Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
Budget Reconciliation
Senate Republicans are pursuing an ambitious timeline to advance the “One Big Beautiful Bill Act” through the budget reconciliation process, potentially passing the landmark domestic spending and policy package as soon as this week. However, procedural hurdles and policy disagreements may derail the GOP’s timeline to pass the bill by their self-imposed Independence Day deadline. Senate Republicans are negotiating internally on the extent of controversial spending cuts, including cuts to core Medicaid and ACA funding and new nationwide work requirements for Medicaid eligibility, which would result in as many as 11.8 million people losing health coverage. The House passed their version of the bill on May 22—as part of their bill drafting process, Congressional Republicans must reconcile the differences between the two chambers before the bill can become law. President Trump called on Congress to pass the package by July 4 amid reports of growing disputes among Senate Republicans.
FY2026 Appropriations
Appropriators are advancing Fiscal Year 2026 (FY2026) spending bills in tandem with the budget reconciliation process. On June 24, Department of Health and Human Services (HHS) Secretary Kennedy appeared before the House Energy & Commerce (E&C) Committee Subcommittee on Health to defend the Administration’s FY2026 budget proposals for HHS. Subcommittee Democrats grilled the Secretary on the overhaul of federal vaccine policy infrastructures across HHS agencies, including the dismissal of all members of the influential Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP). Additionally, Subcommittee members pressed the Secretary to justify deep programmatic cuts proposed across HHS, including the elimination of HIV prevention programs at CDC and the consolidation of hepatitis, STI, and other prevention programs housed under the CDC National Center for HIV, Hepatitis, STI, and TB Prevention (NCHHSTP) into a single block grant.
Additionally, on June 25, Russell Vought, Director of the White House Office of Management and Budget (OMB), appeared before the Senate Appropriations Committee to defend the Administration’s rescissions request to Congress, which would claw back Congressionally approved funding for several programs the Administration does not support. Vought drew bipartisan scrutiny from Senate appropriators, who questioned why certain programs were being targeted for deep cuts, including the President’s Emergency Plan for AIDS Relief (PEPFAR), whose funding was unilaterally eliminated by the White House in April.
Senate HELP Committee Holds Confirmation Hearing for CDC Director Nominee
On June 25, the Senate Committee on Health, Education, Labor, & Pensions (HELP) held a hearing to vet Susan Monarez, the Administration’s nominee for Director of the Centers for Disease Control and Prevention (CDC). Although Monarez is likely seeking to differentiate herself from Secretary Kennedy’s controversial health views, she defended the sweeping changes to HHS agencies and operating divisions, which significantly impacted CDC NCHHSTP. Additionally, Monarez, an immunologist by training, did not condemn Secretary Kennedy’s recent ouster of ACIP members, but alleged that she would operate as an “independent thinker” if confirmed. Monarez is the first nominee to undergo the Senate confirmation process for CDC Director, which became a Senate-confirmed role starting in 2025.
Administration Activities
SCOTUS Holds USPSTF Constitutional, Protecting Access to Preventive Services Under the Affordable Care Act
On June 27, 2025, the Supreme Court of the United States (SCOTUS) issued its decision on Kennedy v. Braidwood, ruling in favor of the U.S. Preventive Services Task Force (USPSTF) and upholding the constitutionality of its role under the Affordable Care Act (ACA). This ruling affirms that insurers are still federally required to cover preventive services recommended by the USPSTF – including HIV PrEP, cancer screenings, and other life-saving interventions – without cost sharing.
The Kennedy v. Braidwood decision represents a momentous win for public health and access to care. By preserving the ACA’s mandate to cover preventive services at no cost to patients, the Court has ensured that millions of Americans can continue to access essential preventive care. However, the win is not without caveats: To argue for the task force’s constitutionality, the government asserted that there was adequate oversight over USPSTF since the HHS Secretary has the authority to remove USPSTF members at will and veto recommendations made by the Task Force. SCOTUS accepted this interpretation of USPSTF oversight authority, which introduces a degree of uncertainty moving forward. While all currently recommended services remain protected under the ACA, future recommendations made by the USPSTF could be subject to political influence or administrative changes depending on how the HHS Secretary exercises this authority.
SCOTUS Rules in Favor of South Carolina’s Right to Defund Planned Parenthood from State Medicaid Program
On June 26, the Supreme Court of the United States (SCOTUS) ruled (6-3) against Planned Parenthood (PP) in Medina v. Planned Parenthood South Atlantic, weakening consumer protections in the Medicaid Act that ensured beneficiary access to a robust provider network. The court rejected a challenge from the sexual and reproductive health provider because it found that the private plaintiff, a South Carolina Medicaid beneficiary, did not have legal standing to challenge the state’s decision to bar PP from participating in the Medicaid program due to its provision of abortions. As a result of the ruling, PP affiliates in South Carolina are “defunded” of Medicaid dollars, and Medicaid beneficiaries will no longer be covered for any services provided by PP. Under federal law, Medicaid programs are already prohibited from funding abortions. The ruling permits other states to target PP and other safety-net providers, potentially putting affordable access to care in jeopardy for millions of people.
NIH to Phase Out HIV Treatment Guidelines by 2026
On June 21, reports revealed that the National Institutes of Health (NIH) Office of AIDS Research (OAR) would no longer develop and issue federal treatment guidelines for HIV. According to an internal email, OAR claims that “budget decreases and revised priorities” warrant the transfer of programmatic management of the HIV treatment guidelines to another agency within NIH, but a replacement has not been identified. Historically, OAR convened a working group of experts across clinical specialties and public health settings to develop federally approved medical practice guidelines for the treatment of HIV recommended for use by US health care practitioners. The Administration’s sunsetting of OAR’s HIV treatment guidelines follow major changes to NIH programs and priorities that targeted HIV research, including the cancellation of at least 145 grants related to advancing HIV care.
Resources
KFF Fact Sheet: A Closer Look at the Medicaid Work Requirement Provisions in the “Big Beautiful Bill”
“On May 22, the House passed a budget reconciliation bill that includes significant changes to the Medicaid program. The Congressional Budget Office (CBO) estimates the Medicaid work requirement provisions in the House bill would be the largest source of Medicaid savings, reducing federal spending by $344 billion over ten years, and would increase the number of people without health insurance by 4.8 million. On June 16, the Senate Finance committee released proposed reconciliation language with some substantive changes to the Medicaid work requirement provisions, but this language may change as the Senate debates the bill.”
KFF Policy Watch: The Supreme Court Case Examining ACA Preventive Service Requirements: Coverage Preserved for Now but More Challenges May Come
“In its ruling, the Supreme Court held that the structure of the USPSTF does not violate the Constitution’s appointment clause. The Court agreed with the federal government, finding that the HHS Secretary has the power to remove USPSTF members at will and to review the recommendations they issue…While the Court’s decision upholds the current ACA USPSTF coverage requirements, it will likely not be the final word on the preventive services that the ACA requires plans to cover free of cost-sharing. The Trump administration could change the membership of the USPSTF in ways that may significantly alter the recommendations it issues or ask the USPSTF re-consider earlier recommendations that it disagrees with.”
KFF: Medina v. Planned Parenthood South Atlantic: What the SCOTUS Decision Means for Medicaid Enrollees
“Following a June 26 Supreme Court decision in Medina v. Planned Parenthood South Atlantic, KFF examines the opinion and what it means for Medicaid enrollees’ access to health care in states that seek to block Planned Parenthood from participating in their state Medicaid program.”
Hepatitis C Online: HCV Test and Cure Overview
“In this hepatitis C fundamentals 5-hour, highly interactive module, health care providers will develop core proficiency in screening and diagnosing hepatitis C, providing simplified treatment of hepatitis C with direct acting antivirals (DAAs), and assessing for cure. Learners who complete all five lessons in this module may take an optional 20-question knowledge assessment test and earn an HCV Test and Cure Training Certificate.”
News Bulletin
The staggering scale of Donald Trump’s War on HIV funding
“Cuts to HIV funding in the U.S. have been a significant casualty of the Trump administration’s efforts to reduce spending and attack Diversity, Equity and Inclusion (DEI). Researchers behind Grant Watch, an independent third-party database of grants terminated by the NIH and the National Science Foundation, have identified HIV-related funding as one of the most common targets for termination. As of June 17, Uncloseted Media has calculated roughly $1.353 billion in HIV-related terminations in Grant Watch’s NIH database, accounting for more than a third of the $3.7 billion in recorded NIH cuts overall.”
5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization
“Nearly seven months after the fatal shooting of an insurance CEO in New York drew widespread attention to health insurers’ practice of denying or delaying doctor-ordered care, the largest U.S. insurers agreed Monday to streamline their often cumbersome preapproval system. Dozens of insurance companies, including Cigna, Aetna, Humana, and UnitedHealthcare, agreed to several measures, which include making fewer medical procedures subject to prior authorization and speeding up the review process. Insurers also pledged to use clear language when communicating with patients and promised that medical professionals would review coverage denials.”
Doctor who claimed to be current GW University professor leaves RFK Jr.'s vaccine panel
“One of Health and Human Services Secretary Robert F. Kennedy Jr.’s picks for a vaccine advisory panel stepped down before the panel held its first meeting Wednesday. Dr. Michael Ross was one of eight people Kennedy chose for the Advisory Committee on Immunization Practices, or ACIP, after he fired the previous 17 members of the panel. Kennedy said Ross was a clinical professor of obstetrics and gynecology at George Washington University and Virginia Commonwealth University. But News4 found Ross had not worked at either school in years.”