Summary
Following the House passing a three-year extension of the lapsed enhanced premium tax credits (EPTCs) last week, in which 17 Republicans joined the Democrats, bipartisan Senators are planning to release their own plan to extend the EPTCs either Tuesday or Wednesday. Sen. Bernie Moreno (R-OH) is leading the Senate effort, which could feature a two-year extension with certain restrictions, with an option for enrollees to accept their subsidy through a health savings account in the second year of the extension. The main sticking point has become abortion funding, with many Republican indicating that they will not support an extension unless it includes a prohibition on subsidies being used to fund abortions in any manner, an issue President Trump has urged Republicans to be more flexible on.
Beyond the EPTCs, Congress continues its work on the fiscal year (FY) 2026 appropriations process. The Senate is expected to hold a vote on the House-passed minibus, which features funding for Energy and Water, Interior and Commerce-Justice-Science, while the House Rules Committee will consider a package that includes funding for Financial Services-General Government, and National Security-State. Full status of the FY 2026 funding bills can be found here.
Regulatory Update
The Office of Management and Budget (OMB) is currently reviewing the following rules:
- ACA Marketplace:
- The HHS Notice of Benefit and Payment Parameters for 2027 proposed rule
- Medicare:
- Procurement of Domestic PPE. An advance notice of proposed rulemaking that would detail program incentives and requirements for Medicare providers and suppliers to invest and phase-in the procurement of American made personal protective equipment (PPE) and essential medicine to secure our nation’s health and safety.
- MA and Part D: Advance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies
- Medicaid:
- State Directed Payments. A proposed rule titled, “Medicaid Managed Care-State Directed 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.”
- Medicaid Tax Waivers.
- A proposed rule titled, “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole.”
- *NEW* A proposed rule titled, “Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes.”
- Anti-Kickback Statute
- *NEW* A proposed rule titled, Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Federal Anti-Kickback Statute and Beneficiary Inducements CMP
- Prescription Drugs:
- A proposed rule titled, “Improving Transparency into Pharmacy Benefit Manager Fee Disclosure” and a proposed rule addressing Transparency in Coverage requirements.
- Health Technology:
- *NEW* A final rule titled, Administrative Simplification: Adoption of Standards for Health Care Attachment Transactions and Electronic Signatures.
- Immigration:
- Unaccompanied Children. An interim final rule titled, “Unaccompanied Children Program Foundational Rule; Update to Include Proof of Identity and Income Verification Standards.”