WASHINGTON D.C. – The week of February 14-20, 2025, proved to be a period of significant activity and pending deadlines within the realm of federal health policy, with key developments unfolding across Congress, federal agencies, and the executive branch.
Lawmakers grappled with impending fiscal cliffs and debated substantial programmatic reforms, while federal departments initiated regulatory shifts and implemented new directives. The policy landscape remains dynamic, influenced by budgetary pressures, ongoing legislative negotiations, and evolving administrative priorities.
Congressional Crossroads: Funding and Policy Priorities
A primary focus on Capitol Hill remains the federal government’s funding mechanism, with the current continuing resolution poised to expire on March 14. This deadline looms large over appropriations discussions, including those impacting health-related agencies and programs.
Adding to the legislative urgency are critical health care extenders set to sunset on March 31. These include crucial provisions such as funding for Medicaid disproportionate share (DSH) hospitals, which serve a high volume of low-income patients, and various telehealth flexibilities that have expanded access to care. Their expiration could significantly impact healthcare providers and patient access nationwide.
Simultaneously, key components of a proposed bipartisan health care package continue to be a high priority. Legislative efforts focusing on prescription drug benefits, particularly reforms targeting pharmacy benefit managers (PBMs), and providing relief from scheduled Medicare physician payment cuts are actively being pursued.
Budgetary Pressures Mount for Health Programs
The House Budget Committee recently advanced a budget resolution for Fiscal Year (FY) 2025 that sets spending levels extending through FY 2034. This resolution signals a significant shift in fiscal strategy, notably calling for the House Energy and Commerce Committee to identify and implement spending reductions totaling $880 billion over the next ten years.
Experts suggest that achieving cuts of this magnitude within the Energy and Commerce Committee’s jurisdiction will almost inevitably impact major entitlement programs, with Medicaid widely seen as a likely target. This prospect has already drawn attention from within Congress.
Notably, a group of eight Republican House members has publicly urged Speaker Johnson against implementing cuts to essential programs like Medicaid. Their statement underscored the program’s vital importance, particularly highlighting its role for Hispanic Americans, raising concerns about potential adverse effects on vulnerable populations.
Navigating Regulatory Shifts: Telemedicine, CMS Programs, and HHS Directives
Federal health agencies also initiated several significant regulatory actions. The effective dates for two final rules concerning the telemedicine prescribing of buprenorphine, a medication used for opioid use disorder treatment, have been postponed. The rules, titled “Expansion of Buprenorphine Treatment via Telemedicine Encounter” and “Continuity of Care via Telemedicine for Veterans Affairs Patients,” were originally slated to become effective on February 18 but have now been delayed until March 21.
The delay allows for further public input, with comments on the postponement accepted until February 28.
Separately, the Centers for Medicare & Medicaid Services (CMS) announced a substantial reduction in funding for the Affordable Care Act (ACA) Navigator program. Funding allocated to organizations assisting individuals in enrolling in ACA health plans will decrease from $98 million in 2024 to just $10 million. CMS cited low enrollment efficiency as the primary reason for this significant cut, suggesting a shift in strategy for outreach and enrollment efforts.
CMS also confirmed the cessation of implementation for the Hospice Special Focus Program for Calendar Year (CY) 2025, effective February 14. The agency indicated that the program, designed to target hospices with poor performance records, would undergo further evaluation before potential future implementation.
Redefining Health and Identity: HHS Guidance and Rescissions
The Department of Health and Human Services (HHS) released new guidance expanding upon sex-based definitions as outlined in Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.” The guidance explicitly states that there are only two sexes.
Concurrently, the HHS Office of Civil Rights officially rescinded previous guidance issued on March 2, 2022, titled “HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy.” These actions signal a clear shift in the department’s approach to defining sex in regulatory contexts.
Executive Actions Shape Access: IVF and Opioid Treatment
In a significant executive action, President Trump signed an executive order titled “Expanding Access to In Vitro Fertilization.” The order aims to ensure affordable access to In Vitro Fertilization (IVF) services and directs relevant agencies to develop policy recommendations within 90 days.
Further highlighting challenges in healthcare access, an HHS Office of Inspector General (OIG) report released during this period presented concerning data regarding opioid use disorder treatment among Medicare enrollees. The report indicated that only about 40 percent of Medicare beneficiaries who initiated buprenorphine treatment continued receiving it, and only approximately one-third received recommended behavioral therapy concurrently with their medication. These findings underscore potential gaps in integrated care for this vulnerable population.
Finally, HHS is also actively implementing policies mandated by other executive orders, specifically Executive Orders 14187 and 14201, which address protections for children and participation in women’s sports, respectively.
The array of policy changes and impending deadlines from February 14-20 underscores a complex and evolving landscape in U.S. federal health policy, with significant implications for funding, program access, and regulatory frameworks in the coming months.
