Congress delayed looming cuts to hospitals, extended community health center funding and addressed a slew of other healthcare priorities in a temporary spending bill that passed Thursday.
The measure prevents a partial government shutdown that would have started Friday. Once President Joe Biden signs the legislation, Congress will face a pair of deadlines to fund the government and reauthorize various programs with action on some issues needed by March 1 and others by March 8. The bill is based on an agreement House Speaker Mike Johnson (R-La.) and Senate Majority Leader Chuck Schumer (D-N.Y.) announced Sunday.
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The stopgap bill passed the majority-Democratic Senate 77-18 and the Republican-led House 314-108. The measure addresses funding and authorizations set to expire Friday and some that would run out on Feb. 2, including Health and Human Services Department appropriations.
"We have good news for America: There will not be a shutdown on Friday," Schumer said. "Because both sides have worked together, the government will stay open. Services will not be disrupted. We will avoid a needless disaster."
The legislation includes numerous healthcare provisions:
- Delays $8 billion in Medicaid Disproportionate Share Hospital cuts until March 8.
- Extends HHS funding until March 8.
- Extends the Work Geographic Index Floor for Medicare physician reimbursements until March 8 but retains a pay cut that took effect Jan. 1.
- Extends community health centers, special diabetes programs, the National Health Service Corps and the Teaching Health Center Graduate Medical Education program through March 8.
- Extends certain flexibilities for health emergencies, including the ability to delegate federal workers to local governments, until March 8.
- Extends FDA and Veterans Affairs Department funding until March 1.
The stopgap bill leaves many other healthcare priorities untouched, such as legislation to mandate greater healthcare pricing transparency, stiffen pharmacy benefit manager regulation, raise Medicare physician pay and broaden access to telehealth services.
Supporters said the temporary funding bill would give Congress time to advance all 12 full-year appropriations bills, which are generally supposed to be enacted before fiscal years end on Sept. 30.
“Passing this measure will allow us the time we need to hammer out those funding bills for fiscal year '24, after many months of needless delays," said Senate Appropriations Committee Chair Patty Murray (D-Wash.). "We all want this to be a drama-free and reliable process. So I hope that House Republicans will work with us to make that possible now, too, which means leaving extreme partisan demands at the door.”
The Senate Appropriations Committee has advanced appropriations bills on bipartisan votes, while House appropriators have only approved GOP-backed bills.
The path ahead for those appropriations bills get is rocky amid intraparty and partisan tension in the House.
Once again, Johnson needed Democratic votes to get a majority for the short-term spending bill. Hardline House conservatives rebelled last October and ousted then-Speaker Kevin McCarthy (R-Calif.) after he relied on Democrats to pass a spending bill. McCarthy has since left Congress.
Johnson won the speakership in October on support from the cadre of lawmakers who pushed out McCarthy. Some of those members have already turned on their new leader, accusing him of breaking promises to slash spending and of making too many concessions to Democrats.
"Our Speaker Mr. Johnson said he was the most conservative speaker we've ever had, and yet here we are," said Rep. Eli Crane (R-Ariz.). "We're honoring the McCarthy-Schumer sides deals from the Fiscal Responsibility Act that led us to vacate Speaker McCarthy in the first place. Talk is cheap."
"The words were so good," said Rep. Warren Davidson (Ohio), one of a number of Republicans who traveled with Johnson to the southern border this month with hopes of linking immigration funding to the spending bill. "By the time we could even get back to this town, our speaker had surrendered to a [leadership] deal, the very thing we said we wouldn't do. It's the deeds that are the problem," Davidson said.
No House Republican has called for Johnson's removal but the chamber's rules allow them to act swiftly to depose the speaker. If that were to happen, the House would be unable to act until members elect a new leader.
