Summary
The House and Senate are in recess, and Senate leadership plans on holding preliminary discussions this week to consider any changes to the House-passed version of the budget reconciliation package, the One Big Beautiful Bill Act (H.R. 1), as well as begin vetting the package against the Byrd Rule. This follows President Trump indicating that he expects the Senate to “make the changes they want,” despite the difficulty House Republicans experienced in securing consensus. Senate Republican moderates and conservatives will battle over the same issues as the House, including overall spending cuts and the impact on the deficit, cuts and program changes to Medicaid and the Supplemental Nutrition Assistance Program (SNAP), and the state-and-local-taxes (SALT) deduction cap. Once the Senate is back in session next week, they will be working on an accelerated timeline, as they intend on bringing the bill to President Trump’s desk by July 4.
Regulatory Update
The Office of Management and Budget completed reviewing a prerule titled “Transparency in Coverage.” This regulatory action is likely the recently announced request for information seeking input on how to improve prescription drug price transparency requirements in the Transparency in Coverage (TiC) final rules. Comments are due 30 days after publication of the RFI in the Federal Register (likely late June). OMB is also 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.