Summary
The House and Senate are in recess and will return on April 28. On Thursday, the House passed the Senate-amended budget resolution that sets up a minimum of $4 billion in savings for Senate Committees and $1.5 trillion in cuts for the House Committees by a vote of 216-214. Following its passage, Senate Majority Leader John Thune (R-SD) stated that the Senate would be as aggressive as possible on spending cuts and asserted that the House and Senate are aligned on savings.
Despite the difficulty in passing the resolution, the real hard work on the budget reconciliation package begins when Congress resumes in late April, with one of the biggest decisions being how the Energy and Commerce (E&C) Committee will handle its $880 billion instruction, after Speaker Johnson promised that Medicaid benefits will not be cut, and will continue to focus on “fraud, waste, and abuse” Below we highlight potential Medicaid options that have been considered and their estimated savings:
- Work Requirements: $109 billion in 10-year savings
- Medicaid per capita caps: $532 billion to $989 billion in 10-year savings, depending on how states respond
- Standardize Medicaid administrative matching rate: $69 billion in 10-year savings
- Limit Medicaid provider taxes: $175 billion in 10-year savings
- Repealing Biden Administration Regulations:
- Repealing the two-part final rule on Medicaid eligibility (part 1 and part 2): $164 billion in 10-year savings
- Repealing the Medicaid/CHIP access final rule: $121 billion in 10-year savings
- Imposing limits on the level of state-directed payments in Medicaid by repealing a policy in the Medicaid and CHIP managed care access final rule: $25 billion in 10-year savings
Regarding timing, Republican leadership is still pushing for a very ambitious deadline of passing the reconciliation package before Memorial Day. As tax bills are required to start in the House, the Committees will begin marking up their respective sections as soon as Congress resumes, with it being reported that the House Judiciary, Homeland Security, and Armed Services Committees will go first. Additionally, the Ways and Means and E&C Committees are expected to mark up their portions the week of May 5th.
Regulatory Update
The Centers for Medicare and Medicaid Services (CMS) released the FY 2026 Medicare payment proposed rules. Our summary of the inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) proposed rule is available here. Impact Health will send summaries of the proposed rules for hospice providers, inpatient psychiatric facilities, inpatient rehabilitation facilities, and skilled nursing facilities today.