IHPP - Impact Health Weekly, March 30, 2026

Summary

Congress is in a two-week recess, despite failing to fund the Department of Homeland Security. House Republicans passed their own continuing resolution rather than the bipartisan Senate bill that would have funded most DHS agencies (except Immigration and Customs Enforcement and Customs and Border Protection) through September. This means that congressional leaders will need to negotiate an agreement when they return on April 13. As long as lawmakers remain occupied with DHS shutdown, Republicans will not be able to shift their attention to reconciliation 2.0. Still, key House Republicans are beginning to lay out a wish list.

House Republicans: Budget Reconciliation

The conservative Republican Study Committee, which represents a majority of the Republican caucus, is calling for a second reconciliation bill that is “fully paid for with commonsense offsets.” Budget Committee Jodey Arrington (R-TX), an RSC member, has expressed interest in policies that crack down on health care fraud and abuse, which would likely entail reduced health care spending. House Energy and Commerce Committee Chair Brett Guthrie is interested in reworking health care policies that were cut from H.R. 1, including funding for cost-sharing reductions, which CBO estimates would reduce the deficit by $37 billion over 10 years. Any health policies will likely need to serve as offsets, given the anticipated $200 billion request for supplemental defense funding, along with potential funding for ICE and CBP.

Democrats: H.R. 1 Accountability and Proactive Agenda

Meanwhile, Democrats continue to highlight the health care impacts of H.R. 1. Last week, Senate Finance Committee Ranking Member Ron Wyden (D-OR) and House Energy and Commerce Committee Ranking Member Frank Pallone (D-NJ) released their latest report highlighting hospital/clinic closures and service reductions and the tradeoffs people are making to afford health care.

Senate Finance Committee Democratic staff begin office hours this week to collect feedback to inform legislation focused on lowering health care costs and improving health coverage. They are also developing policies to lower prescription drug prices.

New MAHA-Focused Advisory Group at HHS and CMS

Last week, HHS and CMS announced the formation of the Healthcare Advisory Committee, a new federal advisory group of leaders and executives from across the health care system that will advise HHS Secretary Kennedy and CMS Administrator Dr. Oz. The Committee is part of the administration’s Make America Health Again initiative. The first meeting will be later this year. Members will serve two-year terms and provide recommendations focused on:

• Developing actionable policy solutions to prevent and better manage chronic disease;
• Advancing accountability for safety and outcomes while reducing unnecessary administrative burden;
• Expanding the use of real-time data to support a higher quality of care, speed up claims processing, and improve quality measurement;
• Enhancing care for vulnerable populations, including those served by Medicaid; and
• Strengthening Medicare Advantage sustainability, including modernizing risk adjustment and quality measurement.

Litigation Updates

The Supreme Court will hear arguments in Trump v. Barbara, the birthright citizenship case, on Wednesday, April 1 beginning at 9:30am. Live oral arguments can be heard on the Supreme Court’s website here. The 14th Amendment has long been understood to guarantee birthright citizenship;  President Trump signed an Executive Orderhis first day in office asserting the contrary.   The Supreme Court’s ruling – expected to be released in June or July – will determine the constitutionality of the Executive Order.  To date, all lower courts have ruled that the order is unconstitutional and have blocked it from taking effect.

As noted below, moving forward, our Monday morning weekly policy update will include litigation highlights.  Additionally, our team maintains a litigation tracker that is always available to you.  A recent related update is available here.

Regulatory Update

The Office of Management and Budget completed its review of the following:

• Immigration Status. A Department of Labor proposed rule titled, “Improving Wage Protections for H-1B and PERM Employment in the United States.”

OMB is also reviewing:

• Coverage and Payment:
  • Medicaid:

• State Directed Payments. A proposed rule titled, “Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments.” The proposed rule appears intended to advance a presidential memorandum released on June 6, which directs HHS to “eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare, to the extent permitted by applicable law.” On February 27, the title of the proposed rule was revised to include Medicaid FFS targeted Medicaid practitioner payments.
• Medicaid Tax Waivers. A proposed rule titled, “Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes.”

• FY 2027 payment proposed rules for hospitals and long-term care hospitals, inpatient psychiatric facilities, hospice facilities, and skilled nursing facilities.
• Medicare Advantage:
  • Policy and Technical Changes. The Contract Year 2027 Policy and Technical Changes to Medicare Advantage, Medicare Prescription Drug Benefit, Medicare Cost Plan, and Programs of All-Inclusive Care for the Elderly Programs final rule.
  • Payment: Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies (the “CY 2027 Rate Announcement”) notice.
• No Surprises Act. A final rule titled, “Independent Dispute Resolution Operations.” The long-awaited rule was proposed in November 2023 by the Biden Administration.

• Prescription Drugs
  • Prior Authorization. A proposed rule on interoperability standards and prior authorization for drugs.
  • Price Negotiation. A proposed rule titled, “Medicare Drug Price Negotiation Program.”

• Oversight and Integrity
  • Fraud and Abuse. A proposed rule titled, “Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).”
  • Accrediting Organizations. A final rule titled, “Strengthening Oversight of Accrediting Organizations (AO), Burden Reduction, and Related Provisions.”

• Nutrition
  • Work Requirements. A proposed rule titled, “Supplemental Nutrition Assistance Program: Modification to Work Requirements for Able-Bodied Adults.”
  • Categorical Eligibility. A proposed rule titled, “Supplemental Nutrition Assistance Program: Reforming Categorical Eligibility.”
• Other Topics:
  • An interim final rule titled, “Unaccompanied Children Program Foundational Rule; Update to Include Proof of Identity and Income Verification Standards.”
  • Medication-Assisted Treatment. A final rule titled, “Implementation of the SUPPORT Act: Dispensing and Administering Controlled Substances for Medication-Assisted Treatment.”