Summary
The House recesses on Wednesday and Speaker Mike Johnson (R-LA) will attempt to pass a stop-gap funding measure along party lines on Tuesday to avoid a government shutdown and fund the government for the remainder of the fiscal year. If passed by the House, the pressure will then be on the Senate, which will require support from several Democrats to approve the bill. However, this may be an uphill battle as top Senate appropriator, Sen. Patty Murray (D-WA) released a statement indicating that the package would “give Donald Trump and Elon Musk more power over federal spending” and instead expressed support for a short-term measure. The Senate will also continue its work confirming several key Department of Health and Human Services (HHS) appointees.
Fiscal Year 2025 Appropriations
On Saturday, House Republicans released a continuing resolution (CR) to fund the government through the end of the fiscal year (September 30) that increases defense spending by $6 billion over the current budget, decreases non-defense spending by $13 billion, and provides additional ICE funding for Trump Administration deportations. The package also includes funding for the following health extender provisions through September 30:
- Extension for community health centers, the National Health Service Corps, and teaching health centers that operate graduate medical education (GME) programs;
- Extension of the special diabetes program;
- National health security extensions;
- Extension of the increased inpatient hospital payment adjustment for certain low-volume hospitals;
- Extension of the Medicare-dependent hospital (MDH) program;
- Extension of the add-on payments for ambulance services;
- Extension of funding for quality measure endorsement, input, and selection;
- Extension of funding outreach and assistance for low-income programs;
- Extension of the work geographic index floor;
- Extension of the COVID-19 Medicare telehealth flexibilities;
- Extension of the acute hospital care at home waiver authorities;
- Extension of the temporary inclusion of authorized oral antiviral drugs as covered Part D drugs;
- Extension of the Medicare sequestration;
- Sexual risk avoidance education extension;
- Personal responsibility education extension;
- Extension of funding for family-to-family health information centers; and
- Extension of the delay of the Medicaid disproportionate share hospital (DSH) reductions.
The package notably excludes policy to avert Medicare physician payment cuts, a priority of Rep. Greg Murphy (R-NC), who co-chairs the GOP Doctors’ Caucus. Rep. Murphy indicated that he would not support the CR without its inclusion and Republicans can only afford to lose two votes to pass the package on party lines.
Trump Administration Nominations
On Friday, the Senate Finance Committee will hold its nomination hearing for the Centers for Medicare and Medicaid Services (CMS) Administrator nominee, Dr. Mehmet Oz. The hearing is likely to shine light on the Trump Administration’s Medicare Advantage (MA) priorities and how they will address certain Biden Administration proposals, such as coverage of anti-obesity medications (AOMs). Medicaid cuts and Department of Government Efficiency (DOGE) firings are also likely to be heavily featured in the hearing.
Additionally, on Thursday, the Senate Health, Education, Labor & Pensions Committee (HELP) will convene an executive session on whether to advance the nominations of Dr. Jayanta Bhattacharya for National Institutes of Health (NIH) Director and Dr. Martin Makary as Food and Drug Administration (FDA) Commissioner and a nomination hearing for David Weldon to serve as the Director of the Centers for Disease Control and Prevention (CDC).
Regulatory Update
The Office of Management and Budget (OMB) is reviewing the following:
- CY 2026 Medicare Advantage: Final rule making changes to Medicare Advantage and the Medicare Prescription Drug Benefit (Part D).
- FY 2026 Medicare Payment Rules: Proposed rules updating payments for acute care hospitals and long-term care hospitals, hospice providers, inpatient psychiatric facilities, inpatient rehabilitation facilities, and skilled nursing facilities. The proposed rules are slated for April.
- ACA Marketplace Program Integrity: A proposed rule likely focused on addressing fraud in Marketplace plans, which has been a primary concern for House Republicans and conservative think tanks, such as the Paragon Health Institute. The proposed rule will likely reverse a number of Biden-era policies related to enrollment and eligibility for premium subsidies, which were promulgated through the annual notice of benefit and payment parameters (NBPP). Peter Nelson, the new head of Center for Consumer Information and Insurance Oversight (CCIIO), identified numerous Biden-era regulations in a report he wrote during his time at the Center of the American Experiment, a conservative think tank. Given the timing of the proposed rule, it seems that the Trump Administration intends for its policies to be finalized and effective before the start of the 2026 Open Enrollment Period on November 1, 2025