Senate Budget Committee debates Medicaid reforms. Republicans expressed concern that states have been using increased federal matching dollars from Medicaid expansion, provider taxes, and state directed payments to increase their Medicaid budgets without regard to how this impacts the federal government. Meanwhile, Democrats said Medicaid cuts from HR 1 have already resulted in hospital closures in rural districts. Democrats said work requirements enacted in HR 1 were a trap meant to disenroll people, and stringent eligibility requirements will make enrollees wait until they are extremely sick to enroll in coverage. Republicans said frequent redetermination periods save the federal government money by preventing waste and could allow states to use those savings for targeted interventions in areas with provider closures.
During the hearing, Senate Finance Committee Ranking Member Wyden (D-OR) and Sen. Warnock (D-GA) announced that every Senate Democrat signed a letter calling on the Trump administration to repeal the work requirements interim final rule. Late last week, Sen. Wyden and House Energy and Commerce Committee Ranking Member Pallone (D-NJ) sent a similar letter to the Centers for Medicare & Medicaid Services (CMS). Senate Budget Committee Chair Johnson rebutted many arguments used by Democrats after each of their lines of questioning during the hearing. Democrats expressed concern about Chair Johnson running the committee in that way, but he stated he intends to continue responding directly to Democratic arguments.
Senate Finance Committee examines the future of biotechnology. Democrats and Republicans agreed that biotechnology innovation can help address the rising threat of antimicrobial resistance. Both parties emphasized the importance to US national security, particularly because foreign dependence could leave the United States vulnerable during a public health crisis. Witnesses stated that additional incentives are needed to support biotechnology development, particularly for antimicrobials, including payment models that reward value rather than volume of use.
Senate 340B Bipartisan Working Group introduces 340B reform bill. The “Gang of Six” bipartisan group includes Sens. Capito (R-WV), Moran (R-KS), Boozman (R-AK), Baldwin (D-WI), Kaine (D-VA), and Hickenlooper (D-CO). This legislation builds on recent efforts by the group, including a draft bill two years ago that never advanced beyond its release. Since then, the Gang of Six membership has changed, and the current group has been working on legislation for months. The SUSTAIN 340B Act would:
Senate moving to advance continuing resolution. Last weekend, the Senate released a continuing resolution (CR) to fund the government until December 11, 2026. The Senate CR differs from the House version that passed in late July by a 220 – 205 vote. Notably, the Senate version includes a provision to prevent the Office of Management and Budget (OMB) from enacting the regulation proposed earlier this year regarding federal financial assistance. The proposed rule was met with bipartisan criticism and received almost 500,000 public comments.
At the time of publication, a final vote on the Senate CR was still pending. Following passage, the two chambers will need to reconcile differences before finalizing a bill for President Trump to sign into law.
CMS issues Medicaid applied behavior analysis toolkit. The state toolkit aims to strengthen oversight of applied behavior analysis (ABA) services for children with autism in Medicaid and the Children’s Health Insurance Program (CHIP), given concerns about ABA fraud, increased expenditures, and inconsistent clinical practices. CMS notes that ABA Medicaid and CHIP spending between 2021 and 2025 increased by 421%, outpacing the 67% growth in the number of children with an autism diagnosis receiving such services. The toolkit outlines state best practices and includes information on:
Once completing its legislative business this week, the Senate will begin its August recess, joining the House. The House is scheduled to return the week of August 31, 2026, when focus will likely be on debating the Senate-passed CR before the House leaves again for a Labor Day recess. After that, both the House and Senate are scheduled to return to session the week of September 14, 2026. The Check-Up will be on hiatus given congressional recess.
