IHPP - Weekly, September 8, 2025

Summary

With twenty-two days until government funding expires, two approaches for addressing fiscal year 2026 appropriations are forming. President Trump and Republican fiscal hawks are in favor of a continuing resolution (CR) to extend funding into the new year or longer, which aligns with OMB Director Russell Vought’s efforts to reduce government funding. On the other side, Republican appropriators and Democrats are pushing for a shorter-term CR, until November or December, which would allow more time to negotiate a bipartisan agreement on government funding. To get Democrats to the negotiating table, Republicans are beginning to consider the possibility of extending the enhanced premium tax credits. Last week, a group of House Representatives, led by Rep. Jen Kiggans (R-VA) introduced the Bipartisan Premium Tax Credit Extension Act, which would extend the enhanced premium tax credits for one year, bypassing next year’s midterm elections. In terms of timing, the House would need to introduce a pass a CR by the end of next week, as Congress will recess from September 22^nd through the 26^th. That would leave the 29^th and the 30^th for the Senate to consider the CR or face a government shutdown.

Regulatory Update

The Trump Administration recently released the Spring 2025 Unified Agenda. The Impact Health team is working on a summary memo that we will soon share.

The Office of Management and Budget (OMB) completed reviewing the following:

• Prescription Drugs: Non-Opioid Analgesics. An FDA notice titled, “Development of Non-Opioid Analgesics for Chronic Pain, Draft Guidance for Industry; Availability.”

OMB is also reviewing the following:

• Medicare:
  • CY 2026 Medicare Advantage/Part D Policy. Final CY 2026 policy and technical changes to the Medicare Advantage, Medicare Prescription Drug Benefit, and Medicare Cost Plan Programs, and PACE
  • CY 2027 Medicare Advantage/Part D Policy. Proposed CY 2027 policy and technical changes to Medicare Advantage, Medicare Prescription Drug Benefit, Medicare Cost Plan, and PACE

• Medicaid:
  • Gender-Affirming Care.
    • A proposed rule titled, “Medicaid Program; Prohibition on Federal Medicaid Funding for Sex Trait Modification Procedures Furnished to Children and Youth.”
    • A proposed rule titled, “Medicare and Medicaid Programs; Hospital Condition of Participation: Limiting Participation Based on the Performance of Sex Trait Modification Procedures on Children.”
  • Immigration Status. A final rule titled, “Medicaid Eligibility Changes Under the Affordable Care Act of 2010; Giving States Freedom to Use Immigration Information to Determine State Residency for Medicaid Eligibility.” The final rule is part of the Trump administration’s efforts to increase federal oversight on states using Federal Medicaid funding for the health care of undocumented immigrants.
  • 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.”

• Prescription Drugs:
  • A notice from the Food and Drug Administration titled, “Safety Labeling Changes–Implementation of Section 505(o)(4) of the Federal Food, Drug, and Cosmetic Act; Draft Guidance for Industry; Availability.”
  • Investigational Drugs. An FDA notice titled, “Expanded Access to Investigational Drugs for Treatment Use: Questions and Answers; Guidance for Industry; Availability.”

• Nutrition:
  • Head Start. A notice from the Administration for Children and Families titled, “Publish Request for Information: Nutrition Services in Head Start Programs