A Flurry of Healthcare-Related Legislative Activity Ahead of the Final Lap of Campaign Season

Readers last week surely noted my coverage of a few of the key regulatory initiatives the Biden Administration intends to undertake during the last part of the year and into 2025.

Congress is on a similar but much stricter timeline to pass spending legislation before government funding runs out next Monday, causing a partial government shutdown. And lawmakers have stated that they want things wrapped up by this Friday night in order to head home for the next month to campaign before the election.

So, here’s where things currently stand.

Last week, House Republicans voted on a six-month stopgap funding measure that was ultimately defeated due to opposition over the extension’s length, as well as a provision requiring proof of citizenship for voter registration.

The bill’s failure signaled that the Speaker of the House would likely propose a new bill that is more acceptable to Democrats. Alternatively, he could wait for the Senate’s version of a stopgap bill, which is expected to run through Dec. 13.

It appears that the former option is exactly what happened, as the text of a new package was readied over the weekend for review before a vote by Wednesday this week. This morning, House Republicans introduced the Continuing Appropriations Act (CAA), a 12-week extension of federal spending with limited add-ons so as not to complicate approval of the bill before Congress recesses on Friday. According to political analysts, the CAA, which is expected to pass with bipartisan support, extends funding through Dec. 20.

Senate leaders, meanwhile, are preparing procedural votes to ensure flexibility in preventing the looming shutdown and moving quickly to a vote on the CAA, assuming it passes the House. House passage of the bill by midweek certainly will not afford the Senate much time to hear the bill and vote by Friday. Typically, House leaders try to adhere to a 72-hour rule to allow members time to review new legislation prior to a vote. 

A few of the healthcare provisions that are likely to be taken up during discussion of the new CAA include extending the availability of funds to implement the No Surprises Act, new Medicaid allocations, and delaying pending clinical lab payment cuts under Medicare.

Two more notable provisions are likely to include another attempt at averting Medicare payment cuts for physicians (though major reform is said to be unlikely) and an extension of eased Medicare telehealth rules.

In connection, the House Committee on Energy and Commerce late last week passed the Telehealth Modernization Act, which would extend critical telehealth provisions for two years that began during the COVID-19 pandemic and were set to expire at the end of the year. 

In particular, it addresses ways to improve access to telehealth services for non-English speakers, rural Americans, and those who require certain specialty care. The bill also extends audio-only telehealth coverage for individuals with limited broadband Internet access, and allows hospitals to provide inpatient care in a patient’s home. There are high hopes that the bill’s provisions are ultimately included in the CAA going in front of the full House this week.

Per usual, new provisions such as these, included in a funding extension, will likely come down to their cost. One suggested offset for such costs is to broaden Medicare’s site-neutral payments policy.However,proposals to expand current Medicare policy so that drugs administered in a hospital outpatient department are reimbursed at the same rate as in a doctor’s office have drawn significant opposition.

The Congressional Budget Office (CBO) estimates that these policy changes would save billions of dollars.

With much still in flux, stay tuned this week, as we’ll almost certainly see a flurry of movement on government spending, with major implications for healthcare.