflects new indications for the treatment of adults and pediatric patients three years and older with acute HCV without cirrhosis or with compensated cirrhosis. Mavyret is the first DAA medication approved for treatment of acute HCV.
Resources
“This longitudinal study provides a first-of-its-kind analysis of the evolution of AIDS Drug Assistance Programs (ADAPs). By examining 14 years of state-level data from 2008 to 2021, the research evaluates trends in ADAP utilization by people living with HIV/AIDS (PLWHA) across the United States, focusing on key demographic subpopulations by age, sex, race, and geographic region…We conclude that while ADAPs have successfully expanded to become a cornerstone of HIV care in the ACA era, significant work remains to ensure equitable access. The persistent disparities affecting women and Black PLWHA point to the need for targeted outreach, partnerships with community-based organizations, and an examination of policies that may create structural barriers to enrollment and recertification. To achieve national goals of ending the HIV epidemic and reducing health inequities, further investment and policy changes are essential to support ADAPs in their mission to serve the nation's most vulnerable people with HIV.”
The AIDS Institute: H.R.1 Would Exacerbate HIV Epidemic
“Medicaid is the single largest source of insurance coverage for people living with HIV and federal funding for HIV treatment and prevention…The reconciliation bill would reverse hard-won gains in the fight against HIV. Cutting coverage, raising costs, and targeting marginalized groups will increase new infections, worsen health outcomes for people with HIV, and overwhelm already-strained clinics and public health systems. We must reject this harmful approach and instead strengthen the coverage and care foundations that are essential to ending the HIV epidemic in the United States.”
“These nonoccupational postexposure prophylaxis (nPEP) recommendations and clinical considerations provide a safe and effective strategy to prevent HIV infection. The continued occurrence of tens of thousands of HIV diagnoses annually in the United States indicates the importance of implementing the full spectrum of HIV prevention options, including nPEP. Increasing HIV nPEP knowledge and awareness, supporting nPEP adherence, and improving nPEP access are all core strategies available to enhance HIV prevention efforts in the United States.”
News Bulletin
Federal cuts to NC public health funding trickling down to local programs
“Eleven disease investigators who track HIV cases in Charlotte are being laid off this week, according to Raynard Washington, health director for Mecklenburg County.
The investigators track down newly diagnosed HIV patients to connect them with care and identify potential contacts who may need testing — work seen as critical to disrupting transmission of the virus.”
CDC Staffing Upheaval Disrupts HIV Projects and Wastes Money, Researchers Say
“Dozens of HIV experts at the Centers for Disease Control and Prevention received emails on Wednesday revoking notices they received 10 weeks ago that laid them off. Damage to their projects may be permanent, however, and ongoing restrictions on their research will harm lives, multiple HIV scientists at the CDC told KFF Health News on condition of anonymity because of fears of retaliation.”
Four Ways Trump’s ‘One Big Beautiful Bill’ Would Undermine Access to Obamacare
“Major changes could be in store for the more than 24 million people with health coverage under the Affordable Care Act, including how and when they can enroll, the paperwork required, and, crucially, the premiums they pay. This story also ran on NPR. It can be republished for free. A driver behind these changes is the “One Big Beautiful Bill,” the name given to spending and tax legislation designed to advance the policy agenda of President Donald Trump. It passed the House on May 22 and is pending in the Senate.”
Jim O’Neill Confirmed as HHS Deputy Secretary
“The Senate on Thursday confirmed Jim O’Neill, co-founder of the Thiel Fellowship, as deputy secretary of the Department of Health and Human Services in a 52-43 vote.”