In a late-night reconvening on May 18, the House Committee on the Budget narrowly approved the budget reconciliation bill by a 17–16 vote. The shift came after a few conservative hardliners who had opposed the measure on May 16 opted to vote “present,” allowing the legislation to advance. Despite the narrow approval, several committee members continue to express reservations about the underlying package.
This development followed the marathon House Committee on Energy and Commerce full committee markup from May 13 to 14. During the markup, Rep. Paul Tonko (D-N.Y.) read America’s Essential Hospitals’ statement on the bill, highlighting the importance of the Medicaid program to essential hospitals and the communities they serve. The association continues to provide input and data to support this critical argument and is coordinating with offices in need of support or information.
The House Committee on Rules will meet May 21, at 1 am ET, to take up the budget reconciliation package with the goal of getting the package to the House floor by May 23, with the possibility of a vote as early as May 21. Speaker Mike Johnson (R-La.) continues to face internal challenges uniting the various factions within his caucus. Even if the measure clears the House by the end of the week, the Senate could still seek major changes that may run contrary to the delicate House negotiations.
Last Week’s Hearings
The Senate Committee on the Judiciary held a May 13 to examine issues in the prescription drug supply chain. There was broad bipartisan concern over pharmacy benefit manager practices throughout the hearing, with calls for increased transparency and structural reform.
The House Committee on the Judiciary Subcommittee on the Administrative State, Regulatory Reform, and Antitrust held a May 14 hearing to discuss the medical residency antitrust exemption. Subcommittee Republicans focused on criticizing the centralized control and monopolistic structure of the medical residency accreditation and matching systems. They portrayed the centralized match system as rigid and harmful to smaller programs, with calls to restore market dynamics, explore alternative certification models, and reevaluate federal involvement.
Subcommittee Democrats defended the overall structure of the existing system while acknowledging areas for improvement; they argued for expanding residency slots and increasing federal funding. They also raised broader issues, such as Medicaid cuts; student debt; diversity, equity, and inclusion; and pharmaceutical industry practices.
On May 15, the Senate Committee on Finance advanced the nominations of James O’Neill to serve as deputy secretary of the Department of Health and Human Services (HHS) by a vote of 14–13 and Gary Andres to serve as assistant secretary of HHS by a vote of 19–8.
Committee Activity This Week
The Senate and House are in session Monday through Thursday this week, with just the former convening on Friday. Both chambers will be out May 26, in observance of the Memorial Day holiday.
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