The committee that writes the rules for Medicare, Medicaid and the tax exemption every nonprofit hospital lives on. In January it changes hands, and more than a third of its Republicans are gone.
Congress does its real work in committees. A small group of senators writes the bills; the full Senate mostly votes yes or no on what they send it. On health care, this is the room where the bills get written.
Has named billionaire taxes, a guarantee of health care for all, and oversight of banks, insurers and drug companies as his priorities. Nonprofit hospital systems are not on his list.
Moves from the gavel to the minority with a depleted bench. Six of his 13 Republican colleagues on the committee will not return.
Two of the committee’s three physicians are out. So is the chairman of the trade subcommittee, and one Democrat.
| Senator | Why | What goes with them |
|---|---|---|
| John Cornyn R-Texas | Lost his primary | Chairman of the trade subcommittee. Seat won by Democrat James Talarico. |
| Bill Cassidy R-Louisiana | Lost his primary | A physician, and chairman of the HELP Committee. Seat won by Republican Julia Letlow. |
| Roger Marshall R-Kansas | Defeated in the general election | A physician. Kansas elects its first Democratic senator since 1932. |
| Thom Tillis R-North Carolina | Retired | Seat won by Democrat Roy Cooper. |
| Steve Daines R-Montana | Retired | Seat held by Republican Kurt Alme. |
| Marsha Blackburn R-Tennessee | Elected governor | Leaves the Senate when she takes office in January, and is expected to appoint her own successor. |
| Tina Smith D-Minnesota | Retired | Seat held by Democrat Peggy Flanagan. |
Each member’s record on the cost drivers this committee controls, and a Machine Score from 0 to 100. The score measures how independent they are from the hospital lobby. Higher is better; 100 means they have never sided with it. Hospital PAC money sits beside the score, not inside it.
| Member | Site-neutral pay | Physician-owned hospitals | Price transparency | Nonprofit tax exemption | Hospital PAC money | Machine Score |
|---|---|---|---|---|---|---|
| Ron Wyden D-Ore. Expected chairman | $2.5K | |||||
| Mike Crapo R-Idaho Expected ranking member | $10.0K | |||||
| John Barrasso R-Wyo. Returning senator; assignment in January | $35.0K | |||||
| Michael F. Bennet D-Colo. Returning senator; assignment in January | $0 | |||||
| Maria Cantwell D-Wash. Returning senator; assignment in January | $0 | |||||
| Chuck Grassley R-Iowa Returning senator; assignment in January | $1.0K | |||||
| Maggie Hassan D-N.H. Health Care subcommittee ranking member, 119th Congress | $0 | |||||
| Ron Johnson R-Wis. Returning senator; assignment in January | $3.5K | |||||
| James Lankford R-Okla. Returning senator; assignment in January | $3.5K | |||||
| Ben Ray Luján D-N.M. Returning senator; assignment in January | $12.5K | |||||
| Catherine Cortez Masto D-Nev. Returning senator; assignment in January | $10.0K | |||||
| Bernie Sanders I-Vt. Returning senator; assignment in January | $0 | |||||
| Tim Scott R-S.C. Returning senator; assignment in January | $2.5K | |||||
| John Thune R-S.D. Returning senator; assignment in January | $5.0K | |||||
| Mark R. Warner D-Va. Returning senator; assignment in January | $31.5K | |||||
| Raphael G. Warnock D-Ga. Returning senator; assignment in January | $0 | |||||
| Elizabeth Warren D-Mass. Returning senator; assignment in January | $0 | |||||
| Peter Welch D-Vt. Returning senator; assignment in January | $0 | |||||
| Sheldon Whitehouse D-R.I. Returning senator; assignment in January | $7.5K | |||||
| Todd Young R-Ind. Health Care subcommittee chairman, 119th Congress | $11.0K |
Records and Machine Scores load when the scored-action list is published. Hospital PAC money: FEC bulk files, 2024 and 2026 cycles, PAC contributions from hospital systems and hospital associations, in FEC files retrieved October 8, 2026.
Whether Medicare keeps paying hospital outpatient departments more than independent offices for the same service. CMS cut the hospital rate for drug administration at off-campus departments from January 1, 2026. Congress decides whether to extend that to other services.
Whether tax-exempt systems must show charity care in proportion to the tax breaks they receive. Not on the incoming chairman’s stated list.
Provider taxes and state-directed payments that recycle federal money back to hospital systems. The 2025 reconciliation law bars new provider taxes, freezes existing ones and phases down directed payments from 2028.
The incoming chairman has called for a new foundation for the health system that guarantees coverage. A Republican White House can veto it.
Every health system in your member’s state, with its subsidies, reserves, executive pay and offshore holdings, sourced to the filing. Ready for a hearing.