The week before a (planned) recess is often a busy one for Congress, especially in the summer. And late June—with its typical “decision days” of the Supreme Court—can make the weeks before the 4^th of July holiday very eventful, to say the least. And this week was (and will likely continue to be through the weekend) politically eventful.

Congressional Hearings with Administration Officials

This week, three top Trump Administration health and budget-related officials testified in hearings on Capitol Hill. On Tuesday, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. testified in front of the Health Subcommittee of the House Committee on Energy and Commerce on the HHS budget for FY26. A recording can be found here; there were frequent questions regarding vaccines and an exchange with Rep. Troy Carter (D-LA) regarding HIV prevention and vaccine research at the 3 hr. 8 min. mark.

Dr. Susan Monarez was in front of the Senate Health, Education, Labor, and Pensions Committee on Wednesday for a hearing on her nomination to be the next CDC Director—a position that is newly confirmable by Congress.

Office of Management and Budget (OMB) Director Russell Vought appeared before the Senate Appropriations Committee on Wednesday afternoon to answer questions about the White House’s first rescissions package. (Recording here.) The rescissions package passed the House last week and claws back funding for NPR, public television, PEPFAR, and more. Vought commented last week on the administration’s intention to use the rescissions tool again in the future and on the possibility of “pocket rescissions” to withhold Congressionally appropriated funding toward the end of the fiscal year.

Reconciliation

To quote other appropriations experts, this is currently One Big Beautiful Mess. As a reminder, the Senate is working to meet the President’s stated deadline of July 4^th to pass this bill (a version has already passed the House). Senate Republicans are still saying they plan to bring the bill to the floor sometime this weekend. But much work needs to be done to get the bill in order for floor consideration. It’s still anyone’s guess how and when things will play out. The Senate Parliamentarian ruled against a number of  Medicaid provisions because they violated the Byrd rule, which left a hole of around $250 billion in the GOP’s spending cuts. One of the largest savings was a provision to curb provider tax arrangements through which states can obtain additional federal Medicaid funds. Even before the Parliamentarian’s ruling, the Senate GOP was struggling to negotiate Medicaid provisions that would garner the needed votes, and we haven’t even discussed the major sticking point of the State and Local Tax deduction (SALT).

So, to summarize, the Senate needs to re-write a number of major provisions that 1) Can garner a simple majority of votes 2) Finds the needed “savings” for the package and 3) Passes the Byrd rule. AND THEN the House needs to agree to pass the bill the Senate passed AND the President needs to sign it. All (apparently?) before next Friday. Buckle up, all, it’s likely going to be an eventful seven days.

Supreme Court Rulings

This week marked the last “decision days” of the Supreme Court’s term. Today, in the case of Kennedy v. Braidwood, the Supreme Court has preserved the provision of the Affordable Care Act that requires insurance companies to cover preventive health services like colonoscopies and HIV prevention drugs at no cost to patients.

Yesterday, in the case of Medina v. Planned Parenthood, the Supreme Court ruled that states (in this case, South Carolina) can remove certain providers (in this case, Planned Parenthood) from their Medicaid network. While this case of course has major implications for its name plaintiff—who is a major provider of STI prevention care across the country—this case has major implications for those on Medicaid more broadly. The Medicaid Act requires that Medicaid recipients be permitted to seek medical care with “any qualified provider.” After South Carolina denied a Medicaid patient the right to seek care at Planned Parenthood, the patient sued the state for violating federal law. The plaintiff was able to file this lawsuit because a key civil rights law, commonly referred to as Section 1983, gives private plaintiffs the power to sue in federal court when states deprive them of their federal rights. This ruling vastly weakens this provision of the law, and Medicaid patient’s ability to choose their own providers.

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