Public Policy

Health Care Policy Press

Politico Pro (4/10/2026): Trump's budget hawk is still trying to slash medical research. Congress is saying no. – White House budget director Russ Vought isn’t done trying to cut the National Institutes of Health's funding, but Congress isn’t taking him seriously anymore. Vought released a proposal last week to slash the 2027 budget for the world’s largest funder of health research by 10 percent, down from 40 percent last year. It's unlikely Congress or the agency’s head will listen to him. Lawmakers rejected Vought’s first big cut in the spending bill they passed in February and already promised to reject the smaller one this year. While Vought has succeeded in trimming spending at some other agencies, the NIH has proven a hard target because lawmakers have a symbiotic relationship with the agency. Most of the money they dole out is returned to their states for disease research, clinical trials and other medical advances — plus photo-ops with researchers boasting about their breakthroughs are a win with voters. The health research agency’s director, Jay Bhattacharya, is expected to defend the budget to Congress, but it’s unclear whether he stands behind cuts to his agency any more than Congress does. While other agencies, like the State Department, defied Congress and implemented Vought’s cost-cutting vision by not spending their budgets last year, Bhattacharya spent every dollar Congress gave him. Vought, considered one of the most powerful budget directors in recent history, held the same position during Trump’s first term. He’s used his second go-around to aggressively wield his budget tools to act as a chokepoint on government spending. But the NIH is likely to illustrate the limits on his power.

Stat (4/8/2026): Trump administration drops court fight to cap NIH payments for research overhead costs - The Trump administration will not be asking the Supreme Court to take up its fight to slash federal support for funding that the nation’s science enterprise relies on for basic operating costs. The deadline to do so came and went this week without a petition from Trump’s Department of Justice, effectively ending the 14-month standoff over a controversial policy to drastically reduce the rate of reimbursement for “indirect costs” on federal grants.  The legal battle between the administration and the research community started last February, when the National Institutes of Health abruptly announced it would cap payments for research overhead at 15%. Three lawsuits opposing the caps were immediately filed by state attorneys general and organizations representing private and public universities, hospitals, and academic medical centers.  Under the previous policy, these institutions would negotiate with the NIH for individual rates — to cover expenses not directly linked to the goals of a particular project, like facility upkeep and salaries for grant management staff. Many of the nation’s most elite research institutions typically receive 50% or more of their direct research expenses to cover indirect costs. The new cap was likely to cause immediate harm, the lawsuits argued, including forcing universities to close labs, cancel clinical trials, and lay off researchers. In April, a federal judge in Massachusetts agreed, ruling that the NIH likely violated several federal statutes in making the sudden change. The judge issued a permanent injunction, replacing an earlier restraining order that had halted the NIH plan three days after it was announced on February 7.

Politico Pro (4/6/2025): Trump admin finalizes $13B boost to private Medicare plans for 2027 - The Trump administration will boost payments to private Medicare plans by 2.48 percent in 2027, or about $13 billion — a sizable jump from the less than 1 percent pay increase officials initially proposed for the private plans. The increased pay rate is a win for private health insurers, who had extensively lobbied the Trump administration to increase the modest pay bump it proposed in January. They argued the roughly $700 million increase for 2027 would not keep pace with seniors’ rising medical costs and would force insurers to cut benefits. Centers for Medicare and Medicaid Services officials said they received more than 40,000 comment letters — a record number — on the proposed rule, which helped inform the changes in the final rate notice, published Monday. More than 10,000 of those letters were connected to Medicare Advantage Majority, an advocacy group, according to KFF Health News. After CMS posted the final rule Monday afternoon, major Medicare Advantage insurers’ stocks soared.

Politico Pro (4/3/2026): White House budget proposes billions in cuts to health programs - President Donald Trump is pitching a more-than-12 percent cut to federal health agencies in the second budget of his second term, calling for the elimination of “bloated, woke, and inefficient programs that do not advance” the goal to “Make America Healthy Again.” His fiscal 2027 budget released today proposes a more-than-$15 billion reduction in discretionary spending, and does not include changes to Medicare, Medicaid and most other mandatory health programs that may be included in a future reconciliation bill the White House has called for. Still, the budget lays out the administration’s continued desire to shrink the federal workforce and reduce spending on research, public health and safety net programs. It also directs tens of millions towards MAHA initiatives like food safety, alternatives to animal testing and nutrition education. As he did last year, Trump called for the creation of an Administration for a Healthy America that he asserts would save $5 billion by consolidating programs that are currently spread across other agencies. Those include “rural health programs; disease prevention and health promotion; injury prevention and control; telehealth; and anti-doping activities,” according to budget documents. Congress did not fulfill the White House’s 2025 request for $14 billion to create the new agency.

Politico Pro (3/27/2026): Trump to send Congress his budget request April 3 - President Donald Trump plans to send Congress a budget request on April 3, detailing his policy and funding wish list for the fiscal year that begins in October, according to a spokesperson for the White House budget office. It’s unclear whether the president will also submit a supplemental military funding request at the same time, to aid the military in the U.S. conflict in Iran. For more than a week, the White House has been reviewing a Pentagon request for about $200 billion in emergency cash to support new military action in the Middle East. Trump already called in January for a $1.5 trillion defense budget for the upcoming fiscal year, a $500 billion increase from the Pentagon’s current funding levels.

The president’s budget is scheduled to arrive on Capitol Hill almost nine weeks after it was due on Feb. 2. Though the fiscal blueprint is nonbinding, top appropriators in both parties have expressed frustration with the delay, since they rely on the framework to begin writing the dozen annual funding bills Congress must pass by Sept. 30.

Politico Pro (3/27/2026): 'Meltdown': DHS shutdown set to drag on after House GOP rejects Senate deal - House Republicans moved Friday to further extend the six-week shutdown of the Department of Homeland Security by rejecting a Senate bill that would fund the vast majority of DHS agencies through September. Instead, Speaker Mike Johnson proposed a temporary extension of all DHS funding through May 22 — a plan that has uncertain prospects in the House and cannot pass the Senate before the shutdown becomes the longest funding lapse in U.S. history Saturday. But Johnson said House Republicans simply could not swallow the Senate bill, which omits funding for Immigration and Customs Enforcement as well as Border Patrol and some other parts of Customs and Border Protection. "The Republicans are not going to be any part of any effort to reopen our borders or to stop immigration enforcement," he said. "We are going to deport dangerous criminal illegal aliens because it is a basic function of the government. The Democrats fundamentally disagree." The move toward an eight-week stopgap creates a tactical gulf between Johnson and Senate Majority Leader John Thune, who called an end to weeks of abortive bipartisan talks Thursday and pushed through the funding bill in hopes of tacking on funding later for ICE and CBP in a party-line budget reconciliation bill. Those agencies are currently funded and operating under appropriations made in last year's GOP megabill. President Donald Trump has largely stayed out of the GOP infighting on Capitol Hill, keeping his criticism trained on Democrats. He ordered DHS to pay TSA officers Thursday as long security lines snarls more U.S. airports, and the administration said Friday that paychecks will be delivered as soon as Monday. Johnson played down the split with his Senate counterpart, saying the Democratic leader there bore more blame for the impasse.

Politico Pro (3/23/2026): Americans prefer stricter testing of new drugs over faster access, POLITICO poll suggests - A majority of Americans say the government should slow approval of new drugs to ensure they are properly tested, even if that means delaying access for patients who urgently need new treatments — a striking finding that subverts how tradeoffs between access and speed are often discussed in Washington. The results suggest voters may prefer a more cautious Food and Drug Administration than the politics surrounding drug approvals often assume. They also lend backing to regulators who say drugmakers should have to present stronger evidence that new medicines are effective before winning approval. Arthur Caplan, a bioethics professor at New York University’s Grossman School of Medicine, said the finding captures the tension between speed and certainty that has embroiled the FDA for years. People who want faster access “are better organized and more vocal, so we tend to hear more from them,” Caplan said. “When people go to Washington, they don't show up and say, ‘Please go slow, please protect us, please make sure that the evidence is sound before anything moves.’” The findings, part of The POLITICO Poll conducted by Public First from March 13 to 18, found that among 3,851 U.S. adults, slightly more than half, or 52 percent, favored slowing approval of new drugs to ensure proper testing even if it means delaying availability for those who urgently need new treatments. A third said the government should grant access to new drugs as early as possible even if it means being less comprehensive in safety testing.

That split illuminates the balancing act top officials face.

Politico Pro (3/17/2026): Republicans and Dems are aligned: Don't mess with NIH funding - With the White House’s 2027 budget request expected within the next two weeks, Republicans and Democrats have a clear message for the president: Don’t cut health research funding. “We will continue to reject cuts to NIH research, because what you do is life-saving. It is that lifeline to Americans and the world,” Appropriations ranking member Rosa DeLauro (D-Conn.) said at a House oversight hearing on Tuesday. DeLauro's warning to the White House comes after both parties rejected the 40 percent budget cut President Donald Trump requested for the National Institutes of Health last year. Instead, bipartisan lawmakers last month approved a $415 million increase for the NIH, allocating $48.7 billion for the agency that funds biomedical research worldwide. At the Tuesday hearing, where NIH Director Jay Bhattacharya testified, neither party seemed interested in repeating last year's mass upheaval as Elon Musk’s DOGE swept through — cutting personnel, restructuring offices and canceling billions in research grants. Republicans and Democrats encouraged Bhattacharya to spend the billions in funding they’ve allocated for 2026 on research conducted in the states they represent and on projects aimed at improving Americans’ health. Oklahoma Republican Rep. Stephanie Bice asked Bhattacharya about what he’s doing to address lags in grant funding. “I don’t see a bottleneck now. We have our funding for the year — you all were very, very generous, actually, with the NIH last year,” Bhattacharya replied. “My job is to make sure every single dollar goes out, and it will go out by the end of the year on excellent science.” Republicans encouraged Bhattacharya to continue his initiative to direct more biomedical research funding to their districts. The NIH director has said that geographically redistributing grant funding will level the playing field between elite coastal institutions like Harvard and Stanford, where he previously taught, and ones in middle America.

Politico Pro (3/17/2026): NIH grants to start flowing again after OMB approval - The National Institutes of Health will now be able to spend the $48.7 billion in funding Congress appropriated for 2026 after the Trump administration for weeks delayed greenlighting the agency’s spending on grants. The Office of Management and Budget “finally” signed off on the NIH’s 2026 spending plans on Monday, said House Appropriations ranking member Rosa DeLauro (D-Conn.) during a Health Subcommittee hearing Tuesday. The approval comes several weeks after the Trump administration missed the 30-day legal deadline to release the funding. The delay raised concerns among researchers that the Trump administration might try to claw back the funding Congress appropriated for the biomedical research agency. Bipartisan lawmakers’ appropriation bill, which passed in February, was a strong rejection of the roughly 40 percent cut that the White House requested for fiscal year 2026. “I find it disconcerting that it took a congressional oversight hearing to prompt OMB to do what it should have done weeks ago,” DeLauro said at the hearing where NIH Director Jay Bhattacharya was testifying. “We are nearly halfway through the fiscal year. NIH grantmaking is well behind schedule.” DeLauro asked Bhattacharya to commit to accelerating the dispersion of grant funding this year, and the NIH director agreed. “We are in the process of identifying the excellent projects. The grants are already going out the door,” he said.

Politico Pro (3/13/2026): One month later, White House and Democrats no closer to ending the DHS shutdown - Top Democrats and White House officials are nowhere near close to a breakthrough in negotiations to end the Homeland Security shutdown as the funding lapse is due to hit its one-month mark Saturday and real pain begins. It’s been more than two weeks since the White House laid out its latest proposal for restoring full Department of Homeland Security operations alongside changes to the Trump administration’s immigration enforcement tactics, and Democrats have yet to send a formal counteroffer in the negotiations spurred by the fatal shootings by federal agents in January of two U.S. citizens in Minnesota. TSA screeners are now missing their first full paychecks of the shutdown, which could lead to more agents skipping work or quitting — and exacerbate already-lengthy wait times at airport security checkpoints throughout the country. Republicans think this could be the breaking point where Democrats relent. “I’m hopeful that as you see these problems at the airports, that the public will start talking to Democrats,” said Sen. John Hoeven (R-N.D.). But Democrats have a legislative rebuttal: Bills that would fully fund TSA and other parts of DHS that are casualties of the larger immigration standoff. Republicans have repeatedly objected over the last two weeks when Democrats asked for votes on those bills on the Senate floor. The Trump administration remains in “frequent” communication with senior Democratic lawmakers, according to one senior White House official granted anonymity to discuss private conversations. Another White House official said the president’s team “remains interested in continuing conversations with Democrats about ways to end this shutdown” but that “Democrats, regrettably, have chosen to punish the American people.”

Politico Pro (3/10/2026): House Budget chair eyes more safety-net cuts for second megabill - “Fraud prevention” in federal and state safety-net programs should be the main target of a new Republican reconciliation bill, House Budget Chair Jodey Arrington said in an interview Tuesday where he also called for reviving Medicaid spending cuts provisions that fell out of last year’s GOP megabill. “The whole kit and caboodle of welfare is $1.6 trillion in our budget,” Arrington said on the sidelines of the House Republican policy retreat. “But it's also not just welfare — it's programs across the federal government that states need to be responsible [for].” Arrington said Republicans needed to act after federal officials identified potentially billions of dollars of potential benefits fraud in Minnesota. But the suggestion of additional cuts to safety-net programs comes as House Republicans vulnerable in the upcoming midterms deal with the political fallout of the Medicaid and food-aid cuts enacted last year. Arrington said he wanted to revisit several proposals to reduce Medicaid spending that did not end up complying with strict Senate rules for a filibuster-skirting budget package. He suggested Senate Republicans didn’t spend “a lot of time” last year reworking them to pass muster. Arrington also said he wants to identify Pentagon spending cuts that would offset new investments President Donald Trump wants for the military — something that will likely trigger pushback from GOP defense hawks.

Politico Pro (3/10/2026): GOP senator plans investigation of FDA’s rare disease calls – A senior Republican senator said Tuesday he is using his power as Senate investigations leader to launch an inquiry into recent FDA decisions that scuttled the development of certain rare disease drugs. Wisconsin Sen. Ron Johnson, an ally of both President Donald Trump and Health Secretary Robert F. Kennedy Jr. and his Make America Healthy Again movement, said at a press conference with Duchenne muscular dystrophy patients and caregivers that he hopes public pressure on the agency will prompt it to reform its approvals process. Trump during his first term signed Johnson’s “right-to-try” legislation aimed at making it easier for patients with incurable, terminal diseases to gain access to experimental therapies. But he and other rare disease advocates have complained that the FDA’s current leadership — particularly outgoing Center for Biologics Evaluation and Research Director Vinay Prasad — has moved the goalposts for drugmakers trying to shore up the data for their drug applications. Johnson directly contacted Trump last year after the FDA moved to halt distribution of the Duchenne drug Elevidys for all customers after deaths were reported. Drugmaker Sarepta and the agency later agreed to limit the pause to a patient subset. The senator, who leads the Senate’s Permanent Subcommittee on Investigations, said he now believes it’s better to first prod the FDA to act.