Legislation that would make Medicare cover blockbuster weight-loss drugs took its first step forward today when House Ways and Means overwhelmingly voted to advance the Treat and Reduce Obesity Act, Victoria reports.

Why it matters: Although TROA has been introduced every Congress for the last decade, it hadn't been marked up until today, when the committee signaled broad bipartisan support with a 36–4 vote.

Yes, but: Key to the bill's approval was a chairman's amendment limiting coverage to people who are diagnosed as obese and who have been taking the drugs at least one year before enrolling in Medicare.

• The narrower criteria will almost certainly reduce the CBO score and ease concern about drugs like Wegovy and Zepbound putting a financial strain on the program. W&M health staff director Patrick Dumas said the pared-down bill was estimated to cost $1.7 billion over 10 years.
• The committee rejected a Democratic attempt to broaden criteria and allow all Medicare beneficiaries to access weight-loss drugs.

Zoom in: It remains to be seen whether the bill will receive a floor vote, but it's a priority for Rep. Brad Wenstrup, a longtime cosponsor who's retiring at the end of this Congress and is close to Majority Leader Steve Scalise.

Driving the news: Committee Democrats during the markup debated whether the bill would benefit only certain groups and isn't equitable.

• Rep. Lloyd Doggett raised the specter of only wealthy individuals who've accessed the drugs on generous private health plans being able to have costs covered by Medicare.
• Rep. Gwen Moore countered that individuals on Medicaid who similarly are already taking the drugs would also gain Medicare coverage.
• Rep. Don Beyer also said that getting Wegovy and Zepbound into the Medicare system was a good way to start lowering the prices of the drugs by making them eligible for Medicare drug price negotiations.

The committee advanced other health bills that would extend Medicare coverage for medical devices approved under the FDA's Breakthrough Devices Programs, to multi-cancer early detection screening tests, and to add a cognitive impairment detection benefit.

House appropriators are eyeing a July 10 full committee markup of an FY25 Labor-HHS spending bill that calls for a 7% funding cut to HHS and a large-scale reorganization of NIH, Victoria reports.

Why it matters: The Republican blueprint, approved by the Labor-HHS subcommittee this morning in a voice vote, is already triggering fights with Democrats and the Biden administration over reproductive health, public health programs and spending levels within caps set out by the Fiscal Responsibility Act.

• It contains numerous contentious riders on abortion, transgender care and family planning — an approach that's expected to be in sharp contrast with Senate appropriators, who've indicated they want to continue to craft bipartisan spending bills.

Republican leaders like House Appropriations Chair Tom Cole are pressing forward, wagering that they can use the appropriations process to overhaul parts of NIH and CDC in the wake of GOP criticism over the agencies' COVID-19 response.

Zoom in: The spending blueprint calls for a 7% cut to HHS, to $107 billion, which is $14 billion below President Biden's budget request.

• NIH funding would remain flat at $48 billion, while CDC would face a 22%, or $1.7 billion, cut.

The bill notably contains a proposed NIH restructuring that would shrink the number of research centers from 27 to 15 and streamline research while increasing congressional oversight.

The other side: Appropriations Ranking Democrat Rosa DeLauro has blasted the funding cuts and "multiple attacks on women" in the bill.

1. Idaho abortion ruling: The Supreme Court today dismissed a closely watched abortion case, delivering a temporary victory to abortion-rights supporters that allows the procedure during medical emergencies in Idaho, Axios' April Rubin reports.

2. Purdue Pharma bankruptcy: Justices also rejected a controversial bankruptcy reorganization plan for OxyContin maker Purdue Pharma that would have shielded members of the Sackler family, who owned the company, from opioid litigation, Axios' Adriel Bettelheim reports.

3. Barriers to care: Despite greater awareness, inequities are baked into U.S. health care and will take policy change and structural redesign to dislodge, the National Academies of Sciences, Engineering, and Medicine concluded yesterday.