THIS WEEK’S DOSE
- CBO releases final scores for OBBBA. The Congressional Budget Office (CBO) estimates that the One Big Beautiful Bill Act (OBBBA) will increase the uninsurance rate by 10 million individuals over 10 years.
- House Energy and Commerce Oversight Subcommittee discusses organ transplant system reform. There was bipartisan agreement that reforms to the organ procurement and transplant network (OPTN) are necessary.
- Senate Finance Committee considers HHS assistant secretary for family support nomination. The hearing primarily focused on Alex Adams’ views of the foster care system and the Head Start program.
- House Ways and Means Health and Oversight Subcommittees examine MA. Both Democrats and Republicans highlighted the increase in Medicare Advantage (MA) enrollment while noting concerns about the program.
- President Trump releases AI action plan, signs AI EOs. The action plan and executive orders (EOs) detail this administration’s views on artificial intelligence (AI).
CONGRESS
CBO releases final scores for OBBBA. CBO estimates that OBBBA will increase the uninsurance rate by 10 million individuals by 2034. This is a decrease compared to CBO’s preliminary estimate that 11.8 million more individuals would be uninsured, mainly attributed to the Senate’s elimination of a provision that would have financially penalized states that cover undocumented immigrants. CBO estimates that the bill will cut almost $1 trillion in federal Medicaid spending, with the largest spending reductions coming from the work requirements, provider taxes, and state directed payments policies.
The House Committee on Ways and Means hosted field hearings this week to promote OBBBA. The committee is in Las Vegas, Nevada, on July 25, 2025, and will be in Simi Valley, California, on July 26, 2025.
In related news, Senate Finance Committee Democrats released a fact sheet detailing changes OBBBA makes to the Marketplace and the enhanced advanced premium tax credits (APTCs). The fact sheet also highlights the implications of not extending the enhanced APTCs, which are set to expire at the end of 2025.
House Energy and Commerce Oversight Subcommittee discusses organ transplant system reform. The hearing follows reports of patient safety concerns and a US Department of Health and Human Services (HHS) announcement of actions taken to improve safety and oversight of organ procurement organizations. During the hearing, there was bipartisan concern over the current state of OPTN and agreement on the need for reform. Republicans emphasized the need for clearer protocols on donation after circulatory death and improved whistleblower protections, while Democrats highlighted racial disparities in organ allocation and advocated for stronger federal oversight. Witnesses included the chief of the Organ Transplant Branch at the Health Resources and Services Administration and leaders within OPTN. They stressed the importance of collaboration, transparency, and restoring public confidence, while also clarifying limitations in oversight authority.
Senate Finance Committee considers HHS assistant secretary for family support nomination. During the hearing, Republicans voiced their support for Alex Adams, PharmD, and discussed the need to improve the foster care system. Democrats raised concerns about his nomination and questioned his views on Head Start funding and his alignment with President Trump and HHS Secretary Kennedy. Adams detailed how he would improve the foster care system and his experience as director of the Idaho Department of Health and Welfare. If confirmed, Adams will lead the Administration for Children and Families.
House Ways and Means Health and Oversight Subcommittees examine MA. Members of both parties raised concerns about MA, including prior authorization, risk adjustment practices, higher spending compared to traditional Medicare, and challenges faced by rural providers. Some members noted the high percentage of their constituents enrolled in the program and the value of supplemental benefits. Witnesses had differing views on the program, with some urging more oversight and others stressing the importance of MA plans in providing coverage with low premiums and supplemental benefits.
ADMINISTRATION
President Trump releases AI action plan, signs AI EOs. The action plan was released on July 23, 2025, in conjunction with a new government webpage devoted to AI, and has specific healthcare recommendations:
- Private sector AI adoption. The National Institute of Standards and Technology should work with agencies, including the US Food and Drug Administration (FDA), to establish AI centers of excellence where researchers, startups, and established enterprises can rapidly deploy and test AI tools while committing to open sharing of data and results.
- Deregulation. The Office of Science and Technology Policy should launch a request for information about current federal regulations that hinder AI innovation and adoption.
- State AI regulation. Federal agencies that have AI-related discretionary funding programs should consider whether a state’s AI regulatory environment would hinder the effectiveness of that funding. A similar policy appeared in preliminary versions of OBBBA but was not included in the final package.
- Diversity, equity, and inclusion. The administration should update federal procurement guidelines to ensure that the government only contracts with frontier large language model (LLM) developers that ensure their systems are “objective and free from top-down ideological bias.”
The same day, President Trump signed three AI EOs:
BIPARTISAN LEGISLATION SPOTLIGHT
| Democratic and Republican lawmakers introduce hospital at home extension. The Hospital Inpatient Services Modernization Act, H.R. 4313/S. 2237, would extend the Hospital at Home Waiver program for five years. Sens. Scott (R-SC) and Warnock (D-GA) and Reps. Buchanan (R-FL), Smucker (R-PA), and Evans (D-PA) introduced the legislation. The program was created during the COVID-19 pandemic to facilitate at-home hospital care in Medicare and is currently set to expire after September 30, 2025. Read the press release here. |
QUICK HITS
- HHS adopts ACIP recommendation to remove thimerosal from flu vaccines. At the June Advisory Committee on Immunization Practices (ACIP) meeting, the committee voted 5 – 1 – 1 to remove thimerosal, a mercury-based preservative, from influenza vaccines used in the United States. The ACIP vote and subsequent HHS action follows HHS’s move to retire and replace ACIP members.
- FTC holds listening session on lowering drug prices. This was the second of three Federal Trade Commission (FTC) listening sessions, called for by the “Lowering Drug Prices by Once Again Putting Americans First” EO. The event focused on formulary and benefit practices used by drug manufacturers and pharmacy benefit managers.
- Senate HELP Committee advances HHS assistant secretary nomination. The Senate Health, Education, Labor, and Pensions (HELP) Committee advanced Brian Christine’s nomination for HHS assistant secretary for health by a 12 – 11 party-line vote. Last week, the committee held a hearing to consider his nomination, during which Democrats focused on the impacts of OBBBA and HHS restructuring and Republicans touted Christine’s experience.
- House Energy and Commerce Committee advances OMUFA reauthorization. In a unanimous vote, the committee advanced H.R. 4273, the Over-the-Counter Monograph Drug User Fee Amendments (OMUFA), to modify and extend the user fee program for five years. OMUFA is currently set to expire September 30, 2025.
- 21 Democratic attorneys general file lawsuit against HHS immigration guidance. The lawsuit alleges that the HHS plan to prohibit certain immigrants from specified programs is unlawful.
- Senate confirms DEA administrator. In a 50 – 47 party-line vote, Terrance Cole was confirmed as the next US Drug Enforcement Administration (DEA) administrator. He most recently was the Virginia secretary of public safety and homeland security, and he worked at the DEA for more than 20 years.
- FDA announces new head of the FDA Center for Drug Evaluation and Research. George Tidmarsh, MD, PhD, is a pediatric oncologist and previously worked for pharmaceutical companies and at Stanford University.
- Senate HELP Committee Chair Cassidy questions providers, insurers on gender-affirming care. Chair Cassidy (R-LA) sent letters to provider and insurance associations requesting information about their policy and guidelines related to gender-affirming care. Responses are due August 7, 2025.
- FDA, HHS, USDA request information on ultra-processed foods. The FDA, HHS, and US Department of Agriculture (USDA) request for information follows the Make America Healthy Again Commission report, which focused on the impact of ultra-processed foods on chronic diseases. Comments are due on September 23, 2025, and you can read the press release here.
- FDA launches Regulatory Accelerator for digital health devices. The initiative provides FDA resources to digital health companies seeking FDA review of their medical devices. The initiative follows previous FDA efforts to accelerate review of drugs and devices, including the Commissioner’s National Priority Voucher program.
NEXT WEEK’S DIAGNOSIS
The House kicked off its August recess one day early after Republican leaders were unable to quell efforts to release the Epstein files that effectively shut down most legislative business on the House floor. Representatives will spend the rest of the summer in their districts and will return to Washington, DC, after the Labor Day holiday.
The Senate will be in session next week, and focus will be on fiscal year (FY) 2026 appropriations bills and confirming additional Trump nominees. Next week is scheduled as the last in-session week for the Senate before its August recess, but Majority Leader Thune (R-SD) could hold members in town for a few more days to continue nominations work. On the healthcare front, the Senate HELP Committee on July 30, 2025, will mark up the OMUFA reauthorization and the Improving Care in Rural America Reauthorization Act of 2025. On July 31, 2025, the HELP Committee will hold a hearing on making healthcare more affordable.
On the regulatory front, we await release of the FY 2026 Inpatient Prospective Payment System final rule.
