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House Speaker Kevin McCarthy (R-Calif.) on Wednesday unveiled a bill to raise the debt ceiling into next year, slash federal spending by roughly $130 billion and unwind some of President Biden’s priorities and recent legislative accomplishments, including his program to cancel college student debt. ... The spending reductions probably would target federal health care, science, education, climate, energy, labor and research programs, while leaving untouched the Pentagon and services for veterans. But the bill does not specify the exact agencies or programs on the chopping block. (Romm, 4/19)

President Joe Biden on Wednesday delivered a sweeping rebuke of House Republicans’ debt limit proposal, calling it a nonstarter that would impose deep cuts to critical programs across the board. “That’s the MAGA economic agenda: spending cuts for working and middle class folks,” Biden said, while speaking from a Maryland union hall. “It’s not about fiscal discipline, it’s about cutting benefits for folks that they don’t seem to care much about.” ... “They say they’re going to default unless I agree to all these wacko notions they have,” Biden said, singling out McCarthy for risking a default that would leave the nation “devastated.” (Cancryn, Scholtes and Ferris, 4/19)

Executives for the brand drug industry’s biggest lobbying group painted a grim picture for the future of drug development under Medicare price negotiation. But others say the sector is fearmongering. Medicare last month provided details for how it will choose which drugs will be subject to price negotiation, and how it will calculate the government’s opening offers. (Wilkerson, 4/19)

House Republicans are floating several draft bills that would significantly affect the hospital industry, including some with far-reaching policies that would authorize Medicare to pay hospitals the identical amount for the same service, regardless of where the service was performed. The bills — which are far from clearing Congress and being signed into law — would address a problem that legislators and policymakers have targeted for years. (Herman, 4/19)

British pop star Elton John urged U.S. senators on Wednesday not to ease up on the fight against HIV and AIDS, as Congress faces a September deadline for reauthorizing the multi-billion-dollar U.S. program to fight the disease. "There is no better symbol of American greatness than PEPFAR, and you should all be very proud of your extraordinary efforts," John, whose foundation has raised hundreds of millions of dollars to fight AIDS, told a Senate Foreign Relations Committee hearing on reauthorizing the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) via videolink. (Zengerle, 4/19)

Shortly after returning home from a 44-day stay in Walter Reed Medical Center's neuropsychiatry unit, Fetterman graciously welcomes PEOPLE into his Braddock, Pennsylvania, home. It's the first time the freshman senator and his wife, Gisele Barreto Fetterman, are speaking with the media since he was discharged, and one of the first real conversations they are publicly having about his mental health. Feeling in many ways transformed, Fetterman, 53, sits down on the couch in his signature Carhartt hoodie and basketball shorts, leans forward and inhales. He's ready to talk. (Alvord, 4/19)