(July 2024) – While presidential politics dominate the airwaves, now is a good time to take stock of where things stand, mid-year, on the Hill. House Speaker Mike Johnson (R-LA) intends to pass all 12 annual appropriations bills to fund the federal government for the fiscal year 2025. Typically, these 12 bills get bundled together for final passage into "minibus" legislative packages or a gigantic, full-budget "omnibus" bill. By taking each bill individually, however, Speaker Johnson is allowing members of the House to take on issues with each and possibly vote them down. So far, all 12 bills have been marked up by the House Appropriations Committee, but only three have passed the full House. So far, two of these bills have failed on final passage votes.
Earlier this month, the House Appropriations Committee reported its fiscal year 2025 Labor- Health and Human Services-Education Appropriations bill to the full House on a party-line 31-25 vote. It contains mixed results for the hospital community. It represents an overall spending cut of 11 percent year over year from FY 2024, and most of these cuts are directed at the Centers for Disease Control and Prevention and Health Resources and Services Administration. Conversely, rural health initiatives received a $36 million increase (to $401 million), and the bill prohibits any funds from being used to implement the Biden Administration's final rule regarding long-term care minimum staffing requirements. While it is possible the House may take up this bill in August, it is unlikely to become law before the end of the federal fiscal year on Sept. 30, 2024. More information on the contents of the so-called "Labor-H" bill is online.
The current political dynamic in Congress is such that Republicans feel comfortable passing partisan appropriations bills they believe will set the table for accomplishing their priorities in 2025. Democrats are less likely to bring their appropriations bills to the floor in the Senate. Because of this dynamic, Congress is likely hurtling toward an FY 2025 continuing resolution to fund federal agencies through the beginning of 2025 at FY 2024 levels.
As the presidential election kicks into high gear, Congress has little time left in 2024 to pass substantive legislation. However, some things must happen by the end of FY 2024, including Congress waiving the additional 4 percent PAYGO cut to sequestration levels in Medicare reimbursements that would otherwise start in FY 2025. Other priorities that hospitals oppose–such as site-neutral payment schemes–are likely to fall by the wayside.
With the primary elections right around the corner, we hope you will share the importance of voting with your employees and communities. The We CARE We VOTE toolkit has several customizable resources to do just that. And, if you like podcasts and want to learn even more about what is happening in Washington, listen to our recent federal podcast produced by Audrey Dunkel and Landon Fuller. Learn more about our federal advocacy initiatives, and keep us posted if you have questions or need assistance.