House Committee Advances Medicare Overhaul and Health Plans

Why it Matters

The House Ways and Means Committee is moving a package of eight bills through markup on Thursday that would reshape Medicare reimbursement, expand coverage for pharmacists and home dialysis patients, crack down on pandemic unemployment fraud, and tighten oversight of the Temporary Assistance for Needy Families (TANF) welfare program. Republicans are now navigating a fraught reconciliation process, and the committee's simultaneous submission of a Views and Estimates Letter to the Budget Committee signals that these bills are being considered within that broader fiscal framework.

The breadth of the package, spanning Medicare payment policy, Social Security disability programs, and pandemic-era fraud recovery, reflects the committee's effort to move a range of member priorities ahead of a closing legislative window. Most of the bills are sponsored by committee members themselves, and several carry bipartisan cosponsor lists, suggesting House leadership calculated that this particular mix could clear markup without a bruising partisan fight.

Medicare Reimbursement at the Center

Two of the most consequential bills on the docket address longstanding instability in how Medicare pays doctors and other providers.

H.R. 3164, the Ensuring Community Access to Pharmacist Services Act, was introduced by committee member Rep. Adrian Smith (R-NE) and has accumulated 87 cosponsors, including a substantial bloc of Ways and Means members on both sides of the aisle. The bill would allow Medicare Part B to pay for pharmacist services, including evaluation and treatment for COVID-19, flu, RSV, and strep throat, when the pharmacist is authorized under state law and working under physician supervision. Medicare would cover 80 percent of the applicable charge for most services, rising to 100 percent for services tied to declared public health emergencies. The bill also prohibits balance billing patients for these services.

H.R. 8163, the Provider Reimbursement Stability Act of 2026, was introduced by committee member Rep. Greg Murphy (R-NC) and targets the chronic volatility in Medicare's physician payment formula. The bill would cap year-to-year payment fluctuations at 2.5 percent and update the threshold that triggers payment adjustments from $20 million to $54.3 million beginning in 2027. It also requires Medicare to reconcile payments when utilization estimates diverge significantly from actual usage, and mandates that cost data used to calculate provider payments be updated at least every five years. Starting in 2032, the payment threshold would be adjusted annually for inflation.

Both bills have drawn support from committee members including Rep. Brad Schneider (D-IL), Rep. Claudia Tenney (R-NY), and Rep. Brian Fitzpatrick (R-PA), among others, a cross-partisan coalition that could smooth their passage through markup.

Expanding Coverage, Tightening Oversight

H.R. 8875, the Improving Home Dialysis Act of 2026, was introduced by committee member Rep. Carol Miller (R-WV) and would add two new Medicare-covered services for patients who perform dialysis at home beginning January 1, 2028, including staff-assisted respite care and renal mental health services. Respite care would be capped at 20 sessions per year during the first 30 days after starting home dialysis, or at any time for patients with physical limitations. Mental health services would be limited to four sessions during the first 60 days on home dialysis. Rural areas would receive higher reimbursement rates than urban areas under the bill's payment structure.

H.R. 8883, introduced by committee member Rep. Beth Van Duyne (R-TX), would add oversight requirements for hospice programs and home health agencies under Medicare. The bill text had not been released as of Wednesday.

H.R. 8871, the DME Scammer Prevention Act of 2026, introduced by committee member Rep. Aaron Bean (R-FL), takes aim at fraud in Medicare's Durable Medical Equipment (DME) coverage. Beginning January 1, 2027, suppliers would be required to submit claims electronically and within 90 days of providing items to patients. By January 1, 2030, the Government Accountability Office would be required to report to Congress on how well the new requirements reduce improper payments.

Fraud Recovery and Welfare Accountability

Two additional bills on the markup agenda address fraud and program integrity in federal benefit programs.

H.R. 8873, the Recover COVID Unemployment Fraud in Banks Act, was introduced by Van Duyne and cosponsor Rep. Tom Suozzi (D-NY), one of the few bipartisan pairings in the package. The bill would establish a National Recovery Coordinator and inter-agency task force under the Secretary of Labor to work with financial institutions and state agencies on identifying and recovering fraudulently obtained pandemic-era unemployment benefits. The statute of limitations for prosecuting pandemic unemployment fraud would be extended to ten years.

H.R. 8872, the Preventing Waste, Fraud, and Abuse in TANF Act, was introduced by committee member Rep. Mike Carey (R-OH) and carries five Republican cosponsors, all committee members. The bill would require states to apply federal payment integrity standards to TANF, limit assistance to families earning below twice the federal poverty line, and prohibit states from using federal TANF dollars to supplant their own spending on the program. States would have one year to obligate federal funds and two years to spend them. The provisions would take effect October 1, 2027.

Social Security Disability Programs

H.R. 8884, the Removing Barriers to Work for Disabled Americans Act, was introduced by Rep. Austin Scott (R-GA), who is not a member of the Ways and Means Committee. The bill would extend the Social Security Administration's authority to run experimental programs testing new approaches to disability benefits through December 31, 2030, and expand the review period for evaluating demonstration projects from 90 to 120 days. A key provision would ensure that participants in these programs would not see their total income reduced as a result of participation. Changes would take effect January 1, 2027.

The Budget Connection

The inclusion of a Views and Estimates Letter to the Committee on the Budget alongside this legislative package is a procedural marker worth watching. Under House rules, committees submit these letters as part of the budget reconciliation process, laying out their spending and revenue projections. The committee's decision to bundle that letter with this markup places the package squarely in the context of the broader reconciliation fight, a signal that at least some of these provisions could be candidates for inclusion in a larger fiscal vehicle as Republicans work to advance their legislative agenda through the 119th Congress.

Rep. Jason Smith (R-MO) chairs the committee. Rep. Richard Neal (D-MA) serves as ranking member. The markup is scheduled for Thursday, May 21, 2026, at 1:00 p.m. in 1100 Longworth House Office Building.

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