Summary
The House and Senate return to Washington this week with just days to avert a March 1 shutdown for agencies funded under the Agriculture, Energy and Water, MilCon-VA and Transportation-HUD spending bills. The Senate comes back into session this afternoon, while the House will come back on Wednesday afternoon. The remainder of the federal government has until March 8 before the second continuing resolution (CR) expires. President Biden is expected to convene a meeting on Tuesday with the House and Senate leadership to urge them to pass both a final budget bill and the emergency package the Senate passed earlier this month that would provide $95 billion in aid for Ukraine and Israel. While the emergency aid package passed the Senate with bipartisan support, House Speaker Mike Johnson (R-LA) has so far refused to bring the bill up for a vote in the House, though bipartisan group in the House has proposed a slimmer $66 billion version.
While the appropriators have mostly finalized spending and programmatic decisions, outstanding controversial policy riders on abortion, immigration, gender affirming care and other hot button issues being pushed by the most conservative House Republicans are still an issue. On Sunday Senate Majority Leader Chuck Schumer (D-NY) sent a letter to his Senate colleagues stating that while he hoped legislative text would be available for review over the weekend, “it is clear now that House Republicans need more time to sort themselves out.” Speaker Johnson indicated on Friday that another short-term CR may be necessary (the consensus seems to be an extension to March 22), but he faces pushback from his Freedom Caucus conservatives who are hoping to stop negotiating and pass a year-long CR that will trigger an automatic 1% across the board cut. Speaker Johnson remains limited by his razor thin 2-vote majority. Any path forward to avoid a shutdown will both require Democratic support and anger the conservative faction of his party putting his very tenuous leadership position at risk.
Featured Hearings
- Senate Agriculture Committee: On Wednesday the Senate Agriculture, Nutrition, and Forestry Committee will hold an oversight hearing to examine the Department of Agriculture (USDA). USDA Secretary Thomas Vilsack will be testifying.
- Senate Budget Committee: On Wednesday the Senate Budget Committee will hold a hearing titled “”No Rights to Speak of: The Economic Harms of Restricting Reproductive Freedom.”
- House Energy & Commerce Committee: On Thursday the House Energy and Commerce Subcommittee on Health will hold a hearing to examine legislative proposals to support patients with rare diseases.
Regulatory Update
The Office of Management and Budget (OMB) is reviewing the following rules:
Medicare
- Alternative Payment Models – The proposed rule would implement a new Medicare payment model titled, Increasing Organ Transplant Access (IOTA) Model (was set for December 2023).
- Payment Update – The proposed rules would make policy payment updates for acute care hospitals inpatient and long-term care hospitals, and hospice (April 2024).
Medicaid
- Disproportionate Share Hospital Program – The final rule would implement requirements under section 203 of the Consolidated Appropriations Act, 2021 (CAA), which relate to Medicaid shortfall and third-party payments (February 2024).
- Eligibility and Enrollment – The final rule would implement changes to align enrollment and renewal requirements for most individuals in Medicaid and promote maintenance of coverage (February 2024).
- Access to Care – A pair of final rules intended to access to care and quality outcomes for Medicaid and CHIP beneficiaries enrolled in managed care delivery systems and fee-for-service Medicaid (April 2024).
Commercial Insurance
- ACA Marketplace – The final rule would make changes to regulations governing Affordable Care Act (ACA) Marketplace plans, insurance standards, and the risk adjustment program for plan year 2025 (not specified but likely April 2024).
- Short-Term Plans – The final rule would modify the definition of short-term, limited duration insurance (STLDI) to limit the initial contract to no more than three months and the maximum coverage period to no more than four months, including renewals and extension (April 2024).
Other Topics:
- Healthcare System Resiliency and Modernization – The proposed rule would revise and update national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers (was set for December 2023).