Summary
Last night, the House Budget Committee reconvened its vote and advanced the budget reconciliation package, by a vote of 17-16, with the Republican holdouts, Reps. Chip Roy (R-TX), Josh Brecheen (R-OK), Ralph Norman (R-SC) and Andrew Clyde (R-GA.), voting ‘present’ to allow the bill to proceed. Prior to the vote, it is reported that discussions were had regarding moving up the implementation of work requirements from 2029 to 2027, with more Conservative members still pushing for changes to the Federal Medical Assistance Percentage (FMAP). During the reconvening, the Committee rejected the following motions:
- Rep. Balint’s motion to amend the bill by striking all provisions the Congressional Budget Office (CBO) estimates would increase the number of Americans without health insurance;
- Rep. Amo’s motion to amend the bill by adopting Donald Trump’s own proposal to raise the income tax rate on millionaires;
- Rep. McGarvey’s motion to amend the bill by removing all provisions CBO projects would reduce participation in the Supplemental Nutrition Assistance Program (SNAP); and
- Rep. Jayapal’s motion to add a point of order prohibiting the use of a current policy baseline to mislead the public about the true cost of Republican tax cuts in the final reconciliation package.
It is expected that manager’s amendment of the bill will be presented for House Rules Committee consideration on Wednesday at 1:00 am, in which the Committee will aim to advance the package and set the ground rules for floor debate. It is the goal of Republican leadership to bring the bill to the floor on Thursday and indicated that members will not be allowed to go home for Memorial Day until the package is approved by the House.
Congress will then be in recess until after Memorial Day. The Senate returns on June 2, which will mark the beginning of its work on the reconciliation package, including the “Byrd Bath,” in which the Senate Parliamentarian will determine which provisions break the Byrd Rule. Where the House side has members pushing for the bill to go farther on overall spending cuts and Medicaid, many moderate Senators have expressed opposition to such an approach, and will seek to temper the included Medicaid cuts. The overall goal remains to have the budget reconciliation package on the President’s desk by July 4.
FDA MAHA Updates
Last week, the Food and Drug Administration (FDA) announced several updates to “Make America Healthy Again” (MAHA) workstreams.
- FDA initiated action to remove concentrated ingestible fluoride prescription drug products for children from the market. FDA reasons that these products are swallowed and ingested unlike toothpaste and fluoride rinses, which they are concerned may impact the developing gut microbiome. The Center for Drug Evaluation and Research will look at evidence about systemic fluoride exposure from ingestible prescription products with a goal date of October 31 for completion.
- FDA launched a systematic review process for food chemicals already on the market. The agency will release a draft for public comment soon. FDA will also expedite its review of chemicals currently under review and will share the status of its work on a public website.
- FDA announced that it will hold a roundtable discussion with an independent panel of scientific experts to discuss the safety and necessity of talc in food, drug, and cosmetic products. This will be held on Tuesday, May 20th and will be open to the public.
Regulatory Update
The Office of Management and Budget is reviewing the following:
- Proposed CY 2026 payment updates for physicians, hospital outpatient departments and ambulatory surgical centers, home health agencies, and end-stage renal disease facilities. These proposed rules are typically published in June or July.
- ACA Marketplace. A final rule with a series of proposals intended to address improper enrollments in Marketplace coverage and reduce improper federal spending on advanced premium tax credits (IHPP summary). If finalized as proposed, 750,000 to 2 million fewer individuals would enroll in Marketplace coverage in 2026.
- A prerule titled “Transparency in Coverage,” likely with proposed changes to health plan price transparency requirements. The prerule would implement President Trump’s executive order directing the Departments of Treasury, Labor, and Health and Human Services to strengthen price transparency requirements (IHPP summary). At the prerule stage, agencies typically submit an “Advanced Notice of Proposed Rulemaking” to allow the public the opportunity to comment on whether or not a rulemaking should be initiated.