The federal government shutdown is entering its third week as lawmakers on Tuesday again failed to pass a funding bill.
For the eighth time, the Senate failed to pass the House-approved measure to fund the government through Nov. 21, The Hill reported Oct. 14. That version of the legislation would extend several key healthcare programs, including the Medicare-dependent hospital and low-volume adjustment programs, telehealth and hospital-at-home flexibilities, and the Cybersecurity Information Sharing Act. That version of the bill, however, does not include an extension of the ACA enhanced premium tax subsidies.
This time, the Republican-backed House proposal was the only spending bill brought to vote by the Senate, according to The Hill. In the previous seven attempts, Senators also voted on a Democratic-backed proposal that would fund the government through Oct. 31. It includes an extension of the ACA subsidies and would restore nearly $1 trillion in Medicaid cuts. Senate Minority Leader Chuck Schumer filed a procedural motion to reconsider their funding bill, but the party plans to bring up the measure for a vote at a later date.
Oct. 15 was once seen by some lawmakers as a potential deadline for action as that was the date active-duty military members could miss a paycheck. President Donald Trump, however, directed Secretary of Defense Pete Hegseth to use “all available funds” to ensure military members get paid this week, according to the report.
Ideas for an ACA enhanced subsidy compromise emerge
The Republican party has four ideas on how to approach a subsidies compromise, Politico reported Oct. 14. Some lawmakers are in favor of imposing new income caps, minimum out-of-pocket payments, limits specifically on new enrollees accessing tax credits and abortion restrictions.
House Speaker Mike Johnson and Senate Majority Thune John Thune remain insistent that any negotiation on the future of the subsidies needs to take place after the government reopens, however, according to the report.
Telehealth reimbursement mired in ‘climate of confusion’
Medicare coverage for telehealth expired on Oct. 1 without the passage of a spending bill. That expiration has triggered a “climate of confusion and hesitation” across the healthcare industry, according to ATA Action, the advocacy arm of the American Telemedicine Association. The organization is urging Congress to enact a short-term solution to restore Medicare telehealth flexibilities and the acute hospital care at home program during the shutdown.
“We’re hearing from many hospitals and healthcare systems that they are continuing to provide telehealth services to Medicare patients during the shutdown, hoping they will receive retroactive reimbursement once the government reopens,” said Kyle Zebley, executive director, ATA Action. “That’s a significant risk for these organizations.”
Additionally, while most commercial insurers have maintained virtual care coverage for now, the absence of clear federal policy has created uncertainty. Many providers fear future reimbursement may dry up, prompting some to reconsider whether they can sustain their telehealth programs.
HHS layoffs underway
The Trump administration on Oct. 10 said it had begun laying off federal workers, including HHS employees deemed “non-essential. It’s unclear how many of the agency’s 79,717 workers will be affected by the layoffs. More than 32,000 HHS workers were furloughed Oct. 1.
Scores of CDC layoffs were reversed, however, after many employees were mistakenly terminated. Those affected by the mixup include leaders of the nation’s measles outbreak response team, staff who work on the “Morbidity and Mortality Weekly Report” and those working on the ebola outbreak response in the Democratic Republic of the Congo. Many of the agency’s epidemic intelligence service officers, individuals responsible for investigating disease outbreaks, were also being rehired.
The American Federation of Government Employees filed a federal lawsuit challenging the layoffs, alleging the move is “designed to punish workers and pressure Congress.”
