House Passes Stop Gap; On To Senate To Avoid Shutdown
The House passed a continuing resolution (CR) to fund the government late Friday. This should avert a midnight shutdown. The CR funded government through March 14, 2025. Far-reaching healthcare provisions once going to pass as part of a free-standing bill or within the CR became a closely tailored list of must-haves for healthcare.
The funding bill extends Medicare telehealth flexibilities and CMS’ acute hospital at home program for 90 days, through March 31, 2025. The CR postpones scheduled cuts to Medicaid disproportionate share payments for safety-net hospitals and extends special Medicare reimbursements for low-volume hospitals and Medicare-dependent hospitals until April 1. It sustains funding for community health centers and pandemic preparedness programs until March 31. No relief for Medicare physicians, who now will see a 2.8% rate reduction as of January 1. ACOs did not see an extension of critical funding. Pharmacy benefit manager (PBM) reforms and steps toward site-neutral payments were axed.
Democrats reversed course and supported the bill after refusing to support a similar bill yesterday. One big change: no debt ceiling extension, which Democrats opposed as they wanted a GOP Congress to own the issue in 2025. Hardline Republicans came around too as they did not want the debt ceiling extension in the bill either, which they believe would erode their leverage to obtain spending guts in the future. Instead, Republicans entered into a gentlemen’s agreement with leadership where the borrowing limit will be increased by $1.5 trillion in exchange for $2.5 trillion in net cuts to spending. This will be done through a reconciliation package in the next Congress.
The Senate will undoubtedly adopt the bill later tonight or tomorrow.
12/21 Update: The Senate passed the bill early Saturday morning.
Additional articles: https://www.modernhealthcare.com/politics-policy/spending-bill-house-healthcare-package and https://insidehealthpolicy.com/inside-drug-pricing-daily-news/house-passes-cr-without-key-health-care-reforms-setting-stage-march and https://thehill.com/homenews/house/5051634-government-funding-shutdown-house-bill/
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