April brought significant legislative activity, federal agency developments, and health policy movement across Congress and the executive branch.
Congressional Activity
Congress resolved several longstanding impasses before departing for recess on April 30. Key actions included:
- President Trump released his FY2027 budget request on April 3, proposing $2.2 trillion in total spending, a 10% cut to non-defense programs, and a major defense budget buildup. The Appropriations Committees began working toward marking up all 12 spending bills ahead of a September 30 deadline.
- Congress ended the longest agency shutdown in U.S. history on April 30, passing and sending to the President legislation that funded the Department of Homeland Security after a 75-day partial closure dating to February 14.
- The House passed the Farm, Food, and National Security Act of 2026 on April 30 by a 224-200 vote, reauthorizing USDA programs through FY2031, covering commodity support, crop insurance, conservation, nutrition assistance, and rural development.
- Congress cleared a 45-day extension of Section 702 of the Foreign Intelligence Surveillance Act after the Senate declined to advance a House-passed version that included a ban on a central bank digital currency.
Health Policy Developments
Congressman Greg Murphy (R-NC) introduced the Provider Reimbursement Stability Act on March 31. The bipartisan legislation aims to reform Medicare physician payment by addressing structural flaws in the current budget neutrality framework. Key provisions include:
- Raising the budget neutrality trigger threshold from approximately $20 million to over $50 million
- Indexing that threshold to inflation
- Improving the accuracy of utilization estimates used by CMS
- Limiting annual fluctuations in payment rates to provide greater predictability for physician practices
Supporters argue the reforms are critical to preserving independent physician practices and maintaining access to care for Medicare beneficiaries.
Senate HELP Committee Oversight and HHS Engagement
The Senate Committee on Health, Education, Labor, and Pensions held oversight hearings on HHS under Secretary Robert F. Kennedy Jr. during April. Senator Bill Cassidy chaired the hearings while facing a competitive Republican primary challenge from Julia Letlow, who has publicly criticized him for insufficient alignment with the administration’s Make America Healthy Again agenda.
Key topics included:
- The nomination of Erica Schwartz to lead the CDC. Schwartz is a career civil servant and former deputy U.S. Surgeon General. Senator Cassidy pressed Secretary Kennedy to ensure she would retain independent decision-making authority free from political influence. Cassidy raised concerns that current political leadership has undermined public trust in immunizations. Secretary Kennedy disputed that characterization but indicated Schwartz would have authority to shape her leadership team if confirmed.
- Abortion medication access. Senator Cassidy questioned why HHS had not moved to reinstate in-person dispensing requirements for abortion medications, which remain accessible via telehealth and mail under current policy. Secretary Kennedy declined to address the issue directly, citing ongoing litigation between Louisiana and the FDA. Cassidy also pressed the Department on enforcement around the importation of unapproved or counterfeit abortion drugs.
Federal Science and Research
On April 24, the White House dismissed all 24 members of the National Science Board, the governing body that oversees the National Science Foundation. Key facts:
- Members received a brief email from a White House personnel official notifying them that their service was terminated, effective immediately
- NSB members are presidential appointees confirmed to staggered six-year terms
- The NSF funds billions of dollars annually in grants to universities, academic medical centers, and research institutions
- The administration has not provided a public explanation for the dismissals or announced a timeline for new appointments
Separately, the Trump administration declined to seek Supreme Court review of a lower court ruling blocking its proposed 15% cap on NIH indirect cost reimbursements. Federal courts had previously found the cap conflicted with existing law and congressional appropriations requirements. By choosing not to appeal the decision, the administration ended the legal pathway for implementing the cap as proposed.
CNS Advocacy on the Hill
On April 23, CNS leaders met with the office of Rep. Frank Pallone (D-NJ), a senior member and former Chairman of the House Energy and Commerce Committee. The meeting addressed the following priorities:
- Expanding patient access to clinical trials and innovative therapies for pediatric populations
- Recent advances in epilepsy treatment and the need for sustained federal investment to ensure emerging therapies reach patients
- The importance of vaccines as a cornerstone of public health
- Concerns regarding immigration enforcement actions affecting children
The office reaffirmed Rep. Pallone’s strong support for medical research funding, including the recent restoration of Congressionally Directed Medical Research Programs.
CNS will continue to monitor these developments and advocate on behalf of its members as Congress returns from recess and federal health policy activity continues.