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Appropriations Update

July 14, 2025

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Appropriations Update – The Senate began its work on fiscal year (FY) 2026 spending last week, with the Appropriations Committee completing consideration of the Legislative Branch spending measure and advancing a $7 billion Agriculture-Food and Drug Administration (FDA) measure in a unanimous, bipartisan vote. The bill includes $3.6 billion in taxpayer funding and $3.4 billion in user fee revenue, approximately even with 2025 enacted levels. The bill was considered by the full committee without first going through the subcommittee markup process. House Republicans’ FDA funding bill that was advanced out of committee last month provided a total of $6.8 billion for the agency, in line with the President’s budget request. The Senate’s higher funding level reflects the chamber’s 60-vote threshold and the Democratic support that would be required for passage.

 

While the House of Representatives was in recess last week, the chamber has already successfully cleared the FY 2026 Military-Construction-Veterans Affairs spending measure, as well as the Agriculture-FDA, Defense, Homeland Security, and Legislative Branch bills. Lawmakers are nevertheless expected to rely on a continuing resolution to avoid a federal government shutdown at the end of the fiscal year on September 30 in the absence of a broader government funding agreement. Such stopgap spending measures often serve as a vehicle for health extenders.

 

Senate Panel Advances CDC Nominee  – The Senate Health, Education, Labor, and Pensions Committee advanced the nomination of Susan Monarez to serve as the next director of the Centers for Disease Control and Prevention (CDC) in a 12-11 party line vote on Wednesday. Monarez has worked in the federal government for two decades, most recently serving as the acting director of the CDC after working as the deputy director of the Advanced Research Projects Agency for Health. Opposition to her nomination from panel Democrats appeared to be a referendum on recent actions by U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., and in particular changes made to the Advisory Committee on Immunization Practices. If confirmed by the full Senate, Monarez would be the first person without a medical degree to lead the CDC since 1953. She would also become the first Senate-confirmed CDC director, following a statutory change made in 2022 requiring approval of the CDC director by the upper chamber. A final vote on her nomination on the Senate floor has not yet been scheduled.

 

Senate Approaches Deadline on President’s Rescissions Request – The Senate currently faces a July 18 deadline to pass the White House’s proposed rescissions package, or the President’s request to claw back $9.4 billion in funding will expire and the administration will be required to spend the money as Congress originally intended. Several Senate Republicans, however, have expressed concerns in recent days about the impact of the proposed cuts on global health; the package would rescind $900 million in funding for global AIDS and other international health efforts. Some GOP members have suggested that the proposal will need to be modified in order to garner the support necessary for passage. If the request is revised, it will need to be sent back to the House of Representatives for a final vote. Senate Republicans can afford to lose three GOP votes and still achieve passage with Vice President JD Vance breaking a tie.

 

New GAO Report on Assisted Outpatient Treatment – The Government Accountability Office (GAO) has released a new report on HHS’s management of assisted outpatient treatment programs that receive grants from the Substance Abuse and Mental Health Services Administration (SAMHSA). GAO found that HHS has struggled to assess the results from assisted outpatient treatment programs, under which adults with serious mental illnesses can be ordered by a judge to adhere to community-based treatment.  The report describes the department’s efforts to assess the effects of the grant program on participants’ health and social outcomes, and what the assessments have revealed. Topics studied by HHS include treatment adherence, psychiatric emergency room visits, hospitalizations, and arrests. SAMHSA has awarded approximately $146 million in grants for the program to more than 60 organizations since 2016.

 

Upcoming Congressional Hearings and Markups

House Veterans’ Affairs Subcommittee on Health hearing “Right Time, Right Place, Right Treatment with VA Community Care;” 2:15 p.m.; July 15

 

Senate Homeland Security and Governmental Affairs Permanent Subcommittee on Investigations hearing “Voices of the Vaccine Injured;” 3:00 p.m.; July 15

 

House Energy and Commerce Subcommittee on Health hearing “Legislative Proposals to Maintain and Improve the Public Health Workforce, Rural Health, and Over-the-Counter Medicines;” 10:00 a.m.; July 16

 

Senate Health, Education, Labor, and Pensions Committee nomination hearing to consider Dr. Brian Christine to be Assistant Secretary for Health, Department of Health and Human Services; 10:00 a.m.; July 16

 

Recently Introduced Health Legislation

H.R.4272 — To prioritize health care facilities and mental or behavioral health facilities in the Community Facilities program for fiscal years 2026 through 2031, and allow loans and grants under the program to be used for medical supplies, increasing telehealth capabilities, supporting staffing needs, or renovating and remodeling closed facilities; Sponsor: Underwood, Lauren [Rep.-D-IL-14]; Committees: House – Agriculture

 

H.R.4273 — To amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user fee program for over-the-counter monograph drugs, and for other purposes; Sponsor: Latta, Robert E. [Rep.-R-OH-5]; Committees: House – Energy and Commerce

 

H.R.4277 — To amend Title XIX of the Social Security Act to clarify that rural emergency hospitals are treated as outpatient hospitals for purposes of Medicaid payment, and for other purposes; Sponsor: Davis, Donald G. [Rep.-D-NC-1]; Committees: House – Energy and Commerce

 

H.R.4282 — To amend the Fairness to Contact Lens Consumers Act to modernize verification of contact lens prescriptions, and for other purposes; Sponsor: Griffith, H. Morgan [Rep.-R-VA-9]; Committees: House – Energy and Commerce

 

H.R.4289 — To amend title 10, United States Code, to reduce the distance required for the Secretary of Defense to reimburse travel expenses relating to specialty care, and for other purposes; Sponsor: Vasquez, Gabe [Rep.-D-NM-2]; Committees: House – Armed Services

 

H.R.4299 — To amend title XVIII of the Social Security Act to provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation; Sponsor: Murphy, Gregory F. [Rep.-R-NC-3]; Committees: House – Energy and Commerce; Ways and Means

 

S.2211 — A bill to reauthorize the Special Diabetes Program for Type 1 Diabetes and the Special Diabetes Program for Indians; Sponsor: Collins, Susan M. [Sen.-R-ME]; Committees: Senate – Health, Education, Labor, and Pensions

 

S.2220 — A bill to expand presumptions of exposure by members of the Armed Forces to toxic substances, and for other purposes; Sponsor: Rosen, Jacky [Sen.-D-NV]; Committees: Senate – Veterans’ Affairs

 

S.2225 — A bill to amend title XVIII of the Social Security Act to add physical therapists to the list of providers allowed to utilize locum tenens arrangements under Medicare; Sponsor: Luján, Ben Ray [Sen.-D-NM]; Committees: Senate – Finance

 

S.Res.318 — A resolution recognizing that climate change poses a growing threat to public health and necessitates coordinated action to mitigate its impacts and safeguard the health and well-being of all people in the United States; Sponsor: Markey, Edward J. [Sen.-D-MA]; Committees: Senate – Health, Education, Labor, and Pensions

 

S.2256 — An original bill making appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies for the fiscal year ending September 30, 2026, and for other purposes; Sponsor: Hoeven, John [Sen.-R-ND]; Committees: Senate – Appropriations

 

S.2244 — A bill to require immediate changes to Medicaid relating to alien eligibility and payments to Medicaid expansion States that furnish health care to certain aliens; Sponsor: Paul, Rand [Sen.-R-KY]; Committees: Senate – Finance

 

S.2237 — A bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities, and to require an additional study and report on such flexibilities; Sponsor: Scott, Tim [Sen.-R-SC]; Committees: Senate – Finance

 

H.Res.568 — Recognizing that climate change poses a growing threat to public health and necessitates coordinated action to mitigate its impacts and safeguard the health and well-being of all people in the United States; Sponsor: Barragán, Nanette Diaz [Rep.-D-CA-44]; Committees: House – Energy and Commerce; Natural Resources; Education and Workforce

 

H.Res.573 — Recognizing World Misophonia Awareness Day; Sponsor: Kim, Young [Rep.-R-CA-40]; Committees: House – Energy and Commerce

 

H.R.4309 — To direct the establishment and maintenance of a National Concussion and Traumatic Brain Injury Clearinghouse, and for other purposes; Sponsor: Bacon, Don [Rep.-R-NE-2]; Committees: House – Energy and Commerce

 

H.R.4313 — To amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities, and to require an additional study and report on such flexibilities; Sponsor: Buchanan, Vern [Rep.-R-FL-16]; Committees: House – Ways and Means

 

H.R.4317 — To assure pharmacy access and choice for Medicare beneficiaries, and for other purposes; Sponsor: Carter, Earl L. “Buddy” [Rep.-R-GA-1]; Committees: House – Energy and Commerce; Education and Workforce; Ways and Means

 

H.R.4321 — To direct the Secretary of Defense to develop a strategy for treating traumatic brain injuries through digital health technologies; Sponsor: Crow, Jason [Rep.-D-CO-6]; Committees: House – Armed Services

 

H.R.4331 — To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement; Sponsor: Joyce, John [Rep.-R-PA-13]; Committees: House – Energy and Commerce; Ways and Means

 

H.R.4340 — To require hospitals, medical examiner offices, and coroner offices to report to the Consumer Product Safety Commission with respect to certain incidents involving the death or serious injury of a child, and for other purposes; Sponsor: Mace, Nancy [Rep.-R-SC-1]; Committees: House – Energy and Commerce; Ways and Means

 

H.R.4342 — To amend the 21st Century Cures Act to improve the administration, oversight, and impact of opioid use disorder grants, and for other purposes; Sponsor: McDowell, Addison P. [Rep.-R-NC-6]; Committees: House – Energy and Commerce

 

H.R.4345 — To amend title XVIII of the Social Security Act to expand the definition of critical access hospital under the Medicare program to include certain hospitals on Indian reservations; Sponsor: Newhouse, Dan [Rep.-R-WA-4]; Committees: House – Ways and Means

 

H.R.4350 — To establish a loan program to expand capabilities to manufacture critical materials to secure the United States supply chain, to amend the Internal Revenue Code of 1986 to provide credits for qualified investments into critical material facilities and production credits for manufacturing critical materials, and to authorize cross-cutting research, development, and demonstration activities relating to critical material supply chains, and for other purposes; Sponsor: Stevens, Haley M. [Rep.-D-MI-11]; Committees: House – Ways and Means; Energy and Commerce; Natural Resources; Education and Workforce; Science, Space, and Technology

 

H.R.4353 — To direct the Secretary of Labor to conduct a study on the effectiveness of spending by the Occupational Safety and Health Administration to provide technical assistance and compliance assistance in relation to heat-related illness; Sponsor: Tenney, Claudia [Rep.-R-NY-24]; Committees: House – Education and Workforce