By: Allen Pinn, Coordinator, Policy

Reintroduced in January, H.R. 277 – the Regulations from the Executive in Need of Scrutiny (REINS) Act of 2023 would have immense consequences on federal policy and advocacy. The legislation aims to limit executive agency rulemaking power by requiring that all ‘major rules’ be approved by a joint resolution of Congress within 70 days. The term ‘major rule’ is defined in the bill as any rule that has the following characteristics:

  • an annual effect on the economy of $100 million or more;
  • a major increase in costs or prices for consumers, individual industries, Federal, State, or local government agencies, or geographic regions; or
  • significant adverse effects on competition, employment, investment, productivity, innovation, or the ability of United States-based enterprises to compete with foreign-based enterprises in domestic and export markets.

What the Proponents Say

Proponents of the legislation praise the bill as reducing power of the bureaucracy within the federal government and creating more transparency within the federal regulatory process. House Republicans have argued the Biden administration has used the rulemaking process aggressively to form policies which should be legislated by Congress. Proponents also argue the legislation could help mitigate the federal government’s spending and lower the national debt.

What the Opponents Say

Critics of the REINS Act describe the bill as radical. Opponents of the REINS Act have stated the Congressional process created by the bill would be too time consuming, and there is already an established review process for rules under the Congressional Review Act. They also argue the bill would alter the separation of powers between Congress and the executive branch by giving Congress the authority to veto executive actions.

What the Patient Community Says

In a letter from nearly 40 organizations, representing thousands of individuals living with chronic diseases urged both the U.S. House of Representatives and Senate to oppose the REINS Act. In their comments, they argued the REINS Act is a threat to public health. If signed into law, patient advocates argue the bill would create major roadblocks to health-protective regulations. Critical agencies to public health that would be negatively impacted include: the Centers for Medicare and Medicaid Services, the Environmental Protection Agency, and the Food and Drug Administration. In effect, the REINS Act would undermine the executive branch’s ability to respond to threats in an efficient and swift manner.


Despite the REINS Act passing in the House (221-210) last Wednesday, the legislation will face an uphill battle in the Senate, where it currently has 28 Senate co-sponsors. The NHC will continue to monitor any new developments as Congress enters the summer.