New Administration, New Congress, and Their Health Priorities Just Starting to Take Shape

The new U.S. Congress is at work in Washington, DC. It is unclear if the healthcare legislation that came so close to passage last December will be included in a March appropriations package. The Senate must confirm political nominees, including the HHS Secretary and the CMS Administrator.

Congress Must Take Action to Keep Government Funded

In December, Congress struck a last-minute agreement to keep the government funded until mid-March, 2025. While a pared-back package was included to extend certain existing health programs, it did not include many of the health priorities supported by GLI and patients. Key provisions left out were the pharmacy benefit manager (PBM) reforms, a Pediatric Rare Disease Priority Review Voucher (PRV) Program extension, the Medicare Multi-Cancer Early Detection and Screening Act (MCED), and the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. Some key reauthorizations were included, though only for a three-month window, including Medicare Telehealth Flexibilities, Medicaid Disproportionate Share Hospital (DSH) Cut Delay, Special Diabetes Program Funding, and Medicare’s Acute Hospital Care at Home Flexibilities. Provisions actively considered in December, but ultimately left out of the end-of-year package, could be reconsidered. GLI will continue to advocate that Congress include policies such as MCED, PRV, telehealth and PBM reforms in the final funding package anticipated in March 2025.

Tracking Trump 2.0 Administration Appointees

President Donald Trump has selected Cabinet-level officials for his administration. GLI is monitoring the Senate’s confirmation process closely. Here are his picks in the healthcare arena:

• HHS: Robert F. Kennedy Jr. (Favorable vote in Finance Cmte, Senate hearing replays from January 29 and January 30)
• CMS: Dr. Mehmet Oz (TBD)
• CDC: Dr. Dave Weldon (TBD)
• FDA: Dr. Martin Mackary (TBD)
• NIH: Dr. Jay Bhattacharya (TBD)
• Surgeon General: Dr. Janette Nesheiwat (TBD)
• VA: Former Rep. Doug Collins (Confirmed)
• Attorney General: Pam Bondi (Confirmed)

New Committee Leadership Selected for 119th Congress

• Cassidy To Lead Senate HELP Committee: Sen. Bill Cassidy (R-LA) will chair the Health, Education, Labor and Pensions (HELP) committee. Sen. Bernie Sanders is the Ranking Member. 
• Crapo to Lead Senate Finance Committee: Sen. Mike Crapo (R-ID) will chair the Senate Finance Committee. Senator Ron Wyden (D-OR) is the Ranking Member.
• Smith to Lead House Ways and Means Committee: Rep. Jason Smith (R-MO) will chair the House Ways and Means Committee. Rep. Richie Neal (D-MA) is the Ranking Member.
• Guthrie to Lead House Energy and Commerce: Rep. Brett Guthrie (R-KY) will chair the House Energy and Commerce Committee. Rep. Frank Pallone (D-NJ) will be the Ranking Member.

GLI Supports CMS Proposal to Cover Obesity Medications Under Medicare

On November 26, CMS proposed to reinterpret an existing statute and permit coverage of anti-obesity medications (AOMs) for weight loss when treating obesity, and CMS would apply this reinterpretation across all Part D plans and Medicaid programs. GLI commented in response to the proposed rule that it strongly supports finalization. As often happens in a new administration, the Trump administration has chosen to “freeze” pending regulations to allow newly appointed officials to review and align rulemaking with the policy goals of the new administration. It is possible that the new administration may amend the final version of the rule. Therefore, it is unclear whether and how the rule will impact efforts to pass legislation that allows for more restrictive coverage of obesity medications. View GLI’s comments here.

Join GLI in Pushing for Patient Access to Care for MASH/NASH
Veterans continue to be denied coverage for metabolic dysfunction-associated steatohepatitis (MASH), formerly known as nonalcoholic steatohepatitis (NASH), treatment without a biopsy or experience delayed care due to requirements to receive “comprehensive lifestyle intervention” for 6 months before being eligible for treatment. The VA’s decision is contrary to the label from the Food and Drug Administration and clinical guidelines. As part of GLI’s Beyond the Biopsy initiative, GLI and its partners sent a letter to the VA. We continue to encourage signatures here on a petition to all payers calling for coverage without biopsy!

Legislative Updates

• The Medicare Multi-Cancer Early Detection Screening Coverage Act has been reintroduced in the US Congress (H.R.842 / S.339). Learn more.
• The ORPHAN Cures Act has been reintroduced in the US Congress (H.R.946).

Patient Highlight

GLI Ambassador and passionate advocate Terri has shared her story, which underscores why it is imperative to advance the use of noninvasive diagnostics for fatty liver disease. Terri’s condition deteriorated rapidly after her biopsy, from being asymptomatic to experiencing ascites, compensated cirrhosis, hepatic encephalopathy, and brain fog. This experience has fueled her passion, and she shared “I will use my voice to advocate, giving doctors – and the patients and veterans that depend on them – an updated toolkit for a smoother journey to wellness.”