Summary
The House is in recess this week after both bodies passed another laddered continuing resolution (CR) keeping the government in operation until March 1 for the for the Agriculture, Energy and Water, MilCon-VA and Transportation-HUD spending bills and March 8 for the remaining federal agencies. The House passed the measure on a bipartisan vote of 314-108 with roughly half of House Republicans voting against it. The bill included extensions on authorizations for many health care programs that expired last year and had been included in previous CRs, but it did not include a “doc-fix” to reverse the 3.37% cut to Medicare physician reimbursement that went into effect Jan. 1. Physician groups are hopeful that Congress will include funding for a retroactive fix in a health care package in March.
While both sides of Congress have agreed on the top line funding amounts, the 12 Appropriations Subcommittees have not yet received their allocations (also known as 302b’s). Until the leadership of the House and Senate Appropriations Committees agree on Subcommittee allocations, Committees cannot get down to the hard work of finalizing their bills. Senate Appropriations Committee Chair Patty Murray (D-WA) has said they are “working around the clock” to finalize allocations.
Senate negotiators are working hard this week to finalize a deal on immigration reform that would be included in a foreign aid emergency supplemental package. A deal has not yet been reached between the bipartisan negotiators, and it would face some stiff resistance in the House, but Senate leaders are optimistic that a package will ultimately pass.
Meanwhile, last week the House Budget Committee passed legislation that would create a commission to study the country’s fiscal issues, including possible changes to entitlement programs. House Budget Committee Chairman Jodey Arrington (R-TX) has stated his intention to try and fold the commission into the final budget deal. Several Democrats, however, have expressed concern about the bill. Senate Finance Committee Chairman Ron Wyden (D-OR) put out a statement on Friday opposing the bill and the Republican’s attempts to “gut Americans’ Social Security and Medicare.”
2024 Presidential Election
This week New Hampshire will be the second state to choose the 2024 Republican nominee. On Tuesday Granite State voters will go to the polls where former President Trump is running ahead in the polls, but former South Carolina Governor Nikki Haley has been closing the gap in recent weeks. Over the weekend Florida Governor Ron DeSantis withdrew from the race, leaving only Governor Haley left to challenge former President Trump’s bid to be the Republican nominee.
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.
- Medicare Advantage and Part D – The proposed rule would make changes for CY 2025 for MA capitation rates and Part C and Part payment policies. Additionally, the proposed rule would provide draft CY 2025 Part D redesign program instructions.
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.
- 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.
- Managed Care – The final rule is intended to improve access to care and quality outcomes for Medicaid and CHIP beneficiaries enrolled in managed care delivery systems.
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.