Summary
Congress is in recess for one more week before it resumes on April 28th and begins in earnest its reconciliation work. The House Energy and Commerce Committee is expected to mark up its portion of the package, including any Medicaid provisions, on May 7th. House Republican leadership is also tentatively planning a vote on President Trump’s recission package, which includes $9.3 billion in cuts to the State Department, NPR, and PBS, the week of May 5th.
Leaked HHS Budget
Last week, a pre-decision version of the Department of Health and Human Services (HHS) 2026 Discretionary Budget Passback was leaked by several news outlets. While not official, it provides a first-look at potential HHS priorities under the Trump Administration. Highlights from the leaked budget include the following:
- Budget cuts: The proposed budget includes cutting the HHS budget by $40 billion. The National Institutes of Health (NIH) budget would be cut by 40 percent, and the Food and Drug Administration (FDA) budget would be cut by 18.6 percent, but would maintain user fees.
- Agencies and programs to be eliminated: The Health Resources Services Administration (HRSA), the Administration for Community Living (ACL), the Substance Abuse and Mental Health Services Administration, the Agency for Healthcare Research and Quality (AHRQ) and the Administration for Strategic Preparedness and Response (ASPR) would be eliminated and some components of these would be absorbed into the Administration for a Healthy America (AHA). Additionally, leaked budget would also eliminate the following programs across HHS:
- Maternal and child health programs: autism and other disorders, healthy start, newborn screening for heritable disorders, sickle cell service demonstrations, universal newborn hearing screening, teen pregnancy prevention (TPP) program, the Office of Population affairs, and embryo adoption awareness campaign.
- Mental health programs: crisis response grants and certified community behavioral health centers.
- HRSA, CDC, and OASH programs: rural hospital flexibility grants, state office of rural health, rural residency development program, at-risk rural hospitals program grants, family planning, Hansen’s disease facilities, youth violence prevention, adverse childhood experiences (ACEs), firearm injury and mortality prevention research, traumatic brain injury, drowning, elderly falls, other injury prevention activities, and injury control research centers.
April 19th Deregulatory Deadline
Pursuant to President Trump’s Executive Order (EO) “Unleashing Prosperity Through Deregulation” agencies were required to submit their deregulatory plans to the Office of Management and Budget (OMB) by April 19th. A recent presidential memo further stated that agencies could begin repealing any unlawful regulation without notice-and-comment requirements and to complete a review of such regulations also by April 19th. Other deregulatory actions include the following:
- OMB request for information (RFI) on federal regulations that are unnecessary, outdated, or excessively burdensome (Impact Health summary). Comments are due May 12.
- DOJ RFI on laws and regulations that stifle competition in sectors like housing and health care (Impact Health summary). Comments are due May 26.
- CMS RFI on opportunities to streamline Medicare regulations and reduce administrative burdens for providers and plans (Impact Health summary). Comments are due June 10.
Braidwood Management vs Kennedy
Today, the Supreme Court of the United States will hear Braidwood Management’s challenge against the U.S. Preventive Services Task Force (USPSTF) recommended preventive services coverage requirement under the Affordable Care Act (ACA). The Supreme Court is narrowly considering whether the USPSTF violates the Constitution’s Appointments Clause. The Trump Administration is continuing with the Biden Administration defense, stating that the USPSTF is under the authority of the HHS Secretary, who can appoint and remove task members at will, and create regulations to approve recommendations before becoming required for insurers. If the Supreme Court rules in favor of Braidwood, private insurers would no longer be required to cover USPSTF-recommended services at no cost sharing. Additional details on the case can be found here.
Regulatory Update
The Office of Management and Budget is reviewing a proposed rule titled, “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole.”
Additionally, CMS is seeking public comment on plans to update the State Plan Amendment template to reflect that the medication assisted treatment Medicaid benefit was made permanent under the Consolidated Appropriations Act, 2024 (CAA, 2024). Comments are due on April 30th, 2025.