Congress is back from recess this week, and focus is on the Senate’s consideration of the House-passed reconciliation bill. Much of this work – for example, ensuring that provisions are consistent with the Byrd Rule – will be done behind the scenes. Senate Republicans must strike a delicate balance because they only have a three-vote margin. They will need to reach near-full consensus to pass the bill, while also maintaining enough of the original provisions for it to get through the House again. And they are still trying to get a finished product to the president’s desk by July 4, 2025.
We are still waiting for an official, complete score from the Congressional Budget Office (CBO) and expect it to be released in the next few days. The CBO score will include the interactive effects of the various policies, including updated figures for the deficit and anticipated coverage losses, both of which are likely to be higher than earlier estimates.
Sens. Collins (R-ME), Hawley (R-MO), Justice (R-WV), Moran (R-KS), and Murkowski (R-AK) have spoken out against the effects of various Medicaid provisions in the bill. In contrast, Sens. Johnson (R-WI), Paul (R-KY), Lee (R-UT), and Scott (R-FL) have stated that the bill does not do enough to cut future deficits. We’ll see if the updated CBO analysis brings out more concerns from additional senators.
Senate Democrats are united in opposition to the bill. Over the weekend, Senate Minority Leader Schumer (D-NY) sent an open letter to Senate Democrats outlining their opposition, with concerns about the bill’s Medicaid and Affordable Care Act changes front and center.
The House will be in session beginning on Tuesday and is scheduled to consider H.R. 2483, the SUPPORT for Patients and Communities Reauthorization Act of 2025, in the full House. This bill has always been bipartisan, but it faced Democratic opposition as it moved through the Energy and Commerce Committee this year because of the broader cuts impacting mental health and substance use disorder services being pursued by the Trump administration.
The FY 2026 appropriations process also begins this week. Last Friday, the administration released the budget in brief and additional information to fill out its “skinny budget” submission, but many details are still missing. The Committee on Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies will hold a hearing on Thursday. The major health-related considerations will not happen until later in July, when the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies is scheduled to meet.
The US Department of Health and Human Services (HHS) budget highlights include:
In this week’s Healthcare Preview, Debbie Curtis joins Maddie News to discuss forthcoming CBO scores and what the Senate margin means for ongoing reconciliation discussions.
