Policy Updates: Hill Happenings and Administration Activities
FY2026 Appropriations
Appropriators are weighing their options to pass a spending package for Fiscal Year 2026 (FY2026) and avoid a government shutdown at the start of the fiscal year on October 1. With limited time remaining to work out a bipartisan spending agreement, Congress will need to advance a continuing resolution (CR) to temporarily extend current spending levels and buy appropriators more time to negotiate on a full-year spending package. Democrats warned Republicans that they would not sign off on a spending package that includes deep spending cuts, raising the potential for a shutdown standoff. Additionally, they called on Republicans to reign in the Office of Management and Budget’s (OMB) aggressive rescissions tactics and uphold the Congressional power of the purse vested by the Constitution.
On September 9, the House Appropriations Committee (HAC) marked up the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS) spending bill, which rejected the Senate’s bipartisan approach and proposed deep spending cuts to health programs, including eliminating HIV prevention funding at the Centers for Disease Control and Prevention (CDC). Notably, the HAC did not opt to include hepatitis funding in the proposal for a consolidated funding line for STIs, tuberculosis, and infectious disease and opioids programs at CDC, instead retaining a dedicated funding line for the CDC Division of Viral Hepatitis and proposing a $10 million increase. NASTAD will monitor progress on the FY2026 spending package and provide more information on spending levels as they are approved.
HHS Secretary Defends his Stewardship of Federal Health Agencies at Senate Finance Committee Oversight Hearing
On September 4, Department of Health and Human Services (HHS) Secretary Kennedy appeared before the Senate Finance Committee to testify at a hearing on the Administration’s health care agenda. The Committee grilled Secretary Kennedy on controversial changes to HHS-wide programming and the overhaul of federal immunization rulemaking bodies and vaccine policy, which the Administration purports will restore trust in public health and streamline federal health work programs and spending. Secretary Kennedy, who champions the Administration’s Make America Healthy Again (MAHA) initiative, drew sharp criticism from Committee Democrats, who called on him to resign over the recent firing of former Centers for Disease Control and Prevention (CDC) Director Monarez. Additionally, a growing number of Committee Republicans joined Democrats to rebuke the Secretary’s dismantling of evidence-based vaccine policy, including Senators Cassidy (R-LA) and Barrasso (R-WY) who warned that access to hepatitis B vaccinations may be in jeopardy. Shortly after the hearing, President Trump defended Secretary Kennedy and praised him for introducing new perspectives and sparking discussions on health policy and public health.
NASTAD Calls on Congress to Pass Cure Hepatitis C Act of 2025
On September 2, NASTAD joined a coalition of nearly 100 organizations and called on Congress to pass the Cure Hepatitis C Act of 2025 (S.1941), a bipartisan bill that would provide unprecedented federal support to boost hepatitis C virus (HCV) treatment access and eliminate the public health threat of HCV in the US. The bill would provide $9.7 billion in funding through 2031 to expand access to rapid screening, treatment, and services to support HCV elimination, including establishing a national drug procurement mechanism that would significantly lower the cost of treatment per patient for certain populations. In addition to reduced HCV morbidity and mortality, the bill is projected to save $6.5 billion in a 10-year budget window. NASTAD, as part of the HCV Elimination Coalition led by the American Association for the Study of Liver Diseases (AASLD), is working closely with key stakeholders and bill sponsors Sens. Cassidy (R-LA) and Van Hollen (D-MD) to pass the elimination bill.
Rep. Waters (D-CA-43) Introduces Legislation to Boost Access to PrEP for HIV and Protect HIV Prevention Programs at CDC
On September 4, Rep. Maxine Waters (D-CA-43) introduced the HIV Prevention Now Act (H.R. 5126) and the PrEP and PEP are Prevention Act (H.R. 5127). The HIV Prevention Now Act would appropriate $2.165 billion in FY2026 for the CDC National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP), including language that would protect HIV prevention funding that the Administration and Congressional Republicans are seeking to eliminate. The PrEP and PEP are Prevention Act would require health insurance plans to cover PrEP and Post-Exposure Prophylaxis (PEP) without out-of-pocket costs, ensuring that these critical services remain accessible amid uncertainty around the future of preventive care recommendations set by the US Preventive Services Task Force (USPSTF). NASTAD endorsed the PrEP and PEP are Prevention Act and applauds Rep. Waters for introducing the life-saving bills.
NASTAD Calls On House E&C Committee to Reauthorize Public Health and Bio-Preparedness Workforce Loan Repayment Programs
On September 8, NASTAD joined a coalition of 86 organizations and called on the House Energy & Commerce (E&C) Subcommittee on Health to quickly take up the Public Health and Bio-Preparedness Workforce Loan Repayment Reauthorization Act of 2025 (H.R.4445). The bipartisan bill, introduced by Reps. Jason Crow (D-CO-06) and Mariannette Miller-Meeks (R-IA-01), would reauthorize public health and bio-preparedness workforce loan repayment programs that support individuals pursuing careers in public health and infectious diseases (ID). The program provides up to three years of loan repayment in exchange for service in rural communities and other areas with health professional shortages, as well as federal facilities like VA hospitals, Ryan White clinics, and community health centers.
HHS Secretary Kennedy Ousts CDC Director, Names New Nominee
On August 27, HHS Secretary Kennedy expelled now-former CDC Director Susan Monarez, sparking widespread criticism and accusations of political interference in federal vaccine rulemaking. Although no reason was given for her termination, Monarez alleges that she was let go due to her refusal to facilitate the Secretary’s efforts to dismantle evidence-based federal vaccine policies and stack the CDC Advisory Committee on Immunization Practices (ACIP) with vaccine critics. Monarez refused to resign and is pursuing legal challenges to the Secretary’s dismissal. HHS quickly tapped HHS Deputy Secretary Jim O’Neill to replace Monarez, who will need to undergo the Senate confirmation process before officially assuming the role of Director. On September 17, Monarez will appear before the Senate Committee on Health, Education, Labor and Pensions (HELP) to testify at an oversight hearing on the recent changes at CDC.
Pivotal CDC Vaccine Advisory Committee to Vote on Potential Updates to HBV Pediatric Immunization Requirements Following Membership Overhaul by Secretary Kennedy
On September 18-19, ACIP will hold a meeting to review current CDC immunization recommendations and decide whether to vote on updates to pediatric vaccine schedules, including the hepatitis B virus (HBV) vaccine. The Committee, whose membership was ousted by Secretary Kennedy and replaced with new members that include vaccine critics, has signaled that it may remove its longstanding recommendation to vaccinate all infants against HBV infection within 24 hours of birth. Significant reductions in HBV morbidity and mortality are attributable to the universal birth dose recommendation, which was officially adopted by CDC in 1991. Public health and hepatitis experts condemned the Committee’s HBV immunization skepticism and highlighted the vaccine’s demonstrated safety and efficacy, urging the Committee not to overlook the significant risk of undermining HBV elimination efforts in the US. HHS will accept public comment through September 13.
HHS Office for Civil Rights Reinforces Religious and Conscience Exemptions from Mandated Childhood Vaccines in Guidance Letter to State Immunization Programs
On September 4, HHS Office for Civil Rights (OCR) issued a Dear Colleague Letter to Vaccines for Children (VFC) Program directors and participating providers that clarifies their obligation to honor federal vaccine exemption requirements on the basis of religious or conscience objections. VCF programs offer safety-net access to pediatric vaccines by covering the cost of immunizations for children who are uninsured, underinsured, eligible for or enrolled in Medicaid coverage, or are American Indian or Alaska Native. HHS issued the guidance to uplift personal liberty in public health programming, citing an unmet need to balance the enforcement of compulsory health services with the protection of individual freedoms. Under federal law, parents may seek exemptions from routine childhood vaccines, including immunization against hepatitis B virus, for sincere and deeply held religious and conscientious beliefs that may be at odds with vaccine administration.
Georgetown University O’Neill Institute:
- Innovative HIV Prevention and Care for People Who Use Drugs (PWUD)
- “Longer-acting medications for HIV treatment and prevention represent a breakthrough moment in the fight against HIV. Current policy proposals and threats to funding for physical, mental and behavioral health, however, place both progress and lives at risk. PWUD, especially PWID, face compounding barriers to care, yet remain central to ending the HIV epidemic. With the right investment in equitable delivery models and policies that include all vulnerable populations, we can close longstanding gaps in HIV outcomes and reduce HIV transmission in this high-risk population.”
- Safe and Affordable Housing Improves HIV Outcomes
- “The U.S. has made major progress at preventing HIV and improving health outcomes for people with HIV. To maintain this progress requires ongoing, stable investments in the range of programs and services that have collectively achieved this success. While attention is appropriately focused on the critical role of health care services, access to safe and affordable housing also is critically important for people with HIV. By maintaining and expanding the HOPWA program as part of comprehensive efforts to improve housing security for all Americans, we can move even closer to ending the HIV epidemic.”
Informed Horizons Education, Inc. (IHE): HEP-DART 2025: Frontiers in Drug Development for Hepatology
Abstracts Due: September 29, 2025
Meeting Date & Location: December 7-11 in Honolulu, Hawai’i
“The DART series is an in-person meeting designed for vibrant scientific presentations and discussion, as well as for new investigators to meet leaders in their field, benefiting from educational feedback on their work.
The aim of HEP-DART 2025 is to assemble clinicians, researchers, basic scientists, nurses and physician assistants together to advance our knowledge of the ongoing drug development processes in the treatment of viral hepatitis (HBV, HCV, HDV, HAV and HEV), metabolic dysfunction-associated steatohepatitis (MASH), fibrosis, and hepatocellular carcinoma (HCC). This CME-accredited workshop will uniquely blend the areas of biology, chemistry, pharmacology and clinical research to provide the scientific community with an increased understanding of the current and future challenges in therapeutics for liver infection, disease and cancer.”
JAMA Network Open: Excess HIV Infections and Costs Associated With Reductions in HIV Prevention Services in the US
“This economic evaluation estimated that if PrEP coverage declined modestly—approximately 3% annually—8618 new infections would fail to be averted in a decade, and the estimated lifetime medical costs of these infections would be $3.6 billion. These findings suggest that changes in policies, especially those that increase out-of-pocket costs of PrEP, risk reversing progress toward ending the HIV epidemic, accruing avertable HIV infections, and incurring additional costs for medical care from avoidable infections.”
In the Fallout From Trump’s Health Funding Cuts, States Face Tough Budget Decisions
“States and local governments have made painful program cuts in the wake of major reductions in federal health funding that have already taken effect. Now, they’re sizing up the financial hits to come — some not until late next year or beyond — from the “One Big Beautiful Bill Act,” the tax and spending law congressional Republicans passed in July that enacts much of President Donald Trump’s domestic agenda. Taken together, the reductions amount to a seismic shift in how state health programs are provided and paid for. The administration is, in effect, pushing a significant amount of health costs to states. That will force their leaders to make difficult choices, as many state budgets are already strained by declining tax revenues, a slowdown in federal pandemic spending, and economic uncertainty.”
Mpox outbreak in Africa is no longer a global health emergency, WHO chief says
“The World Health Organization no longer considers the mpox outbreak in Africa to be an international health emergency, the U.N. agency’s director said Friday. The new form of mpox emerged in early 2024 in Congo and neighboring African countries, spread through close contact including sex. WHO declared it a global health emergency in August of last year.”
Why the medical community is thrilled by U.S. support for a 'breakthrough' HIV drug
“The U.S. announced Thursday that it will make an investment in the new HIV prevention drug called lenacapavir that's been hailed as a "breakthrough" and a "game changer" by the medical community. The Department of State says the aim is to reach up to 2 million people by 2028 with the antiretroviral medication and that this commitment has the potential to save hundreds of thousands of lives. Over the coming months, the U.S. will be working with countries with the largest HIV/AIDS epidemics to develop rollout strategies with a focus on preventing mother-to-child transmission.”