Appropriations Updates
After clearing initial procedural hurdles last week, Senate leaders worked to advance a minibus package that would combine the Commerce-Justice-Science (CJS) and Agriculture-FDA bills with the Military Construction-VA bill (Politico Pro, subscription required). While the Military Construction-VA bill reached consensus, efforts for a minibus were stalled by the CJS bill, where lawmakers sought several adjustments, including around the future location of the FBI. However, Senate Appropriations CJS Subcommittee Chair Jerry Moran (R-KS) opposed revisiting the issue to avoid potentially losing Republican support.
Last night, Senator Chris Van Hollen (D-MD) objected to a unanimous consent request to move the package forward, holding it up on an amendment requiring the new FBI headquarters to meet certain security standards (BGov, subscription required). While Republicans offered a vote on the amendment, Sen. Van Hollen rejected the offer, effectively halting progress on the package. Lawmakers have warned that the objection likely eliminates any action on the CJS bill this fiscal year. Senate leaders are now weighing whether to move forward by dropping the CJS bill from the package altogether.
Legislative Branch Subcommittee Chair Markwayne Mullin (R-OK) had hoped to move his bill before the August recess, despite opposition from Senator John Kennedy (R-LA). Sen. Kennedy eventually secured a vote to oppose the Legislative Branch bill individually, citing its high cost. As of today, they are aiming to move the Military Construction-VA and Agriculture-FDA bills together, while holding a separate vote on the Legislative Branch bill.
Yesterday, the Senate Appropriations Committee approved both the Defense and the Labor-HHS appropriations bills by a vote of 26-3.
The Defense bill can be found here, and the report here. The Defense bill included $897 million for the Congressionally Directed Medical Research Program.
The Labor-HHS bill increases the NIH’s base budget by $400 million and blocks the administration’s attempt to award multi-year grants upfront unless the same number of grants are issued as in FY 2024. Importantly, it also rejects the administration's proposal to restructure and drastically downsize the Department, and rejects the proposed creation of the new Administration for a Healthy America (AHA).
The Committee also released text for the Labor-HHS bill and the report, which outline topline funding numbers and the committee’s priorities for funding. Below, we've provided a breakdown of the topline numbers for various health agencies.
Administration for Children, Families, and Communities
- Final FY 25 CR: $52.7 billion
- Senate FY 26: $52.2 billion
Administration for Community Living
- Final FY 25 CR: $2.6 billion
- Senate FY 26: $ 2.5 billion
Agency for Healthcare Research and Quality
- Final FY 25 CR: $369 million
- Senate FY 26: $345 million
Agency for Toxic Disease Registry
- Final FY 25 CR: $81.6 million
- Senate FY 26: $81.6 million
Centers for Disease Control and Prevention
- Final FY 25 CR: $9.2 billion
- Senate FY 26: $9.15 billion
Centers for Medicare and Medicaid Services (Program Management)
- Final FY 25 CR: $3.7 billion
- Senate FY 26: $3.7 billion
Food and Drug Administration (Including User Fees)
- Final FY 25 CR: $6.7 billion
- Senate FY 26: $7 billion
Health Resources and Services Administration
- Final FY 25 CR: $8.9 billion
- Senate FY 26: $8.86 billion
Indian Health Services
- Final FY 25 CR: $6.96 billion
- Senate FY 26: $8 billion
National Institutes of Health
- Final FY 25 CR: $46.8 billion
- Senate FY 26: $47.2 billion
Advanced Research Projects Agency for Health
- Final FY 25 CR: $1.5 billion
- Senate FY 26: $1.5 billion
Substance Abuse and Mental Health Services Administration
- Final FY 25 CR: $7.4 billion
- Senate FY 26: $7.4 billion
Hill Updates
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On July 30, the Senate confirmed Susan Monarez as the new director of the Centers for Disease Control and Prevention (CDC) in a 51-47 party-line vote. Director Monarez is a microbiologist and former ARPA-H deputy director, and is the first CDC director without a medical degree in over 70 years. She takes over as the agency undergoes significant staffing losses, proposed budget cuts for FY26, and reorganization that may potentially shift noninfectious disease programs to other parts of HHS. During her confirmation hearing, Director Monarez voiced support for core infectious disease work and aligned with Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.'s vision for the agency.
- Senate Democrats introduced a bill on July 30 to reverse $1 trillion in Medicaid cuts from the reconciliation package and permanently extend Affordable Care Act premium tax credits (Inside Health Policy, subscription required). Democrats warn the cuts would destabilize the health care system, particularly in rural areas. Republicans defended the reconciliation bill, highlighting a $50 billion rural health fund and the Medicaid work requirements.
- The Senate Health Committee advanced the Over-the-Counter Monograph Drug User Fee amendment (OMUFA) reauthorization on Wednesday, July 30, after House passage last week (Inside Health Policy, subscription required). The bill was praised for boosting efficiency with the Federal Drug Administration (FDA), though some raised concerns about implementation challenges after recent FDA staffing cuts. Chair Bill Cassidy (R-LA) also signaled plans to advance legislation supporting non-clinical testing to promote medical innovation.
Administration Updates
- A new JAMA Health Forum study warns that the Trump administration’s proposed 40% cut to NIH funding could stifle innovation, shrink the biomedical workforce, and raise long-term health care costs. Using systems modeling, researchers identified how the cuts trigger negative feedback loops that undermine public health, economic growth, and scientific advancement (Inside Health Policy, subscription required). They highlight that short-term deficit reduction strategies ignore broader consequences, like higher drug prices and reduced preventive care. The study cites NIH’s role in supporting nearly every drug approved in the past decade and generating billions in economic output. They further caution that disinvesting in NIH could deepen federal deficits in the long run by destabilizing the research ecosystem.
- On July 30, the National Institutes of Health (NIH) released a Request for Information (RFI) on maximizing research funds by limiting allowable publishing costs. The RFI outlines several policy options, including disallowing publication costs entirely, capping spending per article or per award, and offering higher limits when peer reviewers are compensated and reviews are made public. The proposed policy would take effect January 1, 2026, applying to all new grants, contracts, and other transactions. The NIH is accepting public comments through September 15, 2025.
- HHS has announced a $100 million pilot funding opportunity aimed at eliminating Hepatitis C (HCV) among individuals with substance use disorder (SUD) and serious mental illness (SMI). The program will focus on communities heavily impacted by homelessness and other co-occurring health issues. The initiative seeks to support integrated care models that prevent, test for, treat, and cure HCV, while also addressing risk factors such as addiction and mental health. State and community-based organizations are eligible to apply.
- Within three months, Dr. Vinay Prasad has stepped down as head of the FDA’s Center for Biologics Evaluation and Research (CBER) (Washington Post, subscription required). Dr. Prasad has previously been open in criticizing public health officials’ handling of the Covid-19 pandemic, which gained favor from conservatives. However, his cautious stance on experimental therapies and past criticisms of President Donald Trump drew scrutiny from other far-right voices, leading to his departure under pressure from the White House.
- Similarly, Dr. Gerald Parker, a more bipartisan pick, has resigned after six months after confusion over his reported, but never formalized, appointment to lead the Office of Pandemic Preparedness and Response Policy (OPPR) (STAT, subscription required).
- The Trump administration secured commitments from over 60 tech and health care companies to improve Medicare data access and build a more connected digital health system. The initiative will focus on chronic disease management, AI tools, and streamlining patient check-in using technologies like QR codes. The Centers for Medicare and Medicaid Services (CMS) is seeking voluntary industry commitments on data sharing and privacy instead of pursuing new regulations.
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The Trump administration is planning a five-year experiment allowing Medicare and Medicaid to voluntarily cover GLP-1 weight loss drugs like Ozempic and Wegovy, in efforts to broaden coverage of these treatments (Washington Post, subscription required). The model will begin in 2026 for Medicaid state plans and 2027 for Medicare Part D plans, and requires participating plans to also provide nutrition and exercise support.
- Earlier this week, billions in funding for NIH research were temporarily suspended after confusion over a memo from the Office of Management and Budget (OMB), which was interpreted as blocking the release of research grant funding. OMB later reversed the decision and clarified that the funds are undergoing a “programmatic review” and will be released. The freeze would have affected an estimated $15 billion in funding set to be distributed by September 30.
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