Welcome back everybody. While the momentum around an American Health Care Act (AHCA) comeback is unclear, there's no discounting that efforts are ongoing to reach a consensus among House Republicans with significant pressure from the White House. Those efforts will likely be put on hold this week as Congress works to pass a government-funding bill, which could get complicated if President Trump demands funding for the US-Mexico border wall. A funding bill needs to be complete by Friday to avoid a shutdown. All the while, uncertainty grows around the 2018 plan year as funding for the cost-sharing reductions (CSRs) remains unresolved. This week is all about a potential government shutdown, but important work will continue around the User Fee Acts, the minibus, which we've just written about extensively here, and stabilizing the health insurance market.


  • The Ways & Means Committee does not have hearings scheduled this week, but may have its work cut out for them if the Administration releases anything substantive on tax reform.
  • The Energy & Commerce Committee's work will focus on other issues this week but expect continued work on the User Fee reauthorization in the coming weeks.


On Wednesday (4/26), the Senate HELP Committee will markup four pieces of legislation and vote to advance the nomination of Scott Gottlieb to serve as Commissioner of the FDA. Of note, the committee appears poised to advance the National Clinical Care Commission Act, which would direct HHS to establish a commission and recommend solutions on leveraging federal problems to treat those with certain complex metabolic or autoimmune conditions. There's also legislation to provide clarity to states which would enable emergency medical personnel to administer certain controlled substances in the field.

Also on Wednesday (4/26), the Senate Special Committee on Aging will hold a hearing titled, "Aging Without Community: The Consequences of Isolation and Loneliness."

To Subsidize or Not?

The Administration continues sending mixed signals on whether President Trump will work with Congress to appropriate funding for cost-sharing reductions. While Trump may blame Democrats for failures associated with the ACA, the majority of Americans would now blame Republicans and the Administration, according to an April Kaiser Family Foundation poll. The President may try to exert leverage over the Democrats arguing that the ACA is failing, although it is far from clear that he will win that argument.

The next work period is critical for health care and not just for the ACA.