April 17, 2026 | Vol. MMXXVI | Issue 157

In this edition:

• Appropriations

• Department of Health and Human Services Hearings

• Vaccines

• Oversight Hearing

• New Legislation

• AUCD Materials

• Words to Know

Appropriations

Congress has begun to schedule hearings and markups to consider appropriations legislation for Fiscal Year 2027. The House Appropriations Committee is holding a series of hearings for agency heads to testify about the President’s Budget for Fiscal Year 2027 and the Executive’s policy priorities. This includes hearings with Department of Health and Human Services Secretary Robert F. Kennedy, Jr., whose agency is responsible for funding and providing technical assistance to AUCD programs. The House and Senate are expected to start drafting and then marking up appropriations legislation for FY27 in the coming weeks.

Plain Language

Appropriations means money that is set aside by Congress for a particular use. Congress is starting to write bills that will include appropriations for different federal government departments and programs in the coming weeks. They will hold budget hearings, where they meet with agency leaders who will talk about the President's Budget. This includes hearings with Department of Health and Human Services Secretary Robert F. Kennedy, Jr., which we talk about more below. HHS is in charge of funding and other support that AUCD programs get. Congress will also hold markups, which is when they meet to work on bills and make updates and changes.

Department of Health and Human Services Hearings

On April 16, both the House Ways and Means Committee and the House Appropriations Committee held hearings on the 2027 President’s Budget proposal for the Department of Health and Human Services (HHS). HHS Secretary Robert F. Kennedy, Jr. was the sole witness at both hearings. The hearings covered topics including rural health, vaccines, Medicaid and Medicare fraud, ultra-processed foods, chronic diseases, and maternal mortality rates, among others.

Secretary Kennedy defended the President’s proposed cuts to HHS agencies including the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) as necessary sacrifices to balance the federal budget. Democrats largely criticized Secretary Kennedy’s efforts to make vaccination recommendations more lax and co-signing cuts to Medicaid, while Republicans tended to praise the Secretary’s work, most often focusing on his efforts to curb consumption of ultra-processed foods and root out what they see as fraud and waste in Medicare and Medicaid. The Secretary ardently defended the cuts made to Medicaid in H.R.1, disputed vaccine science, and argued that combatting chronic disease was the most important policy issue for HHS.

Key Takeaways

Ways and Means Committee – Ranking Member Richard Neal (D-MA) and Representatives Mike Thompson (D-CA), John Larson (D-CT), Linda Sánchez (D-CA), Judy Chu (D-CA), Jimmy Panetta (D-CA), and Brad Schneider (D-IL) talked about the damaging vaccine policies that RFK has implemented as Secretary, whether unilaterally or through the Advisory Committee on Immunization Practices (ACIP) and other anti-vaccine HHS officials he has appointed. These Members referenced rising measles cases and misleading claims about the causes of autism. Alternatively, Representative Blake Moore (R-UT), who has a son with autism, said he was encouraged by RFK’s efforts to research autism and find its causes.

Republican Members on the panel echoed many of the Administration’s concerns about significant fraud perpetrated in Medicare and Medicaid through hospice and home care. Representative David Schweikert (R-AZ) alleged significant fraud in home visitation programs under Medicaid. Secretary Kennedy agreed, saying that Medicaid home care waivers enable rampant fraud because family caregivers are being paid for services they would have previously done for free and federal and state Medicaid officials don’t know if those family members are actually providing those services.

The focus on home and community-based services (HCBS) as a frequent source of fraud is misleading, advocates argue—Medicaid HCBS is subject to cost neutrality regulations and providers must go through extensive screening and use Electronic Visit Verification.

Representative Thompson referenced rising measles cases in California, and lamented that while measles used to be considered eliminated in the U.S., that status is now in jeopardy. He said the President has enabled Secretary Kennedy’s propagation of conspiracy theories about vaccines.

Representative Panetta pointed to a lack of leadership at the CDC starting with the Secretary’s firing of former Director Susan Monarez. Without established leadership at CDC, he said, Secretary Kennedy has been able to make unilateral changes to vaccine policies, including rolling back COVID vaccine guidance for pregnant women. This week, former deputy surgeon general Erica Schwartz was named as the President’s nominee to lead the CDC.

Representative Schneider brought up the importance of research funded by NIH; specifically, he said that there was a potential cure for spinal muscular atrophy thanks to research funded by NIH, and was concerned that the President’s Budget shrinks NIH funding.

Appropriations Committee – Ranking Member Rosa DeLauro (D-CT) brought up the huge cuts to HHS in the President's Budget, the Administration’s cuts to Medicaid, and Sec. Kennedy’s cancelation of millions of dollars for research. She criticized HHS’ vaccine policy changes through ACIP, and linked RFK’s rejection of established vaccine science to the spread of measles in multiple states. She was adamant that Congress would not carry out the President’s proposed cuts to CDC and NIH.

Representative Lois Frankel (D-FL) talked about how the Secretary cut funding to Gavi, despite the fact that Congress appropriated funding for it. Gavi is an international agency that works to vaccinate children worldwide to stop the spread of vaccine-preventable diseases, including polio and measles. RFK revoked funding for Gavi because he said it “ignores the science” about vaccine safety, a claim the organization has refuted. Representative Madeleine Dean (D-PA) also had a heated back and forth with Secretary Kennedy about rising measles cases in the U.S., which she linked to Sec. Kennedy’s anti-vaccine rhetoric and the changes he made to ACIP.

Plain Language

On April 16, two committees in the House had hearings about the President's Budget proposal for the Department of Health and Human Services for 2027. The Ways and Means Committee and the Appropriations Committee both had Secretary Kennedy join and talk about HHS and what it is doing. They asked him questions about Medicaid cuts, vaccines, junk food and healthy food, and rural health. Vaccines are shots with medicine that stop people from getting sick. Rural means an area where there is a lot of land and not a lot of people.

Democrats on the committees were upset that HHS and the President have made cuts to Medicaid. They were also upset with Secretary Kennedy because he has changed vaccine advice to make fewer people get fewer vaccines and he has said things about vaccines that are not true. Representatives Richard Neal (D-Massachussetts), Mike Thompson (D-California), John Larson (D-Connecticut), Linda Sánchez (D-California), Judy Chu (D-California), Jimmy Panetta (D-California), Brad Schneider (D-Illinois), Lois Frankel (D-Florida), Madeleine Dean (D-Pennsylvania), and Rosa DeLauro (D-Connecticut) all talked about the damaging changes that Secretary Kennedy has made to vaccine guidance and said that more people are getting measles more than they used to.  Measles is a dangerous disease that can kill people. There is a vaccine to stop people from getting measles, but Secretary Kennedy and many other people have said for years that this vaccine might be unsafe or might cause autism, even though it doesn't. This is why some people have stopped getting vaccinated for measles and more people are getting this disease. The Members also talked about how the Administration has said untrue things about autism. Representative Blake Moore (R-Utah), who has a son with autism, said he was happy about Secretary Kennedy's efforts to research autism and find its causes.

Representative Panetta said that Sec. Kennedy has left the Centers for Disease Control and Prevention (CDC) without a leader for a long time. He said Secretary Kennedy has been able to make decisions by himself because of this. He said the Secretary’s decisions about vaccine policy have been bad. This week, the President announced that Erica Schwartz is his new pick to lead the Centers for Disease Control and Prevention.

Republicans were mostly supportive of Secretary Kennedy's work on getting people to stop eating junk food, as well as his work to stop fraud in Medicare and Medicaid. Fraud is when you pretend to do something or be someone else in order to get money. Republicans and Sec. Kennedy said that there is a lot of fraud happening in home and community-based services (HCBS). They said that family caregivers used to provide care for free, but now they are getting money from Medicaid to provide HCBS. They think that many of these family caregivers might not be giving care but still getting Medicaid money. They said that federal and state Medicaid officials don’t know if those family members are actually providing those services.

Family caregivers are so important because they provide home care for older adults and people with disabilities. A lot of people are on waiting lists to get HCBS from professional caregivers through Medicaid health insurance. They need HCBS but there aren’t enough caregivers. That is why family caregivers often step in to provide this life-saving care. It is a good thing that Medicaid pays many family caregivers because many of them have to quit their jobs to provide care. They need that funding to make sure they and their loved one can stay in their house and live like everyone else.

Secretary Kennedy said that he doesn't like that there have been a lot of funding cuts to HHS but thinks it is still important because the federal government spends too much money. He said no one is going to lose their Medicaid because of the Administration's actions, but that is not true. He said that chronic diseases are the most important issue for HHS. Chronic diseases are diseases and medical conditions that people usually have to live with for most or all of their lives, such as diabetes. Rosa DeLauro, the second most powerful person on the House Appropriations Committee, said that Congress will not cut the funding at HHS that the President wants to cut.

Vaccines

Advisory Committee on Immunization Practices (ACIP) — New reporting has come out about HHS Secretary Kennedy's revisions to the charter that governs ACIP. The following excerpts include new language, bolded, from Sec. Kennedy’s revised charter. The Washington Post reviewed the former charter and compared it with the new one, and reported on those changes, reflected below:

ACIP shall provide advice and guidance to the CDC Director regarding use of vaccines and related agents for effective control of vaccine-preventable diseases and/or decreased symptomatology in the civilian population of the United States and gaps in vaccine safety research including adverse effects following vaccination. Recommendations made by ACIP are initially reviewed by the CDC Director, and if adopted, become official CDC/HHS recommendations, and may be published in the Morbidity and Mortality Weekly Report (MMWR).

Members shall be selected from authorities who are knowledgeable in the fields of medicine, vaccines, immunization practices, immunology, toxicology, pediatric neurodevelopment, epidemiology, data science, statistical analysis, health economics, recovery from serious vaccine injuries, or public health; have expertise in the use of vaccines or other immunobiologic agents in clinical practice or preventive medicine, have expertise with clinical or laboratory vaccine research, or have expertise in assessment of vaccine safety and efficacy. The Committee shall include a person(s) knowledgeable about consumer perspectives and/or social and community aspects of immunization programs.

This paragraph was added:

ACIP shall also be responsible for reviewing data on vaccine safety and adverse events, providing recommendations to enhance vaccine safety surveillance systems, and advising CDC on gaps in vaccine safety research; evaluating the risk/benefit profiles of vaccines based on ongoing surveillance and new research findings; considering analysis of cumulative effects of vaccines and their constituent components; engaging in re-analysis of vaccine safety and efficacy as gaps are identified and new information becomes available; and evaluating the risks and benefits of tailoring immunization practices to maximize benefits and reduce risks and take into account variability in immune response for various populations.

Maryland – Maryland has passed the Vax Act, legislation to decouple the state’s vaccine recommendations from the federal government. It’s the latest in a string of state-led actions across the country to distance states' immunization guidance from ACIP. The Vax Act “establishes new authority for the secretary of the Maryland Department of Health to issue official recommendations for immunizations, screening, and preventive services for Marylanders based on science and clinical guidance.”

Key Takeaways

ACIP – The changes to the charter show how Sec. Kennedy is reshaping the government’s role in vaccine research and recommendations. This new language makes vaccine injury, questioning vaccine safety, and evaluating vaccine risks central foci for ACIP. This action, and others like it that the Secretary has taken, undermines decades of federal government efforts to earn public trust in vaccines by narrowing the committee’s focus to vaccine risks rather than benefits. As vaccine-preventable diseases re-emerge across the country, endangering public health in many states, many public health experts are concerned that skewing ACIP’s focus to vaccine skepticism is the wrong direction for the committee to take.

A federal judge recently halted some of Secretary Kennedy’s changes to vaccine policy and ruled that the 13 vaccine advisors on ACIP selected by Secretary Kennedy were unlawfully appointed, and therefore their vaccine policy changes are unlawful. 

Plain Language

ACIP – The Advisory Committee on Immunization Practices (ACIP) is a group of people in the Department of Health and Human Services (HHS) that makes decisions about vaccines and when people get them. Vaccines are shots with medicine that stop people from getting sick. A while ago, Secretary Kennedy got rid of everyone on ACIP and brought in a new group. This group is mostly anti-vaccine and have said things about vaccines that aren't true. A judge has stopped some of the changes that HHS Secretary Kennedy and ACIP made to vaccine policy. He said that the 13 people that Secretary Kennedy put on ACIP were put on the committee against the rules and they shouldn't be there. 

Now, Secretary Kennedy is trying to make changes to ACIP's charter, which is an official document that says what the rules are for this committee. The changes he wants to make would make ACIP focus more on injuries that people could get from vaccines or ways that vaccines aren't safe. He has done a lot of things like this because he doesn't think vaccines are safe, even though a lot of experts have said for a long time that they are, based on scientific proof. Public health experts are worried about this new charter because there are a lot of people getting measles in the U.S. Measles is a dangerous disease that can kill people. There is a vaccine to stop people from getting measles, but Secretary Kennedy and many other people have said for years that this vaccine might be unsafe or might cause autism, even though it doesn't. This is why some people have stopped getting vaccinated for measles and more people are getting this disease.

Maryland – Maryland has passed the Vax Act. This bill will make sure that Maryland has its own recommendations for when people should get vaccines and which ones they should get. They said that people can’t rely on HHS right now because it is led by Sec. Kennedy, who is anti-vaccine, and he hired many people who are anti-vaccine. Other states have done this too, like New Jersey.

Oversight Hearing

The House Oversight Committee held a hearing titled “Fraud Prevention: Understanding Fraud in Federally Funded Programs Run by the States”. The hearing focused on Medicaid, SNAP, and other programs that legislators and hearing witnesses were concerned were frequent targets for fraudsters. Witnesses talked about the challenges of managing different data sources that are fragmented across states and the work of Inspectors General in different states to investigate fraud while ensuring no benefit delays.

Witnesses:

• Kentucky Auditor Allison Ball talked about finding significant Medicaid fraud in Kentucky.

• Seto Bagdoyan, Director of the Government Accountability Office’s (GAO) Forensic Audits and Investigative Service, talked about the results of GAO’s report titled “Challenges in Managing Fraud Risks in Federally Funded, State-Administered Programs”.

• Dr. OJ Oleka, CEO of the State Financial Officers Foundation, expressed concern about the use of self-attestation for Medicaid, SNAP and unemployment “rather than real-time verification of income, residency, and citizenship status”.

• Former federal Inspector General Bob Westbrooks laid out some of the complexities in preventing fraud in complex federal-state programs.

Key Takeaways

Representatives Eleanor Holmes Norton (D-D.C.) and James Walkinshaw (D-VA) referenced how the Administration has fired many Inspectors General, leaving three fourths of those positions vacant in the federal government. Former IG Bob Westbrooks testified that these vacancies pose a big problem for fraud-busting efforts across the nation, as well as the Administration’s proposed budget cuts. Mr. Westbrooks also pointed out how misaligned data sources from state to state for programs including SNAP and unemployment insurance pose challenges for investigating fraud. Other Democratic Members on the panel argued that the Administration’s new anti-fraud efforts are unfairly targeting blue states.

Representative Emily Randall (D-WA) talked about what Washington is doing to be more proactive in Medicaid program integrity and mentioned that improper payments, a commonly cited proof point of fraud, also includes underpayment. She shared her experience growing up with a family member with disabilities and the challenges in managing the significant administrative burden that came with healthcare coverage.

Plain Language

The House Oversight Committee held a hearing titled “Fraud Prevention: Understanding Fraud in Federally Funded Programs Run by the States”. The hearing focused on Medicaid, SNAP, and other programs. A lot of the Republican Members on the committee said that there is a lot of fraud in these programs. Fraud is when you pretend to do something or be someone else in order to get money. The witnesses talked about how sometimes it is hard to look into fraud across the country because different states have different information and different programs where they keep information about people who commit fraud.

An Inspector General (IG) is a person in federal or state government who looks into fraud. Representatives Eleanor Holmes Norton (D-Washington, D.C.) and James Walkinshaw (D-Virginia) said that the Administration has fired many IGs and cut money at different agencies that would typically go toward looking into fraud. Representative Emily Randall (D-Washington) talked about what Washington is doing to stop Medicaid fraud. She also said that she has a family member with disabilities and it was very hard to keep track of all the paperwork you have to do to get healthcare coverage sometimes.

New Legislation

• The Senior Hunger Prevention Act (S.4286) (H.R.8256)

  • Introduced by Senator Kirsten Gillibrand (D-NY) and Representative Suzanne Bonamici (D-OR)

  • Would increase the minimum monthly SNAP benefit for all participants, simplify application and certification processes, support outreach efforts to enroll more older adults, caregivers, and adults with disabilities in nutrition programs, and enable adults with disabilities to participate in additional nutrition assistance programs

  • You can read Senator Gillibrand’s press release here and Rep. Bonamici’s press release here.
    
    

• The Improving Retirement Security for Family Caregivers Act (S.4292) (H.R.8274)

  • Introduced by Senator Susan Collins (R-ME) and Representative Brittany Pettersen (D-CO)

  • Would allow family caregivers to contribute to a Roth IRA

  • You can read Senator Collins’ press release here.
    
    

• The Catching Up Family Caregivers Act (S.4291) (H.R.8273)

  • Introduced by Senator Susan Collins (R-ME) and Representative Brittany Pettersen (D-CO)

  • Would allow family caregivers additional years of eligibility for the highest catch-up contribution levels in employer-sponsored retirement plans

  • You can read Senator Collins’ press release here.
    
    

• The SSI Savings and Efficiency Act (H.R.8298)

  • Introduced by Representative Sharice Davids (D-KS)

  • Would exclude in-kind support and maintenance (such as food or housing) from income for the purposes of the Supplemental Security Income program

  • You can read Rep. Davids’ press release here.
    
    

• H.R.8293

  • Introduced by Representative Aaron Bean (R-FL)

  • Would abolish the Center for Medicare and Medicaid Innovation

Plain Language

There are a few new bills in the U.S. Congress.

• The Senior Hunger Prevention Act would give more older adults, caregivers, and adults with disabilities access to SNAP, which is money from the government for food. It would also give people more money for SNAP.
  
  

• There are two bills that would help family caregivers save money for the future: The Improving Retirement Security for Family Caregivers Act and the Catching Up Family Caregivers Act.
  
  

• The SSI Savings and Efficiency Act would let people get food and housing without losing their SSI benefits.
  
  

• A bill to get rid of part of the Centers for Medicare and Medicaid Services called the Center for Medicare and Medicaid Innovation. Innovation means new ideas.

AUCD Story Collection

AUCD is collecting stories from the Network on a variety of topics to amplify the effects of this Administration on real people and our programs. If you have a story, we want to hear it. 

We are interested in stories about: 

• Medicaid and its impact on people's lives 

• The impact of dismantling ACL 

• The important work of UCEDDs, LENDs, IDDRCs, PNS’s, DD Councils, P&As

• The impact of zeroing out UCEDDs, LENDs, IDDRCs, PNS’s, DD Councils, P&As  

• Impact of grants that are being cut

• Stories responding to RFK Jr.’s claims about autism or the autism registry 

You can use this link to provide information and let us know if you are comfortable sharing your story with Members of Congress and their staff. 

AUCD Policy Blog

AUCD invites Network members to fill out this form if you’re interested in writing for the AUCD policy blog. We are open to a variety of issues areas, and we will follow up with you as relevant issues come up that we’d like you to write about.

Read our newest blog from Miriam Edelman, a Georgetown University LEND trainee: Attending the Annual Disability Policy Seminar

Disability Policy for All with Liz

Join Liz on Instagram Reels, where she provides plain language updates on policy, highlighting current issues and hot topics in federal disability policy.

Liz Weintraub is AUCD's Senior Advocacy Specialist and the host of “Disability Policy for All with Liz.” She has extensive experience practicing leadership in self-advocacy and has held many board and advisory positions at state and national organizations, including the Council on Quality & Leadership (CQL) and the Maryland Developmental Disabilities Council.

Watch Liz’s recent video on ABLE Bills.

Words to Know

Fraud

Fraud is when you pretend to do something or be someone else in order to get money.

Appropriations

Appropriations means money that is set aside by Congress for a particular use.

Chronic Disease

These are diseases and medical conditions that people usually have to live with for most or all of their lives, such as diabetes.

Inspector General

This is a person in federal or state government who looks into fraud or waste in government agencies.