Congress passed a continuing resolution that will fund the federal government through Sept. 30
March 21, 2025 (ACP) -- The spending bill passed by Congress last week failed to include increased medical funding or take action to reverse Medicare payment cuts, but it did avert what had been a looming government shutdown.
“ACP is glad they prevented a lapse in funding because it would have had major impacts on health care. While federal programs like Medicare, Medicaid and Social Security would continue during a shutdown, an extended shutdown could eventually affect the processing of Medicare payments,” said Jared Frost, ACP manager for legislative affairs and ACP Services PAC. “What is most troubling regarding the continuing resolution that Congress passed is what was left out. There is no Medicare doc payment fix and no long-term Medicare telehealth waivers, or long-term authorizations for the National Health Service Corps (NHSC) and Teaching Health Centers Graduate Medical Education (THCGME) program, ACP is pressing lawmakers to enact these initiatives.”
The need for the recent spending bill stems from the lack of approval of a federal budget for the fiscal year that began Oct. 1, 2024.
“Congress should have funded the federal government by passing 12 appropriations bills by Oct. 1,” Frost said. “Instead, the federal government has been kept running by two temporary stopgap funding measures called continuing resolutions (CR). A CR means that the current fiscal year is funded at the previous fiscal year's funding levels with no increases. The second one had been set to expire on March 14, but was instead extended through the end of the current fiscal year.”
On March 11, the House of Representatives -- almost entirely on party lines with Republicans in support -- passed a CR that would fund the federal government through Sept. 30, 2025, and the Senate subsequently passed the CR on Friday. But there will be changes from the previous fiscal year's funding -- $6 billion in additional funding for defense discretionary spending and a $13 billion cut in nondefense discretionary spending. “Much of the $13 billion reduction comes from eliminating earmarks -- spending directions by Congress,” Frost said.
Unfortunately, restoring the 2.83 percent cuts that were made to Medicare physician payments at the beginning of the year “is out of the picture for the moment,” Frost said. “Congress had at least two opportunities to include it in its CRs and failed to do so despite urging from ACP and other physician organizations.”
As he noted, “while there are published reports that some sort of doc fix could be included later this year in congressional Republicans' reconciliation legislation, it is not clear how much or how long or how retroactive that doc fix would be. Any final reconciliation vote could be weeks or possibly months into the future, and the physicians would go half the year before seeing any relief from the Medicare physician payment cut.”
For other federal health programs, a CR “is a little like being frozen in time because generally no new projects or funding changes can take place. Funding for ACP priorities -- such as the Agency for Healthcare Research and Quality, the Health Resources and Services Administration, the Centers for Disease Control and Prevention and the National Institutes of Health -- all continue with no funding increases through Sept. 30, 2025,” Frost explained.
ACP had urged Congress to include in their spending legislation a long-term reauthorization of funding for programs that are essential to primary care and the health workforce, including the National Health Service Corps and the Teaching Health Center Graduate Medical Education program, which are currently only funded through Sept. 30.
As an ACP advocacy alert that was sent to members last week notes, these programs “provide critical training for primary care physicians and support their placement in communities with physician shortages.” Frost noted, “temporary funding means that Congress must act again in six months to fund these vital programs.”
ACP is also concerned that the CR drastically cuts the NIH Innovation Account under the CURES Act and Health Resources and Services Administration program support. This would impact health care facilities' construction and renovations and one-time grants that support health-related activities.
In addition, ACP is deeply disappointed that the CR only extends Medicare telehealth flexibilities until Sept. 30, 2025, as well as the NHSC and THCGME programs.
ACP members can help put pressure on Congress regarding the doc payment fix, telehealth waivers and long-term authorizations for the National Health Service Corps and the Teaching Health Center Graduate Medical Education programs. “These vital issues are part of ACP priorities, and ACP members can use the Advocates in Internal Medicine Network (AIMn) to take direct action to contact their lawmakers about these topics,” Frost said.
Back to the March 21, 2025 issue of ACP Advocate