Summary
The House and Senate are both in session this week as the House attempts to move forward on passing their FY 2025 budget resolution and the Senate continues working on moving President Trump’s nominees.
Nominations:
This week the Senate Health, Education, Labor and Pensions (HELP) Committee will hold a markup to consider the nomination of Lori Chavez-DeRemer to be Secretary of Labor and will hold a hearing for the nominee to be Deputy Secretary of Labor, Keith Sonderling. The full Senate will vote on Daniel Driscoll’s nomination to serve as secretary of the Army, followed by Jamieson Greer’s nomination for U.S. trade representative.
Budget Reconciliation:
This week, the House is scheduled to bring their Budget Committee’s resolution to the floor, possibly as soon as Tuesday, following Rules Committee action this afternoon. The sweeping House bill includes $4.5 trillion in tax cut extensions, $1.5 trillion in spending cuts, and lifts the statutory debt ceiling by $4 trillion (text/charts). Among the key provisions in the budget, substantial cuts are mandated across several committees. Notably, the Energy and Commerce Committee is tasked with finding at least $880 billion in savings, which could include cuts to Medicaid; the Agriculture Committee must reduce spending by at least $230 billion; and the Education and Workforce Committee is expected to slash $330 billion. At least one Republican has already stated she will vote no on the measure, while many other Republicans have outwardly expressed serious concerns, particularly with projected cuts to the Medicaid program. With only a single vote majority, passage far from certain.
Passing a budget resolution is just the first step in the reconciliation process. Both the House and Senate will need to adopt an identical budget resolution before committees can get to work on drafting the actual budget reconciliation text. The very slim margins in the House are further complicated by the Senate passing a $342 billion “skinny” budget resolution last week that focuses on securing the border ($175 billion), enhancing and revitalizing the nation’s military capacity ($150 billion), and facilitating energy independence by allowing offshore leases for oil drilling. Senator Rand Paul (R-KY) was the only Republican to join all 47 Democrats in voting against the measure. This bill does not address an extension of President Trump’s tax cuts but instead focuses on providing the President with policy wins before taking on the more politically contentious tax debate. Senate leaders have claimed their package is a “plan B” if the House fails to move a comprehensive package.
Hearings
House Oversight and Government Reform: On Tuesday the House Oversight and Government Reform Committee will hold a hearing to examine the Government Accountability Office (GAO)’s 2025 High-Risk List to shine a light on federal programs that are especially susceptible to waste and abuse, as well as identify solutions to ensure the government is working efficiently and effectively.
House Energy and Commerce Committee: On Wednesday the House Energy and Commerce Health Subcommittee will hold a hearing to examine consolidation in the pharmacy benefit manager (PBM) marketplace, focusing on legislative solutions to drive competition and lower costs for patients.
Regulatory Update
The Office of Management and Budget (OMB) is reviewing the following:
- FY 2026 Medicare Payment Rules: Proposed rules updating payments for acute care hospitals and long-term care hospitals, as well as hospice providers. The proposed rules are slated for April.
- ACA Marketplace Program Integrity: A proposed rule likely focused on addressing fraud in Marketplace plans, which has been a primary concern for House Republicans and conservative think tanks, such as the Paragon Health Institute. The proposed rule will likely reverse a number of Biden-era policies related to enrollment and eligibility for premium subsidies, which were promulgated through the annual notice of benefit and payment parameters (NBPP). Peter Nelson, the new head of Center for Consumer Information and Insurance Oversight (CCIIO), identified numerous Biden-era regulations in a report he wrote during his time at the Center of the American Experiment, a conservative think tank. Given the timing of the proposed rule, it seems that the Trump Administration intends for its policies to be finalized and effective before the start of the 2026 Open Enrollment Period on November 1, 2025.