Appropriations and Budget Updates
Lawmakers on the Hill have yet to decide whether to finalize FY25 appropriations or punt negotiations another three months as government funding is set to expire in less than a month on December 20. Democrats continue to oppose any further stopgap measures and insist on finalizing FY25 appropriations before the end of the calendar year. House Appropriations Committee Ranking Member Rosa DeLauro (D-CT) has stated that she continues to discuss the tight legislative timeline with Chair Tom Cole (R-OK) and Senate Appropriations leaders Patty Murray (D-WA) and Susan Collins (R-ME). Ranking Member DeLauro criticized delaying funding into next year, calling it “madness” and emphasizing the importance of finalizing this fiscal year’s spending bills now. Yet without movement soon, a short-term CR by the December 20 deadline will be inevitable. After all, it typically takes about a month to finalize spending bills once topline agreements are reached—and bipartisan negotiations haven’t even begun.
As funding discussions continue, the Biden administration also formally submitted a $100 billion emergency funding request to Congress to assist communities devastated by hurricanes Helene and Milton. The proposal includes $40 billion for FEMA’s disaster relief fund, plus funding for housing, infrastructure, schools, firefighter pay, and employment support for survivors. FEMA’s Disaster Relief Fund has dwindled to $5.4 billion, raising alarms about imminent funding shortages. Administrator Deanne Criswell has warned that without congressional action on the Biden administration’s $100 billion disaster aid request, the agency could soon limit spending to “immediate needs” only. Lawmakers have expressed bipartisan interest in passing disaster aid, though Speaker Mike Johnson (R-LA) noted that the request would need thorough evaluating.
Meanwhile, Republican lawmakers also continue to lay out an ambitious agenda for next year, with hopes to tackle extending the expiring tax cuts, supercharging domestic energy production, funding the border wall while ramping up immigration enforcement, repealing Biden-era policies with corresponding spending cuts, and downsizing federal agencies.
Hill Updates
- Republican Senators are divided over Robert F. Kennedy Jr.’s nomination as HHS Secretary, with concerns raised about his past vaccine skepticism, views on abortion, and criticisms of the pharmaceutical and agriculture industries. Kennedy’s nomination faces opposition from both pro-life and agricultural groups, though some senators dismiss these concerns, suggesting Kennedy’s views on vaccines have been exaggerated and that states should handle abortion policy.
- Republican lawmakers are pushing for significant restructuring of the NIH, proposing cuts to its institutes and centers, as well as limiting its authority on gain-of-function research and director terms, while President-elect Donald Trump’s nominees support similar reforms. Current NIH Director Monica Bertagnolli defended the agency’s current structure and its commitment to health research, addressing concerns about nutrition, vaccine effectiveness, and scientific integrity amidst a highly politicized climate during a House Appropriations Committee hearing. (Subscription required)
- Senator Bill Cassidy (R-LA), set to chair the Senate HELP committee, plans to focus on bipartisan reforms in areas such as PBMs, drug patent policies, and site-neutral payment policies, while also addressing more contentious issues like transgender care, data privacy, and laboratory-developed tests. His leadership may bring a shift towards regulatory reform, reducing federal oversight in areas like the FDA’s regulation of clinical tests, while also pushing for changes to programs like 340B, expanding access to gene therapies, and tackling healthcare costs through bipartisan efforts. (Subscription required)
- On Thursday, November 21, House Oversight Committee Chair James Comer (R-KY) announced that Representative Marjory Taylor Greene (R-GA), a supporter of President-elect Donald Trump, would lead a new subcommittee focused on government efficiency, aligning with President-elect Trump’s Department of Government Efficiency (DOGE) to cut health funding, staff, and regulations.
Health Policy Updates
- A coalition of in vitro diagnostics stakeholders is urging Congress to pass a bill that limits FDA oversight of laboratory-developed tests (LDTs) to high-risk categories, warning that the final FDA rule could severely impact the industry. The coalition, led by the College of American Pathologists, seeks legislation to provide regulatory certainty, protect patient access, and allow innovation, urging action before the FDA’s rule takes full effect. (Subscription required)
- HHS Secretary-nominee Robert F. Kennedy Jr. and his advisers are considering a significant overhaul of Medicare’s payment system to shift incentives towards primary care and prevention, focusing on revising billing codes that currently favor costly procedures. This move comes as they have expressed concerns about the influence of the American Medical Association in setting payment rates, which many believe skews incentives toward specialty care and exacerbates healthcare costs.
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