| |  | The Lead Brief | What happens this month will shape the direction of health policy for the rest of the year — health policy riders in government funding bills, congressional oversight of Health and Human Services Secretary Robert F. Kennedy Jr.’s leadership, and actions on vaccines that impact who can get shots and how much they’ll cost. Here are three things to watch for next week, including one that may fly under the radar: 1. Shutdown watch Congress is on a collision course to fund the government, and health policy has taken center stage. With less than three weeks — and even fewer legislative days — to go until the Sept. 30 government funding deadline, Senate Minority Leader Chuck Schumer (D-New York) appears to be drawing a line in the sand about what it will take to get a deal, according to a report this morning from The Post’s Theodoric Meyer, Marianna Sotomayor and Riley Beggin. Schumer and House Minority Leader Hakeem Jeffries (D-New York) huddled on Thursday with other top House and Senate Democrats to craft a unified strategy, but Schumer said Senate Majority Leader John Thune (R-South Dakota) refused to meet with him, according to the report. The demands: - Reverse the Medicaid cuts that the GOP passed in July as part of the One Big Beautiful Bill.
- Extend Affordable Care Act health insurance subsidies set to expire at the end of the year.
- Undo the Trump administration’s cuts to the National Institutes of Health.
Some Republicans have seemed open to some of the demands, such as the Obamacare subsidies — realizing the electoral risk if premiums spike for voters — but outstanding differences and tense talks mean there is risk the government could shut down. → While congressional leadership will be the ones to hammer out a deal — if there is one — both House and Senate appropriations panels have rejected NIH cuts in their respective funding bills, on a bipartisan basis. 2. Vaccine policy and oversight Get ready for vaccine whiplash. A panel of vaccine advisers will meet Thursday and Friday to discuss — and potentially vote on — updated recommendations for shots for covid; hepatitis B; measles, mumps, rubella and varicella (MMRV); and respiratory syncytial virus (RSV). The day before, the Senate will be probing upheaval at the Centers for Disease Control and Prevention that culminated in the ouster of its leader, Susan Monarez, and the subsequent departure of several high-level officials. Monarez will testify, as will former CDC chief medical officer Debra Houry. It’s part of a planned set of Senate Health, Education, Labor and Pensions Committee hearings to investigate Kennedy’s stewardship of HHS and strategy on vaccines. → When the CDC’s Advisory Committee on Immunization Practices meets next week, it could roll back coverage recommendations for key vaccines ahead of the winter, when cases of illnesses like covid and RSV begin to spike. The panel consists of members handpicked by Kennedy, including many who have a history of expressing vaccine skepticism. → The Washington Post is out today with an exclusive that Trump health officials plan to link coronavirus vaccines to the deaths of 25 children in a presentation before the panel, with reporting by Lena H. Sun, Rachel Roubein and Dan Diamond. Although the report states the presentation is not final — and the methodology is unclear — experts are worried the data draws from the federal Vaccine Adverse Event Reporting System, which contains unverified reports of side effects or bad experiences with vaccines that can be submitted by anyone. The Trump administration has already taken actions to reduce who is eligible to receive a coronavirus vaccine, and the Post report says the panel is weighing whether to recommend restricting shots further. The following are reportedly under consideration: Recommending the shot for those 75 and older but instructing people who are younger to speak to a physician before they get the vaccine. Not recommending the vaccine to people under 75 without preexisting conditions. What’s next: Limiting access to vaccines for older people could cause a backlash politically, my colleagues report — with an estimated 43 percent of people ages 65 to 71 receiving a 2024-2025 version of the coronavirus vaccine. The events are likely to set off a chain reaction involving increasing uncertainty around insurance coverage of vaccines and states — which have historically followed the federal government’s direction — continuing to go their own way in developing their own immunization guidance. 3. There could be a break in the logjam for ‘breakthrough’ medical devices There’s momentum behind efforts to expand and expedite coverage for “breakthrough” technologies — medical devices and diagnostic tests that regulators determine can offer “more effective” treatment or diagnosis for serious conditions. This includes surgical robots and multi-cancer early detection tests. There are about 68 million Americans on Medicare, and policymakers argue that the current regulatory setup makes it too difficult for patients to get coverage for treatments or services involving the products the Food and Drug Administration has approved under the Breakthrough Devices Program. On Thursday, the House Energy and Commerce health subcommittee will consider several bills involving expediting coverage of these products, including legislation that would temporarily cover medical devices and tests that the FDA has determined are breakthrough technologies while the Centers for Medicare and Medicaid Services establishes more permanent pathways. The industry has been pushing for speedier coverage of these products, saying that it can take roughly six years before a product that’s been approved by the FDA can also get the okay for coverage under Medicare. CMS established a pathway to coverage of some of these products, but the industry argues that it’s unpredictable and far too limited. | 
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