With just eight days until Speaker Mike Johnson’s deadline to get budget reconciliation through the House before Memorial Day recess, the House committees on Energy and Commerce and Ways and Means released legislative text May 11.
The Energy and Commerce text proposes to cut more than $700 billion from the Medicaid program, amounting to what the Congressional Budget Office (CBO) estimates will be, when combined with other cuts and non-extended programs, nearly 14 million uninsured individuals.
The most troubling provisions for essential hospitals include a moratorium on state directed payment (SDP) programs that exceed the existing Medicare rate and a moratorium on new or increased provider taxes, both of which create questions about the realistic applications of keeping programs exempt for different facilities and entities.
In a statement, America’s Essential Hospitals expressed concern about the magnitude of the cuts. Staff will keep member leaders informed of the legislative process and any potential policy changes as the reconciliation package moves through the House and Senate. This will include updates on proposed increased eligibility checks for the population eligible for Medicaid under the Affordable Care Act expansion, a federal medical assistance percentage decrease for expansion populations, and mandatory work requirements with “expectations” about which association staff seek clarity. The association also will reach out to committees of jurisdiction in coordination with their markups of the language and to all members of the House ahead of next week’s floor vote, urging them to vote no on the harmful Medicaid proposals. Further changes to the proposed text are possible as this process moves forward.
Republicans hope to get the budget reconciliation package to President Trump’s desk before the July 4 recess not only to accelerate the process, but also to finalize a debt limit increase contained in the reconciliation legislative text before reaching the debt ceiling in mid-July.
After key markups in the committees of jurisdiction early this week, the House Committee on the Budget will assemble the bill by the end of the week. Republican leadership then will bring the package to the House Committee on Rules, which could make more changes early the week of May 19 before scheduling a floor vote later that week.
Last Week’s Hearings
On May 6, the Senate Committee on Finance held a confirmation hearing to consider the nominations of James O’Neill for deputy secretary of health and human services (HHS) and Gary Andres as assistant secretary of HHS.
Committee Republicans emphasized improving administrative efficiency, embracing technology, and ensuring responsiveness from HHS. Republicans highlighted priorities including rural health, pharmacy benefit manager reform, organ transplantation, and the potential of artificial intelligence. Sen. Bill Cassidy (R-La.) also questioned James O’Neill on his vaccination beliefs and Centers for Disease Control and Prevention (CDC) recommendations.
Committee Democrats concentrated on the consequences of staffing cuts, threats to public health, and program disruptions. They pressed for clarity on Medicaid cuts, criticized the handling of vaccine-preventable diseases, and questioned the leadership and transparency of Robert F. Kennedy Jr. Democrats raised concerns about the weakening of essential programs, such as those related to the CDC, Low Income Home Energy Assistance Program, and National Institutes of Health, as well as public trust in science and health guidance. Democrats called to restore public health functions, safeguard vulnerable populations, reform the PBM market, and ensure timely and quality responses to congressional inquiries.
On May 8, the Senate Committee on Health, Education, Labor, and Pensions held a nomination hearing to consider James O’Neill as deputy secretary of HHS. Committee Republicans focused on enhancing privacy protections and strengthening national health security. Discussions emphasized the need to modernize health data regulations and address risks related to unsupervised research and drug safety.
Committee Democrats stressed transparency, accountability, and protection of public health programs. Broader concerns included safeguarding vulnerable populations, restoring trust in agency leadership, and reinforcing federal commitment to scientific research and social services.
President Trump withdrew Janette Nesheiwat as nominee for U.S. Surgeon General just before the scheduled confirmation hearing and nominated Casey Means, MD, as a replacement.
Committee Activity This Week
The Senate was in session on Monday, with both the House and Senate convening Tuesday through Thursday.
The House Committee on Energy and Commerce will hold a full committee markup of the budget reconciliation text on May 13, at 2 pm ET.
The House Committee on Ways and Means also will hold a full committee markup of the budget reconciliation text on May 13, at 2 pm ET.
The Senate Committee on Health, Education, Labor, and Pensions will hold a full committee hearing on the Fiscal Year 2026 Department of Health and Human Services Budget on May 14, at 1:30 pm ET. HHS Secretary Robert F. Kennedy Jr. will serve as a witness.
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