THIS WEEK’S DOSE

• Senate Committees Continue Nomination Hearings. Senate-wide votes have begun as the confirmation process progresses.
• House VA Committee Holds Oversight Hearing on Community Care. Members of the House Veterans’ Affairs (VA) Committee examined Congress’ role in improving veterans’ healthcare.
• White House Revokes Biden-Era Healthcare EOs. The rescinded executive orders (EOs) relate to health equity, prescription drug costs, and artificial intelligence (AI).
• Trump Pauses Regulatory Activity. The pause includes external communications for all agencies.

CONGRESS

Senate Committees Continue Nomination Hearings. The Senate VA Committee held a hearing for VA secretary nominee Doug Collins and subsequently voted for his confirmation with broad bipartisan support. His confirmation vote will now be scheduled for consideration by the full Senate. Russell Vought’s nomination for Office of Management and Budget (OMB) director advanced out of the Senate Homeland Security and Governmental Affairs Committee in an 8 – 7 vote along party lines earlier this week. The Budget Committee held another hearing for Vought’s nomination, where Democrats expressed concerns about potential cuts to Medicaid, especially for low-income and elderly individuals. Republicans focused on the importance of reducing waste, fraud, and abuse in healthcare and advocated against providing care to undocumented immigrants. The Senate Budget Committee will vote on Vought’s confirmation in the coming days, after which his confirmation should be scheduled for consideration by the full Senate.

House VA Committee Holds Oversight Hearing on Community Care. In the hearing, members agreed that Congress has a role to play in improving care for veterans and supporting community care, and expressed concern about the lack of access to VA facilities across the country. Many Democratic members emphasized the need for more hearings on this issue, particularly with witnesses from the VA and third-party VA administrators.

ADMINISTRATION

White House Revokes Biden-Era Healthcare EOs. President Trump was inaugurated on January 20, 2025, and he spent his first day issuing new EOs and revoking others signed into law by former President Biden, 12 of which were healthcare-related. Revoking these EOs has little immediate impact, because additional steps would be necessary to effectuate changes to current policy. The revocations may be indicative of future policymaking, however. Below is a summary of a few key rescinded EOs:

• Strengthening Medicaid and the ACA. This EO directed the US Department of Health and Human Services (HHS) to consider creating a special enrollment period for the health insurance marketplace in response to COVID-19. It also directed HHS and the US Departments of Labor and the Treasury to examine and consider suspending or rescinding policies or practices that may undermine Medicaid, Affordable Care Act (ACA) coverage, or the Health Insurance Marketplace. The EO also revoked two first-term Trump Administration EOs: Minimizing the Economic Burden of the Patient Protection and ACA Pending Repeal, and Promoting Healthcare Choice and Competition Across the United States.
• Lowering Prescription Drug Costs for Americans. This EO directed the Centers for Medicare & Medicaid Innovation Center to consider models that would lower drug costs and promote access to innovative drug therapies for beneficiaries enrolled in the Medicare and Medicaid programs, including models that may lead to lower cost-sharing for commonly used drugs and support value-based payment that promotes high-quality care.
• Safe, Secure, and Trustworthy Development and Use of AI. This EO set forth principles that executive agencies should follow when utilizing AI, including requirements that AI be safe, secure, responsible, and equitable. The EO also established the White House AI Council, which consisted of the assistant to the president and deputy chief of staff for policy, and representatives from various agencies and departments, including HHS.

Through another EO, President Trump started the process of withdrawing the United States from the World Health Organization (WHO), citing mishandling of the COVID-19 pandemic and an inability to demonstrate independence from the political influence of WHO member states. The EO directs OMB and the US Department of State to pause transfer of funds to the WHO and recall any personnel working in any capacity at the WHO.

Trump Pauses Regulatory Activity. As part of the transition, the new Trump Administration issued an EO that paused regulatory activity, including issuance of new proposed rules unless an exemption is provided. While this is typical of a new Administration, memos from department heads have placed more restrictions on third-party and formal communications, even outside of the rulemaking process. For HHS, the “freeze” in regulatory activity is set to run until February 1, 2025.

QUICK HITS

• MACPAC Holds January 2025 Meeting. The Medicaid and CHIP Payment and Access Commission (MACPAC) meeting included discussion related to home- and community-based services, opioid-use disorder treatment, residential services access for children and youth, external quality review for managed care organizations, the transition from pediatric to adult healthcare, and the All-Inclusive Care for the Elderly model.
• President Trump Announces Investment in AI Infrastructure. The president announced the Stargate Project, which is a multibillion-dollar investment by private technology companies. The project’s goal is to create AI infrastructure in the United States and includes a focus on curing diseases.

NEXT WEEK’S DIAGNOSIS

We expect the new Administration to continue to release EOs and take additional actions on healthcare in the coming week. The House will be in recess next week, and the Senate will be in session, with confirmations expected to continue in committees and on the floor. HHS secretary nominee RFK Jr. will appear before the Senate Finance and Health, Education, Labor, & Pensions Committees next week. Other hearings include a Senate VA Committee hearing on the VA’s community care program, and a Senate Aging Committee hearing on fiscal policies related to seniors.