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December 3rd, 2024

Federal Legislative Update

Last Updated: December 3, 2024

OVERVIEW

President Trump and the 119th Congressional leadership are signaling their plans and priorities. Tax cuts, tariffs, funding cuts and increases, vaccine scrutiny, shrinking government, pro-business regulatory reforms, end to DEI policies, and many more are among those topping the list.

 

Here's the Scoop

Currently, Congress is back in session this first week of December with those who are retiring or lost re-election packing up their offices and freshmen members for the 119th Congress participating in trainings, lobbying to get onto committees of their choice, and hiring staff. Both Congress and President Biden would like to pass the National Defense Authorization Act that has passed the House but not the Senate as well as a potential $98 billion disaster aide package to help states hit by the Hurricanes Helene and Milton before the end of 2024.

FY25 Appropriations

Congress has until December 20 to complete the FY25 appropriations process or pass another Continuing Resolution (CR) as the new fiscal year started October 1. Senate appropriators are making public statements about passing a new CR to fund government through January that includes disaster aid funding totaling somewhere between $30 billion and $90 billion. To complete the FY25 process, the chambers must address a $90 billion gap between the House and Senate bills as the House followed the statutory spending caps set by the debt-limit deal negotiated between former Speaker Kevin McCarthy and President Biden last year, while Senate appropriators ignored the caps. With the power shift in the Senate from Democrats to Republicans in addition to the White House shift, the final FY25 omnibus package is expected Q1 2025.

A big challenge in completing these funding measures will be the razor thin margin Republicans will have in the House of Representatives next year (217 Rs to 215 Ds) with the election results plus Reps. Elise Stefanik (R-NY) and Mike Waltz (R-FL) both leaving due to Trump's nominations for UN Ambassador and National Security Adviser, respectively. Finally, they need to follow a procedure called reconciliation in order to push through expiring tax cuts, spending cuts and increases with a simple majority as a budget for FY26 that must pass Congress by April 15 and the requisite implementing legislation by June 15. It is a lot for a new Congress and new President to get done within just a few months of inauguration.

 

Issues and Challenges

In 2025, after Trump's inauguration on January 20, the GOP will hit the ground running. They will use the budget reconciliation procedure to push through an extension of the 2017 Tax Cuts and Jobs Act tax law with some tweaks, such as addressing the SALT cap, tariffs, and the Biden administration’s energy credits. Trump has said he supports elevating the $10,000 federal limit on the state and local tax deduction imposed in the 2017 law (SALT cap) that most Members representing rural states oppose, called for tariffs of 60% on imports from China and up to 20% from elsewhere that some lawmakers fear will harm too many businesses, and aims to end the $7,500 subsidy for electric vehicles and other carbon sequestration, biofuels, hydrogen, and nuclear energy tax credits from the Democrats’ 2022 tax-and-climate law although some Republicans support these and represent districts where those energy tax credits have spurred big projects. Plus, billions that were earmarked for IRS modernization are also likely to be redirected in this budget plan. The childcare tax credit is yet another part of the 2017 law that garners broad support, but disagreement over adjusting the total credit remains.

Then there is the issue of cost. The price tag for a decade-long extension of the 2017 law totals $4.6 trillion, according to the Congressional Budget Office. If other items promised on the campaign trail are added, such as tax exemptions for tipped wages, the blanket tariffs, and more cuts to the corporate tax rate then these would increase the deficit by an additional $3 trillion over a decade, according to the Tax Foundation. The deficit hawks in Congress are likely to oppose this $7.6 trillion hole in the budget. Still others have proposed eliminating the corporate rate and capital gains tax altogether and shifting collection to individuals, making more adjustments to the personal income tax brackets, and ensuring pass-through entities can write off 20% of their business income. All these proposals increase the deficit even further, giving some Republicans too much heartburn to go along.

2025

We will be tracking the nomination process, rulemaking rescissions, State of the Union, and President Trump's FY26 Budget Proposal as well as the first key steps of the new Congress: committee assignments and chairmanships (and their priorities), leadership positions, budget reconciliation process, and hearings that set the tone for the next two years in the House and Senate.

The next Congress will be empowered to scrap any finalized rules dating back to August 1 under the Congressional Review Act. Federal agencies completed work on many regulations earlier this year so they would be outside the review window. These include prescription drug transparency, Defense Department's sex as a biological variable (SABV) consideration in research and care, and limits on noncompete clauses, but excludes the recent over the counter contraception access proposed ruling from October, the Environmental Protection Agency rule imposing methane emission fees and the FDA rule on tobacco age requirements. Previously, this process was used to overturn 16 Obama-era rules during President Trump’s first term and three Trump-era rules at the beginning of the Biden administration.

Trump has plowed through his nomination selections, including just yesterday nominating Dr. Jay Bhattacharya, a Stanford University professor and vocal critic of COVID-19 lockdowns, as the next director of NIH. This follows his selection of former Rep. David Weldon, MD from Florida to head the CDC, who has long questioned the safety of the vaccines and Robert F. Kennedy Jr. as the Secretary of the Health and Human Services Department, who has challenged vaccines since 2005 and specifically the scientifically disproven claim of a causal link between vaccines and autism.

Trump is next working on his policy priorities. Key organizations shaping this agenda include:

  • America First Legal — Backed by Trump’s soon-to-be deputy chief of staff in the White House (Stephen Miller) who has promised to “completely transform the legal architecture in this country.” This group has focused on cases to defeat diversity initiatives in corporate America, pare back federal and state pro-immigrant activities, and oppose gender-identity discrimination protections.
  • Alliance Defending Freedom — A legal organization that helped to orchestrate the fall of Roe v. Wade and its CEO (Kristen Waggoner) was lead defense counsel in the landmark Supreme Court case that found a Colorado baker didn’t discriminate against LGBTQ people by declining to make cakes for same-sex couples.
  • America First Policy Institute — The group’s litigation leader was nominated for Attorney General (Pam Bondi). They have already drafted hundreds of executive orders and regulations for Trump to use next year with a focus on reducing the federal government, halting funding for Planned Parenthood, supporting oil and gas production, limiting immigration, and giving more resources to the police.

Health

Women's Health is Becoming a National Priority

Several mentions of women's health issues appear in the FY25 appropriations measures that are still pending in Congress. Of particular interest is the expressed interest in increasing investment in women's health research thanks to the leadership of Women's Health Access Matters (WHAM), multiple mentions of menopause and the first-ever recognition of the importance of the ovaries thanks to the leadership of Celmatix.

"Based on an analysis of NIH extramural grants awarded in fiscal year 2019, doubling research focused on women-focused funding in just four conditions, coronary artery disease, lung cancer, Alzheimer's disease, and rheumatoid arthritis could provide a $14 billion economic return. Despite progress made, opportunities to enhance NIH efforts focused on the health of women across the lifespan could bridge gaps in knowledge about diseases that affect women differently or disproportionately. Additional NIH-wide investments in research addressing pressing conditions and diseases which negatively impact the health of women could produce significant economic returns. The Committee urges NIH to focus women's health research on these areas."
— FY25 House Labor, Health and Human Services, and Education Appropriations Report

"Ovarian Health.—The Committee recognizes that ovarian health impacts a woman’s whole health throughout her lifetime, affecting health of her heart, immune system, metabolic function, among other systems. When ovarian function declines or ceases due to menopause, various medical conditions, or following surgery, woman are at increase risks for developing many chronic conditions, including heart disease, osteoporosis, dementia, and autoimmune diseases. Advancing knowledge and research on ovarian health could reduce many of these chronic conditions, especially as women age."
— FY25 House Agriculture-FDA Appropriations Report

Since these were included in the Republican controlled House, it is likely to garner similar attention in the omnibus and FY26 legislation. G2G played a role in inserting this language so we are partial to it, but see opportunities to keep educating and building momentum for increased awareness and funding for menopause research and care. We will keep tracking, reporting and advocating for inclusion in the omnibus.

 

Health Bills to Watch

Some pending bills during this 118th Congress we are watching and advocating for include these that have garnered bipartisan, bicameral support and for which efforts are underway to include some portions in a larger omnibus package:

  • Find It Early Act — breast cancer screening technologies coverage and access, key for the 50% of women with dense breasts — Reps. Rosa DeLauro (D-CT) and  Brian Fitzpatrick (R-PA) and Senators Amy Klobuchar (D-MN) and Roger Marshall, MD (R-KS)
  • Advancing Menopause Care and Mid-Life Women’s Health Act — funding for research and care — Reps. Lisa Blunt Rochester (D-DE) and Yvette Clarke (D-NY) and Senators Patty Murray (D-WA) and Lisa Murkowski (R-AK)
  • Black Maternal Health Momnibus Act — investments in social determinants of health, expanded access to quality maternal healthcare, perinatal workforce diversification, and data collection improvements — Reps. Lauren Underwood, RN, MPH (D-IL) and Alma Adams (D-NC)
  • National Plan for Epilepsy Act — Senators Eric Schmitt (R-MO) and Amy Klobuchar (D-MN) and Reps. Greg Murphy, MD (R-NC) and Jim Costa (D-MD)
  • Medicare Patient Access and Practice Stabilization Act — stop the 2.8% CMS Medicare reimbursement cut for physician services that starts January 1, 2025 that is compounded by the 3.6% projected increase in expenses next year totaling a 6.4% cut — Reps. Greg Murphy, MD (R-NC), Jimmy Panetta (R-CA), Mariannette Miller-Meeks, MD (R-IA) and Ami Bera, MD (D-CA)