By Megan R. Wilson

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Today’s edition: Two failed Senate votes on tackling the enhanced Affordable Care Act subsidies puts the ball in the House’s court. … Regulators may approve the first new sunscreen ingredient in more than 25 years.… Confirmed cases of measles nationwide reach the highest level since the U.S. declared the illness eliminated … and more.

Hello and welcome to the Health Brief newsletter. Do you have any tips, scoops or gossip from Washington’s holiday party season? Reach out. You can find me at megan.wilson@washpost.com, or message me securely on Signal at megan.434.

This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from the Washington Post newsroom. Learn more about WP Intelligence.

Rep. Josh Gottheimer (D-New Jersey) launched one of two bipartisan discharge petitions to force a vote in the House on measures that would extend the enhanced Obamacare premium subsidies. (Jabin Botsford/The Washington Post)

	The Lead Brief

The Senate rejected dueling plans championed by both Democrats and Republicans in an effort to avert an impending spike in health costs for people with Affordable Care Act plans. There’s now a scramble in the House to force a vote on separate efforts to extend the enhanced premium subsidies, which expire at the end of the year.

The Post’s Theodoric Meyer, Paige Winfield Cunningham, Riley Beggin and Marianna Sotomayor have a new story out on the Senate votes. Both pieces of legislation only received 51 votes — nine short of the 60-vote threshold needed to pass the Senate.

Outliers: Republicans Sens. Susan Collins (Maine), Josh Hawley (Missouri), Lisa Murkowski (Alaska) and Dan Sullivan (Alaska) voted for the Democrat’s offering, a three-year extension of the enhanced premium tax credits that expire at year’s end.

Sen. Rand Paul (R-Kentucky) voted against the Republican plan — led by Sens. Bill Cassidy (Louisiana) and Mike Crapo (Idaho) — that’s focused on putting the federal cash into health savings accounts.

WHERE DO WE GO FROM HERE?

All eyes are on the House. In particular, two discharge petitions that would force a vote on proposals that include an extension of the enhanced subsidies. Discharge petitions need 218 signatures to move measures forward.

The last-ditch bipartisan efforts — both launched yesterday — have enough support from Republicans that Democrats could decide to unite behind one of them and tip the scales.

— One, from Rep. Brian Fitzpatrick (R-Pennsylvania), involves legislation to extend them for two years, while adding some eligibility requirements — such as an income cap of 700 percent of the poverty level — an extension of the enrollment period and expanded access to health savings accounts, among other policies.

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Signature count: 17 — 6 Democrats, 11 Republicans.

— Another, from Rep. Josh Gottheimer (D-New Jersey) and Jen Kiggans (R-Virginia), would push a bill that extends the enhanced subsidies for one year. This proposal has an income cap of 1,000 percent above poverty level, with a phase-out starting at 600 percent of poverty level, among other provisions. This discharge petition had the most new signers today.

Signature count: 33 — 22 Democrats, 11 Republicans.

House Democratic leadership — which has its own discharge petition that would force a vote on a clean three-year extension — has been noncommittal about whether it would throw its support behind the more recent efforts.

House Democratic leadership prefers Gottheimer’s option, Punchbowl News reported Thursday morning. However, House Minority Leader Hakeem Jeffries (D-New York) didn’t immediately respond to an inquiry about whether he has a preference.

→ It’s also unclear whether the Senate would take up any House-passed bill should any proposal manage to cross the finish line.

But, wait: There’s a sense that real action on whether to extend the enhanced subsidies depends on where President Donald Trump stands. And he’s been all over the place on the issue — acknowledging that he doesn’t like the Affordable Care Act and doesn’t want to extend the enhanced assistance, but that it may be necessary.

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Asked on Thursday what Trump wanted to do on the Affordable Care Act enhanced subsidies in the next few weeks, before the subsidies expire, White House press secretary Karoline Leavitt said during a press briefing: “You’ll hear more from the president, from the White House on that very soon.”

“The president is prepared to take action on health care and wants Republicans on the Hill to do the same,” she said.

	Agency alert

The Food and Drug Administration is moving to approve the first new sunscreen ingredient in more than two decades. The active ingredient, bemotrizinol, is already approved for use in Europe, Asia and Australia, and has been found to protect against both ultraviolet A and B rays, which can result in skin aging, sunburn and skin cancer.

“The agency has historically moved too slowly in this area, leaving Americans with fewer options than consumers abroad,” said FDA Commissioner Marty Makary in a statement. Comments on the FDA’s proposal are due by Monday, Jan. 26.

Why it matters: Bemotrizinol is considered highly effective because it doesn’t break down as quickly when exposed to sunlight — reducing the need for reapplication — like other sunscreen ingredients do, the FDA said after reviewing the data. It’s also composed of larger molecules, which means it doesn’t absorb into the skin as much, the FDA said. Although the science isn’t conclusive, there have been concerns about the potential health impacts of chemical sunscreen absorption into the body.

Henry W. Lim, senior vice president of academic affairs and former chair of dermatology at Henry Ford Health and spokesman for the American Academy of Dermatology, told my Washington Post colleague Sabrina Malhi that bemotrizinol is one of the most well-studied, broad spectrum UV filters.

“So far it has been very difficult to get any new filter approved in the U.S., and so this one is a breakthrough,” Lim said.

What it means for industry: Companies such as La Roche-Posay, Neutrogena, Beauty of Joseon and Bioré sell sunscreens containing the ingredient abroad, but have to reformulate their products for the U.S. market. If the FDA approves the ingredient, they wouldn’t need to.

The Public Access to SunScreens Coalition — an advocacy group of sunscreen manufacturers, public health groups and physician organizations — cheered the FDA’s move.

Michael Werner, a policy adviser to the coalition and partner at Holland & Knight, called it a “historic action, which represents a monumental step forward for public health in the United States.”

	Numbers Game

1,912

The number of confirmed cases of measles in the U.S. has grown to almost 2,000 people across 43 states, according to the Centers for Disease Control and Prevention. Of those cases, 92 percent have occurred in people who were unvaccinated against the highly contagious virus or had an unknown vaccination status. So far this year, three people have died from measles and 11 people were hospitalized, according to numbers compiled by the CDC.

Why it matters: It’s the highest number of measles cases in the country since the U.S. declared the illness eliminated — meaning it had not spread domestically for more than 12 months — in 2000. The CDC says that one dose of the measles vaccine is 93 percent effective at preventing the illness, while the full two-dose regimen is 97 percent effective.

→ The outbreaks occurring nationwide come as the Trump administration has cast doubt on the safety of the combined measles, mumps and rubella (MMR) vaccine. The number of kindergarteners receiving the shot has been declining over the last decade, according to CDC data.

South Carolina state epidemiologist Linda Bell said that “high vaccine coverage was responsible for eliminating ongoing transmission in this country,” my colleague Kelly Kasulis Cho in The Washington Post newsroom reports. “Now that we are … at the brink of seeing continued transmission in the United States for almost a year now, we’ve run the risk of losing that designation as a country.”

READ MORE FROM WAPO: “Hundreds quarantined as South Carolina measles outbreak accelerates.”

	Document Drop

Covid vaccines were 76 percent effective in preventing covid-related emergency department or urgent care visits among children aged 9 months to 4 years old compared to young children who didn’t receive the shot, according to a new report released by the CDC. It was 56 percent effective in preventing hospital visits among children between 5 and 17 years old. CDC conducted the study from Aug. 29, 2024, to Sept. 2, 2025. The report comes as the FDA is investigating whether the shots are linked to deaths in children.

	WP Intel File

TOMORROW: The first WP Intelligence health care briefing will be centered on the Trump administration’s efforts to incorporate AI into the Medicare program and its rollout of the Rural Health Transformation program. You don’t have to be a WP Intelligence subscriber to join us, so grab a seat for this virtual event.

Lead health analyst Rebecca Adams and Andy Slavitt, the co-founder of Town Hall Ventures, will be taking your questions. Slavitt, who served as acting head of the Centers for Medicare and Medicaid Services in the Obama administration, recently helped CMS vet its AI plans.

→ Here are some of the questions we’ve received so far:

• CMS is supposed to be announcing awards to states that have applied for Rural Health Transformation Fund grants by the end of this month. What should people be watching for?
• The administration is signaling an interest in incentivizing greater use of technology in health care, both through the $50 billion rural health fund and through the new Medicare payment proposal. How are virtual telehealth providers, app developers and other companies responding? How will this change the care that consumers receive?
• Regarding a CMS pilot initiative being referred to as TEMPO, which Rebecca wrote about in her report on AI, and which seeks to expand the use of health tech and wearables: The FDA is planning to waive reviews for some device makers. Why is that? And how will they ensure that devices are safe and effective?
• As the use of AI technology in health care grows, what are the most pressing concerns that regulators and the public ought to have?

	What We’re Reading

“Lilly’s three-pronged drug puts obesity field ‘on notice’,” Kristin Jensen writes for BioPharma Dive.

“What fraud? State Obamacare officials don’t see the problem GOP subsidy opponents do,” Robert King reports at Politico.

“Calls to pull COVID vaccines get louder,” Axois’s Caitlin Owens writes.