A government shutdown is becoming increasingly likely after the Senate on Sept. 19 voted against a continuing resolution that would have extended federal funding and several healthcare provisions set to expire this month.
The House passed the resolution earlier in the day by a 217-212 vote, but it failed in the Senate 44-48. A competing proposal from Senate Democrats — which would have funded the government through Oct. 31 and included additional healthcare funding — also failed by a 47-45 vote.
In the Senate, a funding bill generally needs 60 votes to overcome a legislative filibuster, which delays or blocks a final vote. A final vote on a bill actually requires only a simple majority (51 votes), but a minority of senators can use the filibuster to prevent that final vote from happening at all.
Without a funding deal, the federal government will shut down Oct. 1.
The House-passed bill would have extended several key healthcare programs through Nov. 21, including the Medicare-dependent hospital and low-volume adjustment programs, telehealth and hospital-at-home flexibilities, and the Cybersecurity Information Sharing Act. It also would have delayed Medicaid disproportionate share hospital cuts set to take effect Oct. 1.
Senate Democrats rejected the Republican-led proposal over concerns it did not include provisions to extend ACA enhanced premium tax credits or reverse nearly $1 trillion in Medicaid cuts outlined in the One Big Beautiful Bill Act, according to The Hill.
“The health security of working families will be threatened if Congress fails to extend the healthcare tax credits before open enrollment on November 1,” Federation of American Hospitals President and CEO Chip Kahn said in a statement. “Premium notices are being sent, and Americans’ costs will go up if Congress does not act now. Time is of the essence.”
Mr. Kahn added that millions of Americans face “sticker shock” if the tax credits expire, pricing many out of coverage altogether.
Hospitals are also sounding the alarm about looming Medicaid DSH cuts. More than 250 essential hospitals and health systems have urged Congress to act before the cuts take effect Oct. 1. Under current law, Medicaid DSH funding will be cut by $8 billion annually from 2026 through 2028.
“Hospitals are facing unprecedented financial challenges, impacting their ability to serve patients and their communities,” Bruce Siegel, MD, president and CEO of America’s Essential Hospitals, said. “It is critical that Congress stops these damaging Medicaid DSH cuts.”
Lawmakers now have 11 days to reach an agreement and avoid a government shutdown and the expiration of several key healthcare policies.
