Health Care Policy Update – Weekly Wrap-up and What’s Ahead – January 13, 2025


When is Congress in session? House 2025 Calendar Senate 2025 Calendar

What’s Ahead: This Week

Hearings and Markups – 

  • Tuesday, January 14
    • House Ways and Means Committee, “Hearing on the Need to Make Permanent the Trump Tax Cuts for Working Families.” Additional Information
  • Wednesday, January 15 to Thursday, January 16
    • Senate Judiciary Committee, “The Nomination of the Honorable Pamela Jo Bondi to be Attorney General of the United States.” Additional Information
  • Wednesday, January 15
    • Senate Homeland Security & Government Affairs Committee, “Hearings to Examine the Expected Nomination of Russell Vought, to be Director, Office of Management and Budget.” Additional Information
    • Senate Special Committee on Aging, “Improving Wellness Among Seniors: Setting a Standard for the American Dream.” Additional Information

Notable Policy Events – 

  • Thursday, January 16 to Friday, January 17
    • Medicare Payment Advisory Commission (MedPAC), “January Public Meeting.” Free, Virtual. Additional Information

Weekly Wrap-Up: Notable Health Care Developments from Last Week

Medicare & Medicaid –

  • On January 8, CMS approved an amendment to the “Utah Medicaid Reform Section 1115 Demonstration,” giving the state authority to provide health-related social needs (HRSN) services and infrastructure support and non-medical transportation (NMT) to and from HRSN services. Amendment Approval
  • Also on January 8, CMS approved an amendment to Washington State’s Section 1115 demonstration, “Medicaid Transformation Project 2.0,” giving the state authority to provide coverage to former foster care youth and  continuous eligibility for CHIP recipients until age six. Amendment Approval
  • Also on January 8, CMS approved a five-year extension to the “Hawaii QUEST Integration” section 1115 demonstration. Extension Approval
  • On January 10, CMS published an article in Health Affairs, ” A Stronger Medicare Program—Now And Into The Future,” which details the accomplishments of the Biden Administration, remaining challenges, and lessons learned. Article
  • Also on January 10, CMS released the Contract Year 2026 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies. Comments are due by February 10, 2024. CMS will publish the final Rate Announcement by April 7, 2024. Press Release Fact Sheet Part D Redesign Fact Sheet Advance Notice
  • Also on January 10, CMS released Medicaid state plan amendment (SPA) templates for justice-involved juveniles requirements. Press Release SPA Templates
  • Also on January 10, the Medicaid and CHIP Payment and Access Commission (MACPAC) released an issue brief evaluating the effects of Medicaid payment changes on access to physician services. Issue Brief Press Release

Marketplaces – On January 8, CMS reported that 23.6 million individuals have selected plan year 2025 ACA marketplace coverage since the start of open enrollment. ACA Marketplace National Enrollment Snapshot Press Release

Payment & Delivery System Models – On December 6, CMS announced the 15 states selected to participate in the Transforming Maternal Health (TMaH) Model. Announcement and TMaH Model Overview

Public Health Prevention, Preparedness, Surveillance – On January 7, the CDC published an op-ed urging the incoming Trump Administration to continue investing in infectious disease prevention and data modernization. Op-Ed

Health IT, Privacy, & Digital Health –

  • On January 6, the FDA issued a guidance document detailing considerations for the use of artificial intelligence (AI) to support regulatory decision-making for drug and biological products. Federal Register Notice Guidance Document Press Release
  • On January 7, the HHS Office for Civil Rights (OCR) announced a settlement with an electronic medical record and billing support company, resolving an investigation concerning a ransomware attack on the company’s information system. Press Release Resolution Agreement
  • Also on January 7, HHS OCR issued a blog on its 2024 Health Insurance Portability and Accountability Act (HIPAA) rulemakings, enforcement actions, and HIPAA privacy and cybersecurity resources for the health care sector. Blog
  • On January 10, HHS released its AI Strategic Plan, which lays out a framework and roadmap for using emerging technologies to advance its mission responsibly. HHS AI Strategic Plan AI Strategic Plan Overview Press Release
Mental Health and Substance Use Disorder Policy – 
  • On January 6, HHS issued a report assessing the feasibility of creating a national behavioral health workforce database. Press Release Report
  • On January 7, HHS awarded 14 states and Washington, D.C. with $1 million, one-year Certified Community Behavioral Health Clinic (CCBHC) Medicaid Demonstration Program planning grants for expanding access to mental health and substance use disorder services. Press Release
  • On January 8, HHS issued a report on behavioral health service use among Medicaid and CHIP beneficiaries before and during the COVID-19 Public Health Emergency. Press Release Report
  • On January 9, the Substance Abuse and Mental Health Services Administration (SAMHSA) published an advisory describing a change in funding for Contingency Management (CM) and applicable guardrails. Advisory Press Release
Health Systems & Health Care Workforce –
  • On January 7, Sens. Grassley (R-IA) and Whitehouse (D-RI) released a bipartisan staff report on the impact of private equity firms on the U.S. health care system. Full Report Press Release
  • On January 8, HHS issued a report on health insurance coverage and health care access between 2021 and 2024. Press Release Report
Miscellaneous – 
  • On January 7, the Consumer Financial Protection Bureau (CFPB) issued a final rule which removes a regulatory exception that had permitted creditors to obtain and use information on medical debts. Final Rule Press Release
  • On January 10, the Treasury Department released a report, “The Cost and Distribution of Extending Expiring Provisions of the Tax Cuts and Jobs Act of 2017.” Report
Legislative Activity
Introduced Legislation –
  • On January 9, Rep. Yakym (R-IN) introduced the Sergeant Ted Grubbs Mental Healthcare for Disabled Veterans Act (H.R. 241), which would provide for access standards with respect to the provision by the VA of hospital care, medical services, or extended care services that are applicable to certain veterans with mental disorders. Bill Text Press Release
  • Also on January 9, Rep. Underwood (D-IL) and 22 cosponsors introduced the Health Care Affordability Act of 2025 (H.R. 247), which would expand eligibility for the refundable credit for coverage under an ACA qualified health plan. Sen. Shaheen (D-NH) and 39 cosponsors introduced companion legislation (S. 46) in the Senate. Press Release