SURPRISE: AN E&C DELAY — House GOP leaders are delaying an Energy and Commerce Committee megabill markup another week to coalesce a strategy toward Medicaid spending cuts, POLITICO’s Meredith Lee Hill reports.The decision comes after Speaker Mike Johnson, E&C Chair Brett Guthrie (R-Ky.) and other members of the House GOP leadership team ran through Medicaid proposals and other major pieces of the GOP’s party-line domestic policy package with President Donald Trump during a White House meeting Thursday.One key issue remaining is how far Republicans will go to implement a controversial proposal to cap federal Medicaid payments to states as leaders try to work through various estimates about savings, according to two other people with direct knowledge of the matter. The committee will hold a series of meetings next Tuesday and Wednesday. The larger funding puzzle includes energy programs, spectrum auctions and Medicaid.The White House is pushing Congress to consider a plan to slash drug prices as part of Republicans’ party-line megabill that would only apply to the cost of medicines in the Medicaid program, a White House official told POLITICO on Thursday.The “most favored nation” proposal would seek to cut costs by bringing what Medicaid pays for drugs in line with the lower prices paid abroad, in a move designed to generate savings for the GOP’s sweeping tax bill while also advancing President Donald Trump’s vow to crack down on pharmaceutical prices, Adam reports.“Savings is a big part of it, but it’s something the president has been open about in wanting to decrease health care and drug costs,” said the White House official, who was granted anonymity to discuss internal thinking.Trump officials are “actively” pushing congressional Republicans to include the idea in the bill, the official said, despite trepidation over the concept from GOP lawmakers, including Johnson.The pharmaceutical industry is already pushing back against the idea.“At a time when we are facing growing competition from China, policymakers should focus on fixing the flaws in the U.S. system, not importing failed policies from abroad,” PhRMA spokesperson Alex Schriver said.IT’S FRIDAY. WELCOME BACK TO PULSE. FDA reporter David Lim here, pinch-hitting for today. Send tips to David Lim (, @davidalim or davidalim.49 on Signal), as well as and . Follow along at @Kelhoops and @ChelseaCirruzzo.
SKINNY BUDGET EXPECTED TODAY — A sparse outline of President Donald Trump’s budget request to Congress is expected to be released by the White House today. The document that should give lawmakers spending targets the administration wants for the next fiscal year, POLITICO’s Katherine Tully-McManus, Meredith Lee Hill and Irie Sentner report.The new fiscal year begins in October, and House Appropriations Chair Tom Cole (R-Okla.) wants his committee to approve the dozen bills Congress has to clear each year to fund the government before the August recess.“You’re looking at a government shutdown if we can’t move these bills,” Cole told reporters Thursday.
PLANNED PARENTHOOD AFFILIATES SUE — Five Planned Parenthood chapters sued the Trump administration Thursday over new restrictions on HHS’s Teen Pregnancy Prevention program, POLITICO’s Alice Miranda Ollstein reports.The challenge filed in the U.S. District Court for the District of Columbia by chapters representing California and Hawaii, Iowa, Nevada, Nebraska and New York says they were awarded five-year grants under the program in 2023. But on March 31, they were informed by HHS that the money would stop flowing if they didn’t abide by new “substantial and onerous” requirements.The grantees were asked to prove that they’re following President Donald Trump’s executive orders barring federal spending on diversity initiatives, gender-affirming care and “radical indoctrination” — or risk losing their next round of funding slated for release on July 1.An HHS spokesperson declined to comment on the lawsuit. The Justice Department did not respond to a request for comment.
D.C. SEEKS TO AVOID CUT — District of Columbia Mayor Muriel Bowser is drawing attention to GOP efforts to cut the city’s Medicaid funding, Robert reports.Bowser is scheduled to hold a press conference this morning at Children’s National Hospital to discuss a nascent effort to lower the federal funding rate for the district, according to her office.The House Energy and Commerce Committee, which oversees Medicaid, is searching for $880 billion in savings to help pay for a massive spending package that extends President Donald Trump’s tax cuts and funds border, energy and other GOP priorities. One idea being considered, according to one lobbyist, is to lower the federal matching rate for D.C.Medicaid is funded jointly by the federal government and states. Typically, the state and federal governments split the costs 50-50, although the federal government sometimes pays more depending on the poverty level of a state’s residents.But a provision in the 1998 Social Security Act raised D.C.’s federal matching rate to 70 percent. Lowering the rate to 50 percent would require a change to federal law.D.C. says the change could amount to a $2.1 billion loss in funding, just as the district is trying to plug a $1 billion hole in its public services budget. The March spending package that extended government funding included the cut.While the Senate passed a bill reversing the $1 billion cut, the House has yet to take up the package.
COVID ORIGINS PROBES RETURN — National Intelligence Director Tulsi Gabbard told podcast host Megyn Kelly she’s working with top HHS officials to investigate Covid-19’s origins.In an interview Thursday, Gabbard said that in addition to working with NIH Director Jay Bhattacharya and HHS Secretary Robert F. Kennedy Jr., she wants to end so-called gain-of-function research, in which scientists alter pathogens to make them more transmissible or deadly so they can study them.Gabbard, like many in the Trump administration and Republicans in Congress, believes the pandemic was caused by a laboratory accident in Wuhan, China, not by the virus spilling over from animals to people, as many virologists say is more likely, Erin reports.Bhattacharya has said regulating risky research is among his top priorities as NIH director.While the CIA said earlier this year that Covid was more likely to have originated in a lab, it also said it had “low confidence” in that assessment and would continue to evaluate any new evidence. The FBI previously said it favored the lab leak theory with moderate confidence, while the Energy Department said it thought, with low confidence, that a lab leak was more likely.The National Intelligence Council, which advises the director of national intelligence, favored the natural origin theory during the Biden administration.
Drugmakers have spent millions targeting pharmacy benefit managers through donations to nonprofits, media sponsorships and lobbying, The Wall Street Journal’s Josh Dawsey, Kristina Peterson and Maggie Severns report.Despite HHS backing away from a new autism registry floated by NIH Director Jay Bhattacharya, parents are canceling autism clinical evaluations for children out of fear, STAT’s O. Rose Broderick reports.Rep. David Valadao (R-Calif.) is among House Republicans working to avert cuts to Medicaid spending, POLITICO’s Ben Leonard and Meredith Lee Hill write in a profile of the dairy farmer who represents more Medicaid beneficiaries than his GOP colleagues.
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SKINNY BUDGET EXPECTED TODAY — A sparse outline of President Donald Trump’s budget request to Congress is expected to be released by the White House today. The document that should give lawmakers spending targets the administration wants for the next fiscal year, POLITICO’s Katherine Tully-McManus, Meredith Lee Hill and Irie Sentner report.The new fiscal year begins in October, and House Appropriations Chair Tom Cole (R-Okla.) wants his committee to approve the dozen bills Congress has to clear each year to fund the government before the August recess.“You’re looking at a government shutdown if we can’t move these bills,” Cole told reporters Thursday.
PLANNED PARENTHOOD AFFILIATES SUE — Five Planned Parenthood chapters sued the Trump administration Thursday over new restrictions on HHS’s Teen Pregnancy Prevention program, POLITICO’s Alice Miranda Ollstein reports.The challenge filed in the U.S. District Court for the District of Columbia by chapters representing California and Hawaii, Iowa, Nevada, Nebraska and New York says they were awarded five-year grants under the program in 2023. But on March 31, they were informed by HHS that the money would stop flowing if they didn’t abide by new “substantial and onerous” requirements.The grantees were asked to prove that they’re following President Donald Trump’s executive orders barring federal spending on diversity initiatives, gender-affirming care and “radical indoctrination” — or risk losing their next round of funding slated for release on July 1.An HHS spokesperson declined to comment on the lawsuit. The Justice Department did not respond to a request for comment.
D.C. SEEKS TO AVOID CUT — District of Columbia Mayor Muriel Bowser is drawing attention to GOP efforts to cut the city’s Medicaid funding, Robert reports.Bowser is scheduled to hold a press conference this morning at Children’s National Hospital to discuss a nascent effort to lower the federal funding rate for the district, according to her office.The House Energy and Commerce Committee, which oversees Medicaid, is searching for $880 billion in savings to help pay for a massive spending package that extends President Donald Trump’s tax cuts and funds border, energy and other GOP priorities. One idea being considered, according to one lobbyist, is to lower the federal matching rate for D.C.Medicaid is funded jointly by the federal government and states. Typically, the state and federal governments split the costs 50-50, although the federal government sometimes pays more depending on the poverty level of a state’s residents.But a provision in the 1998 Social Security Act raised D.C.’s federal matching rate to 70 percent. Lowering the rate to 50 percent would require a change to federal law.D.C. says the change could amount to a $2.1 billion loss in funding, just as the district is trying to plug a $1 billion hole in its public services budget. The March spending package that extended government funding included the cut.While the Senate passed a bill reversing the $1 billion cut, the House has yet to take up the package.
COVID ORIGINS PROBES RETURN — National Intelligence Director Tulsi Gabbard told podcast host Megyn Kelly she’s working with top HHS officials to investigate Covid-19’s origins.In an interview Thursday, Gabbard said that in addition to working with NIH Director Jay Bhattacharya and HHS Secretary Robert F. Kennedy Jr., she wants to end so-called gain-of-function research, in which scientists alter pathogens to make them more transmissible or deadly so they can study them.Gabbard, like many in the Trump administration and Republicans in Congress, believes the pandemic was caused by a laboratory accident in Wuhan, China, not by the virus spilling over from animals to people, as many virologists say is more likely, Erin reports.Bhattacharya has said regulating risky research is among his top priorities as NIH director.While the CIA said earlier this year that Covid was more likely to have originated in a lab, it also said it had “low confidence” in that assessment and would continue to evaluate any new evidence. The FBI previously said it favored the lab leak theory with moderate confidence, while the Energy Department said it thought, with low confidence, that a lab leak was more likely.The National Intelligence Council, which advises the director of national intelligence, favored the natural origin theory during the Biden administration.
Drugmakers have spent millions targeting pharmacy benefit managers through donations to nonprofits, media sponsorships and lobbying, The Wall Street Journal’s Josh Dawsey, Kristina Peterson and Maggie Severns report.Despite HHS backing away from a new autism registry floated by NIH Director Jay Bhattacharya, parents are canceling autism clinical evaluations for children out of fear, STAT’s O. Rose Broderick reports.Rep. David Valadao (R-Calif.) is among House Republicans working to avert cuts to Medicaid spending, POLITICO’s Ben Leonard and Meredith Lee Hill write in a profile of the dairy farmer who represents more Medicaid beneficiaries than his GOP colleagues.
