CONTINUED FROM PG 13
and policy recommendations from the various departments . The White House also has its own policy support agencies – including the National Security Council , the National Economic Council , the Domestic Policy Council , and the Council of Economic Advisors , that augment what the President receives from other portions of the executive branch .
How the Department of Health and Human Services is Structured
Most federal health policy is made through the Department of Health and Human Services . Exceptions include the Veterans Health Administration , run by the Department of Veterans Affairs ; TRICARE , the health insurance program for activeduty military members and dependents , run by the Defense Department ; and the Federal Employees Health Benefits Program ( FEHB ), which provides health insurance for civilian federal workers and families and is run by the independent agency the Office of Personnel Management .
The health-related agencies within HHS are roughly divided into the resource delivery , research , regulatory , and training agencies that comprise the U . S . Public Health Service and the health insurance programs run by the Centers for Medicare and Medicaid Services ( CMS ).
Ten of the 13 operating divisions of HHS are part of the U . S . Public Health Service , which also plays a role in U . S . global health programs . They are :
• The Administration for Strategic Preparedness and Response ( ASPR )
• The Advanced Research Projects Agency for Health ( ARPA-H )
• The Agency for Healthcare Research and Quality ( AHRQ )
• The Agency for Toxic Substances and Disease Registry ( ATSDR )
• The Centers for Disease Control and Prevention ( CDC )
• The Food and Drug Administration ( FDA )
• The Health Resources and Services Administration ( HRSA )
• The Indian Health Service ( IHS )
• The National Institutes of Health ( NIH )
• The Substance Abuse and Mental Health Services Administration ( SAMHSA )
The Centers for Medicare and Medicaid Services ( CMS ) is by far the largest operating division of HHS . It oversees not just the Medicare and Medicaid programs , but also the federal Children ’ s Health Insurance Program ( CHIP ) and the health insurance portions of the Affordable Care Act . Together , the programs under the auspices of CMS account for nearly a quarter of all federal spending in fiscal 2023 , cost an estimated $ 1.5 Trillion in fiscal 2023 , and served more than 170 million Americans – more than half the population .
Who Makes Health Policy in Congress ?
How Congress oversees the federal health care-industrial complex is almost as byzantine as the U . S . health system itself . Jurisdiction and responsibility for various health agencies and policies is divided among more than two dozen committees in the House and Senate ( see Table 1 and Table 2 on the next page ).
In each chamber , however , three major committees deal with most health issues .
In the House , the Ways and Means Committee , which sets tax policy , oversees Part A of Medicare ( because it is funded by the Social
Security payroll tax ) and shares jurisdiction over other parts of the Medicare program with the Energy and Commerce Committee . Ways and Means also oversees tax subsidies and credits for the Affordable Care Act and tax policy for most employerprovided insurance .
The Energy and Commerce Committee has sole jurisdiction over the Medicaid program in the House and shares jurisdiction over Medicare Parts B , C , and D with Ways and Means . Energy and Commerce also oversees the U . S . Public Health Service , whose agencies include the Food and Drug Administration , the National Institutes of Health , and the Centers for Disease Control and Prevention .
While Ways and Means and Energy and Commerce are in charge of the policymaking for most of the federal government ’ s health programs , the actual amounts allocated for many of those programs are determined by the House Appropriations Committee through the annual Labor-Health and Human Services-Education and Related Agencies spending bill .
In the Senate , responsibility for health programs is divided somewhat differently . The Senate Finance Committee , which , like House Ways and Means , is in charge of tax policy , oversees all of Medicare and Medicaid and most of the ACA .
The Senate counterpart to the House Energy and Commerce Committee is the Senate Health , Education , Labor and Pensions Committee , which has jurisdiction over the Public Health Service ( but not Medicare or Medicaid ).
The Senate Appropriations Committee , like the one in the House , sets actual spending for discretionary programs as part of its annual Labor- HHS-Education spending bill .
16 HEALTHCARE GUIDE 2025 NEWS AND TRIBUNE