Legislation creating health home programs for chronically ill kids—long on the wish list for children's hospitals—remains in flux as Congress is trying to recess for the year.
On Thursday, children's hospitals were still pushing for the Senate to take up the bill somehow before the end of the year as drama over a potential government shutdown played out in the House of Representatives and the White House.
The bill, known in Congress as the Advancing Care for Exceptional Kids (ACE) Kids Act, had finally reached imminent passage after years of tweaking, controversy and last-minute negotiations that watered down its cost.
Medicaid managed-care companies, which were set to lose the most if states let hospitals and physicians take on full risk for treatment of this expensive set of patients, opposed the legislation despite the changes.
Earlier this month the measure easily passed the House, where retiring Rep. Joe Barton (R-Texas) hoped it would stand as his legacy legislation. Senate leaders planned to pass it quickly on the floor with a vote of unanimous consent after approving Wednesday night's continuing budget resolution to keep the government open.
But conservatives have never been comfortable with the bill, and their concern ended up killing the unanimous consent vote. A single "no" blocks this vote.
An aide to Sen. Mike Lee (R-Utah) confirmed he is one holdout, but the others could not be confirmed by deadline.
Children's hospitals on Thursday said they hadn't yet given up on winning passage in the waning days of the 115th Congress.
"We continue asking Congress to seize this opportunity and pass this bipartisan legislation for our nation's sickest kids this year," a spokesperson for the Children's Hospital Association said.