Congress Debates Government Funding. In advance of the March 14, 2025, government funding deadline, House Republicans on March 8 released a 99-page CR to fund the government through September 30, 2025, the end of the fiscal year (FY). The CR includes short-term extensions of healthcare programs and provisions, including Medicare telehealth flexibilities and community health center funding, through September 30. The legislation includes increases in defense spending and cuts to nondefense spending, including a 50% cut to the Congressionally Directed Medical Research Programs (CDMRP) within the US Department of Defense. CDMRP funds biomedical research on conditions such as cancer, Alzheimer’s disease, and autism.
The CR does not include a Medicare physician payment fix or additional bipartisan health provisions, such as pharmacy benefit manager reform, from the December 2024 bipartisan healthcare package, which has been reintroduced by Sens. Wyden (D-OR) and Sanders (I-VT). Rep. Murphy (R-NC), Co-Chair of the GOP Doctors Caucus, originally said he would oppose the CR if it did not include the so-called doc fix. However, the caucus received a commitment from Republican leadership to include a doc fix in the upcoming budget reconciliation bill, so Rep. Murphy supported the CR.
On March 11, 2025, the House passed the CR mostly along party lines in a 217 – 213 vote. Rep. Golden (D-ME) joined Republicans in voting yes, and Rep. Massie (R-KY) joined Democrats in voting no. In the Senate, the bill needs 60 votes to overcome a procedural hurdle, known as cloture, before final passage, necessitating support from Democrats. Senate Minority Leader Schumer (D-NY) initially pushed back and said Democrats would seek a separate vote on a clean, shorter-term CR that would allow appropriators to finish the full slate of FY 2025 bills. Schumer later reversed and stated he and other Senate Democrats would vote yes on the cloture vote to avoid a government shutdown. As of the time of this publication, votes have not yet occurred, but the cloture vote and subsequent vote on final passage are expected to occur today, which would avert a government shutdown and complete the FY 2025 appropriations process.
Senate HELP Committee Advances NIH, FDA Nominations, Meanwhile White House Pulls CDC Director Nomination. The Senate Health, Education, Labor, and Pensions (HELP) Committee voted on the nominations of Jay Bhattacharya, MD, for NIH director and Martin Makary, MD, for FDA commissioner. The committee held its nomination hearings last week. Bhattacharya advanced with a vote of 12 – 11 along party lines. Makary advanced with a vote of 14 – 9, with Sens. Hassan (D-NH) and Hickenlooper (D-CO) joining Republicans. Both nominations now move to the full Senate floor, where they are expected to be confirmed. Sen. Hawley (R-MO) expressed concern over Makary’s initial support of Hilary Perkins as FDA chief counsel. Perkins previously worked for the US Department of Justice under President Biden and defended that administration’s abortion and vaccine policies. Sen. Hawley noted that Makary withdrew his support for Perkins, who resigned on March 13, 2025, only two days after becoming FDA chief counsel.
On the morning of Dave Weldon’s scheduled Senate HELP Committee nomination hearing for CDC director, the White House suddenly withdrew his nomination. Weldon was previously a US representative from Florida. He has been subject to significant scrutiny for his views on vaccines, and there have been rumors for some time that his nomination could be withdrawn. At the time of publication, President Trump had not yet announced a new CDC director nominee.
Senate Finance Committee Holds CMS Administrator Nomination Hearing. The Senate Finance Committee held its nomination hearing for Mehmet Oz, MD, to be administrator of CMS as this issue went to press.
House Oversight Committee Holds Hearing on Preventing Improper Payments and Fraud. The hearing included three witnesses who discussed the prevalence of fraud broadly across federal spending, including in Social Security and Medicaid. Members of both parties expressed interest in working together to address waste, fraud, and abuse, but Democrats emphasized the importance of Medicaid and ensuring it remains accessible. Republicans highlighted the Department of Government Efficiency’s role in addressing waste, fraud, and abuse.
House Ways and Means Committee Examines Access to Medicare Post-Acute Care. During the hearing, Democrats predominantly focused on the impact that potential cuts to Medicare and Medicaid (under discussion as part of the ongoing budget reconciliation process) would have on long-term care hospitals and skilled nursing facilities. Republicans focused on the burden of prior authorization for beneficiaries and the impact of workforce shortages on access to care. Both members and witnesses discussed the importance of Medicare telehealth flexibilities in home health and hospice care and the proposal to create a single Medicare payment system for all post-acute care providers.
Senate Aging Committee Discusses Solutions to Senior Loneliness. Witnesses for the hearing included individuals from organizations that provide social services to seniors. Members of both parties expressed concern about senior loneliness and its impact on health outcomes. Both members and witnesses expressed support for the Social Engagement and Network Initiatives for Older Relief (SENIOR) Act and the Older Americans Act. There was discussion about the cost burden of senior loneliness on Medicare and Medicaid.
CMS Issues ACA Marketplace Integrity and Affordability Proposed Rule. CMS issued a proposed rule on March 10, 2025, that would undo Biden-era policies designed to enhance enrollments through the Marketplace. Key proposals include the following:
The policies would have varying effective dates, some as early as immediately upon implementation, but the proposed rule specifically requests input on implementation timelines. There is a 30-day comment window that ends April 11, 2025. Click here for the press release, and here for the fact sheet.
CMMI Releases Statement on Strategic Direction. On March 12, 2025, CMMI stated that it plans to announce a new strategy focused on choice, competition, consumer empowerment, and evidence-based practices. CMMI will also work to streamline payment models, and some models will end early on December 31, 2025, with participants transitioning to other models. CMMI subsequently announced that the Maryland Total Cost of Care, Primary Care First, ESRD Treatment Choices, and Making Care Primary models will end early. CMMI is considering options to reduce the size of the Integrated Care for Kids model, and the Medicare $2 Drug List and Accelerating Clinical Evidence models will not be implemented. CMMI estimates that ending these models will save taxpayers approximately $750 million but doesn’t spell out how those savings will be realized. Read more about what’s next for value-based care under the Trump administration here.
OCR Announces Investigations into Four Medical Schools and Hospitals. The HHS Office for Civil Rights (OCR) stated that four medical schools and hospitals provide medical education and training that discriminates on the basis of race, color, national origin, or sex. OCR alleges that the institutions are in violation of Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act. The announcement states that the action aligns with President Trump’s executive order “Ending Illegal Discrimination and Restoring Merit-Based Opportunity.” The institutions subject to the investigation are not officially identified. For more details, please see this article by our McDermott Will & Emery colleagues.
Federal Judges Rule Agencies Must Reinstate Fired Probationary Employees. On March 13, 2025, two federal judges ruled that certain federal agencies must reinstate fired probationary employees. The first judge’s order applied only to six agencies, while the second judge’s order applied to 18 agencies, including HHS. Both judges ruled that the firings by the Office of Personnel Management were unlawful. The Trump administration is likely to appeal the decisions. Other efforts by the Trump administration to shrink the federal workforce, including a reduction in force, will likely continue.
| Reps. Matsui (D-CA) and Bilirakis (R-FL) and Sens. Klobuchar (D-MN) and Wicker (R-MS) reintroduced the Scientific External Process for Educated Review of Therapeutics Act of 2025. The legislation would require the FDA to convene quarterly externally-led scientific-focused drug development meetings to discuss the development and review of rare disease treatments. |
The House and Senate are both scheduled to be in recess next week and return March 24, 2025. After the federal government is funded, Republicans will return their attention to the budget reconciliation process. Votes to confirm President Trump’s nominees are also expected to continue in the Senate when members return.
