The Senate on April 3 voted 52-48 to pass an amended budget resolution for fiscal 2025, a significant move toward aligning both chambers on a unified budget framework that could unlock the reconciliation process.
While the Senate’s version includes several key adjustments, it preserves a directive instructing the House Energy and Commerce Committee to identify at least $880 billion in spending cuts — keeping Medicaid squarely in the crosshairs. The amendment also proposes raising the federal debt limit by $5 trillion, $1 trillion more than the House’s original resolution.
An hourslong “vote-a-rama” — a marathon session of amendment votes — is expected to take place Friday and potentially spill into the weekend, according to The Hill. The resolution includes differing instructions for the Senate and House in several key areas, potentially complicating efforts to reach a final compromise.
“With the passage of this budget resolution, we unlock the ability for the appropriate Senate committees to fully fund our border needs for four years, provide much-needed financial relief to our military at a time of great danger, make the 2017 tax cuts permanent to energize the economy, and do what has been promised for decades: go through every line item of the budget to cut wasteful and unnecessary spending — hopefully by the trillions,” Sen. Lindsey Graham, Senate Budget Committee Chair, said in an April 2 statement.
As budget negotiations continue, hospital executives are intensifying their advocacy efforts against the proposed Medicaid cuts, warning that such reductions could threaten access to care, destabilize hospital finances and lead to further service and facility closures — particularly in safety-net and rural communities.
“We remain deeply concerned that the budget reconciliation process could eventually lead to unsustainable funding cuts to federal health programs, like Medicaid, that would endanger access to care for millions of patients and the ability for healthcare providers to serve them,” Danielle Turnipseed, chief public policy officer for the Association of American Medical Colleges, said in an April 3 statement shared with Becker’s.
Ms. Turnipseed also cautioned that federal student financial aid — critical for diversifying the physician workforce — could be at risk under current proposals.
Amid budget negotiations, hospital leaders have traveled to Washington, D.C., to meet with lawmakers and voice opposition. Among them is Brett Tande, CFO of San Diego-based Scripps Health, who recently discussed the proposed cuts on Becker’s CFO and Revenue Cycle Podcast.
“The bill that came out of the House proposed $880 billion in Medicaid cost reductions over several years — a massive number that some argue aims to return Medicaid to its original intent. There’s significant debate about that,” Brett Tande, CFO of San Diego-based Scripps Health, said during an episode of the Becker’s CFO and Revenue Cycle Podcast.
Mr. Tande emphasized the cumulative challenges facing hospitals — including policy shifts like site-neutral payment proposals and mounting payer denials — which make Medicaid cuts especially daunting.
“My sense of the direction is they are trying to get Medicaid — some of the expansion that we’ve seen over the years and some of the variety in the way in which states implemented that expansion — back under control,” Mr. Tande said. “Work requirements came up in nearly every meeting we had [on Capitol Hill]. My understanding is that, over the 10 years, that would be worth $130 billion in savings. It does seem like there is broad Senate Republican support for that change.”
