Healthcare Preview for the Week of: September 25, 2023 - McDermott+Consulting

Healthcare Preview for the Week of: September 25, 2023

Do We End the Week with a Shutdown?

That is the question of the week. We’ll know the answer in five days, but right now, “yes” is a far more plausible answer than “no.”

On the House side, Speaker McCarthy will first try to move forward four appropriations bills—to address those in his party who want to see these bills move forward individually. That effort may not succeed. It is also possible that Speaker McCarthy may advance a continuing resolution (CR) to temporarily fund the government that would appease his most conservative base by increasing the already significant funding cuts for government operations put forth in the House and adding policies relating to the southern border. If he’s able to advance such a CR, it would be dead on arrival in the Senate, and so its passage would most assuredly mean a shutdown at the end of the week.

Across the Capitol, the Senate is working on its own bipartisan CR package. A Senate CR would likely include funding for Ukraine and disaster relief. However, Majority Leader Schumer has his own challenges in advancing this CR, most notably time. Senator Rand Paul (R-KY) has indicated that he will reject measures to speed up the process to advance the CR. If this CR passes the Senate this week, the big question is whether Speaker McCarthy can advance it through the House on a bipartisan basis and remain speaker. That raises a host of additional questions that can’t be answered yet.

Finally, there is beginning to be more talk about a discharge petition in the House as a last-ditch effort to maintain government funding. This strategy would not avoid a shutdown, but it could end one sooner rather than later, and could prevent an immediate showdown in the House over Speaker McCarthy. We will continue to watch this angle in the coming days.

All this being said, it is hard to see a path that avoids a likely government shutdown at the end of this week. 

Some healthcare-related items to note if there is a government shutdown:

  • The US Department of Health and Human Services (HHS) updated its Contingency Staffing Plan for Operations in the Absence of Enacted Annual Appropriations.
  • In that plan, HHS provides details on staff who will continue work as funded through prior year appropriations, mandatory appropriations, and user fees or other reimbursements of non-lapsed appropriations, with more than 40% of the agency’s staff being furloughed.
  • The Medicare program will continue during a lapse in appropriations. The impact on providers will occur in stages based on how long a shutdown continues.
  • CMS will have sufficient funding for Medicaid to fund the first quarter of FY 2024, based on the advance appropriation already provided through FY 2023 appropriations.
  • CMS will continue federal exchange activities, such as eligibility verification, using federal exchange user fee carryover.
  • This current plan represents initial estimates for HHS activities under a lapse. HHS will continue to review its resources, authorities and flexibilities during any lapse.

For more information, contact Debra Curtis, Kayla Holgash, Katie Waldo or Rodney Whitlock.