1222: View from Washington, D.C.: Nominations, FY2027 Funding and the Post-Midterm Outlook

JOHN SHEEHAN:

This is Public Health Review Morning Edition for Friday, October 9, 2026. I'm John Sheehan

with news from the Association of State and Territorial Health Officials. With midterm elections

approaching, uncertainty is building around the next phase of the congressional calendar.

In this, View from Washington, D.C., Jeffrey Ekoma, ASTHO's vice president of Government

Affairs, talks about the latest developments in Washington and what they could mean for health

policy and federal funding. We'll hear about the status of key health and human services

nominations and the competing scenarios for FY 2027 appropriations. Jeffrey Ikoma, welcome

back to the show.

JEFFREY EKOMA:

It's a pleasure to be back. Good morning.

SHEEHAN:

Good morning. So, Jeffrey, a lot of developments in Washington, one of them being the health

and human services nominations. What's going on there?

And what can we expect from Congress before it adjourns later this year?

EKOMA:

There's lots of activity in space right now. We expect that it's going to pick up significantly through

the rest of the calendar year. There are several folks that we've been actively tracking their

nominations, and they include Chris Klomp, who was nominated to be the next deputy secretary

at HHS in his nomination advance out of the Senate Finance Committee. Also tracking the nomination of Sean Kaufman, who has been nominated to be the next ASPR. And he recently moved into the principal deputy assistant secretary role at ASPR earlier this week in his nomination advance out of the Senate Health Committee. Dr. Heidi Overton, who was nominated to be the next FDA commissioner. Her nomination is still with the Health Committee, and they have not voted yet to move her nomination out of the committee. Dr. Nicole Sapphire, who was nominated to be the next surgeon general. Her nomination also advanced out of the Senate Health Committee. Dr. Timothy Westlake, who was nominated to serve as the next leader of SAMHSA. His nomination also advanced out of the Senate Health Committee. If you sense a theme that's happening here, there's some optimism that several folks could make it into the next Senate on block vote of non-cabinet level nominees, which we do expect to happen after midterms.

And this will likely be the last on block vote this year of non-cabinet nominees. So we're going to

be checking that closely. It is expected that, or let me say, things are a little bit unclear as to what

may happen for nominees who are not advanced out of the Senate before the end of the calendar year. And if that were to be the case, those nominees would have to be re-nominated by the president in the next congressional cycle that begins the beginning of January of next year.

SHEEHAN:

Okay. A lot to watch. Another long running storyline is the continuing resolution, which is running

out on December 11th. Where do things stand on negotiations for FY27?

EKOMA:

Clarity on FY27 funding will be, honestly, will be much more clear after midterm elections. At that

point, that's when we expect negotiations to commence. It's important to know a couple of things

that may complicate sort of where we are going forward. For one, the OMB director mentioned his interest in getting rid of the filibuster on appropriation bills, and that reconciliation bills are the only way to pass funding bills, and that has caused a stir on Capitol Hill. I think the outcome of midterms will determine not only what will happen next, and I think there are a couple of scenarios that we're monitoring really closely on our end. One is Congress potentially passing a one to two week extension of the current CR if they are able to get to an agreement on top line spending numbers for appropriation bills. In this scenario, the one to two week extension would allow them to essentially wrap up the work before the end of the calendar year and potentially pass full year appropriation bills. Another potential scenario would be Congress punting work on appropriations to the next session of Congress and potentially passing a short term extension of the current CR through the beginning of next year, possibly through February or through March, which is not unheard of. Another scenario could be that Congress could pass a full year CR before the end of the current CR that would extend through the end of the current fiscal year, which ends September 30 of next year. Now, I say this today, Friday, that the odds of a government shutdown by our assessment are still very low at this moment. Again, we do expect a lot more clarity, but things are likely subject to change in the next couple of weeks.

SHEEHAN:

Wow. Yeah, that's a range of possibilities there. After the midterms, it's going to be a pretty short

window between that and Congress going on break. What can we expect them to get done?

EKOMA:

Yeah. If you think outside of figuring out FY27 appropriations and pending nominations I just

talked about, we expect there to be a lot of activity. One, the veracity of these activities will really

truly depend on how much the current makeup of Congress changes going into 2027.

We expect members, particularly those that are retiring, to push bills as they exit Congress.

They're going to want to have those legacy defining bills be considered or potentially be passed

and signed by the president before the end of the calendar year. We've been engaged in

conversations on the potential of a reauthorization of the pandemic and all has preparedness act

of PAPA, which I've talked about a lot, but it seems like the reauthorization of PAPA more than

likely won't happen this session of Congress, which will mean that we will need to start the whole

entire process next year. Congress may also pursue continuing to extend health provisions for things like the National Health Service Corps, funding for community health centers going forward before the end of the year. They may also even continue efforts to pass another reconciliation bill, which would also be

very interesting as well.

SHEEHAN:

Okay. On that topic of reconciliation, how realistic, especially during the lame duck period, will it

be for Congress to really get things through and what would need to happen for them to

accomplish it?

EKOMA:

You know what's interesting? There's some thinking that another reconciliation bill is possible in

lame duck. However, when you think of the limited legislative days between the end of midterms,

the end of the calendar year, that creates a pretty significant challenge. In addition, both the House and the Senate will need to agree on a budget resolution that unlocks the ability for respective committees to write legislation that satisfies reconciliation rules. If you think back prior to going on August recess, the House passed a budget resolution that would have instructed relevant committees to provide funding for the Pentagon, funding that was going to be earmarked for temporary economic assistance to farmers, the funding for election integrity efforts, and funding for intelligence related activities. Those priorities are subject to change. The Senate might have much different thinking on what this potentially could look like. So when you think about the House and the Senate having to be on the same page, the administration is

likely going to offer their perspective on what needs to be in a reconciliation bill through the end of

the year. It makes it really tight, right? And what it also means that those priorities are subject to change. When you consider the Senate has not passed their own separate resolution that also needs to be aligned with the House's budget resolution, you can expect that, you know, it could happen, it may not happen. There's just a lot of coordination that will need to happen very quickly post midterms.

SHEEHAN:

Yeah, a lot of coordination that needs to happen quickly and that hasn't really happened quickly

historically.

EKOMA:

It has not, but we'll see. I mean, again, everything's gonna look a lot different after midterms. So

I'm looking forward to just having a little bit more clarity for our members so they can understand

what to expect for the rest of the calendar year.

SHEEHAN:

Absolutely. Jeffrey Ekoma, thanks as always.

EKOMA:

I appreciate it. And wake me up when midterms are over because I'm ready to understand what's

happening next on Capitol Hill.

SHEEHAN:

Jeffrey Ekoma is ASTHO's Vice President of Government Affairs. This has been A View from

Washington, D.C., part of Public Health Review Morning Edition. I'm John Sheehan for the

Association of State and Territorial Health Officials