Fight Over House Anti-Shutdown Bill Affects Medicare Provisions

3. Create a short bill that simply prevents a shutdown and postpones the deadline for resolving other issues. In the past, Congress has avoided shutdowns during complicated negotiations by passing bills that authorized the continuation of normal government operations for a few days at a time.

4. Develop a major new anti-shutdown package.

The Timeline

House leaders posted a draft of the first anti-shutdown package to show up, the Further Continuing Appropriations package, Monday.

Some House Republicans objected to the rushed process used to develop the bill.

President-elect Donald Trump blocked work on the Further Continuing Appropriations package by opposing it.

Trump objected to some funding provisions in the package, and he said the package should include a provision raising the federal debt limit, to ensure that the government will not face future debt-limit fights that could hamper Republicans' efforts to enact trillions of dollars in tax cuts before 2026.

Trump has not discussed the Medicare or Older Americans Act reauthorization provisions in the package.

House Republicans responded to Trump's objections by developing the American Relief Act package, and they posted that package Thursday. They hoped to have the full House consider the package quickly.

House leaders needed approval from two-thirds of members to rush the bill to the floor. Instead, House members voted 174-235 against the bill.

The House was called to recess at 9:12 a.m. Thursday. "The next meeting is subject to the call of the Chair," according to a note on the House website.

Around 2:30 p.m., Politico reported that House Republicans may pursue the fourth option and that they agreed to support a package that would need votes from Democrats, would include some measures stripped out of the Further Continuing Appropriations package and would not include the debt ceiling limit elimination provision sought by Trump.

The American Relief Act Medicare Provisions

If anti-shutdown negotiators end up reviving a bill based on the American Relief Act, it could include Further Continuing Appropriations provisions related to:

• Boosting Medicare reimbursement rates for doctors and hospitals.
• Boosting Medicare reimbursement rates for ambulance services providers.
• Keeping the current, temporary Medicare telehealth coverage rules, which are more flexible than the older rules and were adopted in response to the COVID-19 pandemic, in place.

The ARA package appears to exclude Further Continuing Appropriations provisions that would:

• Require Medicare Advantage plans to update their provider directories more quickly.
• Move toward having Medicare cover Grail's Galleri blood test and other blood tests that screen people for many different kinds of cancer at the same time.
• Limit pharmacy benefit managers that serve Medicare prescription drug plans to collecting service fees and prohibit the PBMs from basing compensation on the value of discounts negotiated.
• Reauthorize the Older Americans Act.

What if the government 'shuts down'?

The Congressional Research Service provided an extensive guide to what would really happen to government operations in a shutdown.

The Social Security Administration, for example, would:

• Continue to pay Social Security retirement and disability benefits.
• Continue to process applications for benefits.
• Stop issuing replacement Medicare cards.

This article may be updated after press time to reflect new developments.

Credit: Bloomberg