June 2026

Proposed OMB Rule Threatens Federal Research Funding

The Office of Management and Budget (OMB) recently issued a 400+ page proposed rule, "Regulation for Federal Financial Assistance," that would apply to all federal departments and agencies and significantly reshape the federal grant-making process. The rule would formalize grant review by political appointees, allow broad grant cancellations, restrict certain research topics (such as diversity, equity, and inclusion), and prohibit use of funds for publishing, subscriptions, and conference attendance. ASH staff are closely analyzing the proposal’s impact on hematology and will submit formal comments before the July 13 deadline as part of the ongoing #Fight4Hematology. Read the full summary here.

House Appropriations Committee Advances FY 2027 HHS Spending Bill

In June, the House Appropriations Committee voted along party lines to advance its fiscal year (FY) 2027 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) funding bill. The bill would:

Increase funding for the National Institutes of Health (NIH) by $100 million to $47.3 billion.
Not restructure NIH or cut or eliminate funding for any Institute or Center.
Limit the NIH's use of multi-year funding to FY 2025 levels.

However, the bill would make deep cuts in funding to other key health agencies such as the Centers for Disease Control and Prevention (CDC) and essentially eliminate the Agency for Healthcare Research and Quality (AHRQ) and Patient-Centered Outcomes Research Institute (PCORI).

Click here to read the statement ASH issued following the House Appropriations Committee’s approval of the bill. Additionally, on June 16, ASH signed onto a group letter urging Congressional leadership to:

Provide $51.3 billion for NIH in FY 27 appropriations; and
Ensure that these funds are spent as intended by Congress to support meritorious research consistent with scientific opportunity and public health priorities.

The appropriations process is far from over. The Senate has yet to release its Labor-HHS bill, and negotiations will continue in the months ahead. The House bill shows that engagement can influence the outcome, and there is still time to shape the final package.

Advocacy now is critical. Decisions made in the coming months will determine whether NIH will have the resources it needs to advance medical research and sustain U.S. leadership in science and innovation. Lawmakers need to hear from constituents about the impact NIH funding has on the development of cures and treatments for serious diseases. Take action here and contact your elected officials in support of hematology research.

Community Engagement Requirements for Medicaid Beneficiaries Finalized by CMS

On June 1, the Centers for Medicare & Medicaid Services (CMS) released an interim final rule with comment period, which implements the community engagement requirements for certain adults applying to or enrolled in Medicaid. A fact sheet and press release accompany the interim final rule.

The work requirements, also known as community engagement requirements, were established in the One Big Beautiful Bill Act (H.R.1), now renamed as the Working Families Tax Cut legislation. The rule includes a definition of applicable individuals and defines how an individual can meet the 80 hours of community engagement, as well as provides information on exceptions to the requirement and outlines steps that states will take to verify individual’s community engagement.

CMS did not establish an exhaustive list of conditions that may be deemed as an exclusion to meeting the work requirements, instead deferring to states to determine those exclusions. CMS stated, “it would be reasonable for states to consider certain conditions as serious or complex, when such conditions significantly impair an individual’s ability to comply with the community engagement requirement.” Even though an exhaustive list was not prepared, CMS provided examples of conditions that may lead to exclusions including cancer, end stage renal disease, viral hepatitis, sickle cell disease, chronic obstructive pulmonary disease, HIV/AIDS, sarcoidosis, cognitive impairment, heart disease, amyotrophic lateral sclerosis, Parkinson’s disease, Huntington’s disease, cystic fibrosis, multiple sclerosis, spinocerebellar ataxias, muscular dystrophy, hemophilia, trauma disorders, and thalassemia major. Of importance, states are not required to accept these examples as exclusions.

The Society has been following the development of this final rule, advocating with CMS that patients with complex hematologic conditions be excluded from community engagement requirements. ASH will continue to advocate on behalf of hematologic patients and will submit comments on the interim final rule, which are due July 31.

ASH Sends Letter to Congress Urging for Exemptions to the Community Engagement Requirements for Patients with Complex Hematologic Conditions

On May 2, ahead of the posting of the CMS interim final rule, ASH wrote a letter to Congressional leadership emphasizing the importance of exemptions from the community engagement requirements following the statutory language of HR 1. In the letter, the Society urged Congress to ensure that CMS define and implement the medically frail exemption from the OBBBA requirements in a manner consistent with the statutory language and intent in the forthcoming interim final rule. ASH emphasized that individuals with debilitating hematologic conditions fit the medically frail category based on how this term has historically been interpreted and applied across CMS programs. Additionally, ASH recommended the use of automatic verification processes leveraging already available diagnosis and utilization data, as well as preserving state flexibility to use self-attestation.

ASH Submits Statement to Congress on Medicare Payment Reform

On May 20, ASH submitted a statement for the Record to the House Energy and Commerce Committee hearing to examine efforts to reform Medicare physician payment. The hearing explored current challenges in the Mediare physician fee scheduled and the Medicare Access and CHIP Reauthorization Act. ASH highlighted that as inflation-adjusted Medicare physician reimbursement has fallen, hospitals and other facilities have received regular inflationary updates. This leaves hematologists underpaid despite rising practice costs and increasing clinical complexity. In the comments, ASH advocated for a permanent, sustainable, solution that includes reforming the Medicare Physician Fee Schedule budget neutrality and provides periodic increases tied to the cumulative Medicare Economic Index.

ASH Joins over 60 Groups Urging Congress to Support FY 27 Pediatric Specialty Loan Repayment Program Funds

On May 21, ASH Joined the Academic Pediatric Association (APA) and over 60 other organizations in sending letters to House and Senate appropriations leaders urging for $30 million in fiscal year 2027 funding for the Pediatric Specialty Loan Repayment Program (PSLRP). The letters highlighted ongoing shortages in pediatric specialty and mental health care and emphasized the importance of PSLRP in recruiting and retaining providers in underserved communities through loan repayment assistance.

ASH Submits Comments on National Institutes of Health Strategic Plan

ASH submitted comments to the National Institutes of Health (NIH) in response to its Request for Information (RFI) on the agency’s FY 2027–FY 2031 Strategic Plan. The Society highlighted priorities from the ASH Agenda for Hematology Research and underscored the importance of hematology research and care across NIH priorities. Read the comments here.