Unraveling the Intricacies of Government and Healthcare
President-elect Trump and Vice President-elect JD Vance's Stance
President-elect Trump and Vice President-elect JD Vance have made their voices heard on the continuing resolution. It's not looking good for Mike Johnson as they have expressed their views. Sources indicate that Congress will not be voting on a continuing resolution to fund the government tonight due to the afternoon's disarray. Funding runs out on December 20th. On X, Fox & Friends television anchor shared that Trump is "totally against" the currently proposed spending bill while understanding the difficulty in getting it together. Shortly after, Vance urged Congress to pass a skinnier spending bill, blaming Democrats for the country's debt ceiling situation and certain provisions. He emphasized that Republicans want to support farmers, provide disaster relief, and set the country up for success in 2025 through a temporary funding bill without Democrat giveaways combined with an increase in the debt ceiling.This shows the first signal of the Department of Government Efficiency's influence on shaping the legislative agenda. Elon Musk and Vivek Ramaswamy, who are working closely with Congressional leaders, have declared their hardline opposition, setting off a flurry of activity.
Johnson's Dilemma and the Future of Spending Bill
Johnson seems to be losing support from House members, and the future of the spending bill and healthcare package is in question. Democrats are unlikely to strongly support a new, streamlined bill after believing a deal was close. House Minority Leader Hakeem Jeffries stated that if the bipartisan agreement is broken, one has to own the consequences.The situation is highly uncertain, and it remains to be seen how it will unfold.
Healthcare Deal in Trouble
Lobbyists have informed Fierce Healthcare that Congress' end-of-year healthcare deal may be falling apart. The bill text for extending expiring healthcare programs like Medicare telehealth flexibilities was completed on Wednesday evening, but by Thursday morning, there was blowback from Elon Musk about the cost and the rush to pass it. Musk, who President-elect Donald Trump wants to advise on federal spending through the Department of Government Efficiency, opposed the bill on his social media platform X. Three telehealth lobbyists are worried that Republicans might back out. The healthcare package was a big win for telehealth advocates, but there are concerns about the remaining fractional decrease in physician pay rates and doubts from the Congressional Doctor's Caucus.The current turmoil on Capitol Hill may impact healthcare if other political fights get in the way. Mike Johnson is said to be working on a Plan B for the continuing resolution that excludes $100 billion in disaster aid.
Healthcare Orgs' Reactions to the Bill
The 1,500-page continuing resolution to fund the government through March 14 has been released, and it includes both positive and negative aspects for healthcare trade groups. Brian Blase, president of the conservative think tank Paragon Health Institute, criticized the Congressional budgeting process as fundamentally broken.One surprise in the CR is its impact on lawmakers. It would give a pay increase to Congress for the first time since 2009 and allow them to switch to the Federal Employees Health Benefits Program. Department of Government Efficiency commission co-leaders Elon Musk and Vivek Ramaswamy oppose the bill on principle. Ramaswamy said the bill could have been shorter and should have had more debate. Musk was more blunt, saying any member voting for it "deserves to be voted out in two years."
However, many healthcare priorities are included, such as extending Medicare telehealth flexibilities for two years, which a broad coalition supports. Alye Mlinar of TAFA stated that this extension is crucial for patients and providers. Other provisions include extending coverage of high-deductible health saving accounts and funding the Medicare Diabetes Prevention Program Expanded Model.
On the pharmacy benefit manager side, the bill includes important measures like banning spread pricing in Medicaid, delinking PBM compensation, and mandating a 100% pass-through rate of rebates. Pharmacy and pharma groups are happy with these provisions.
There is also agitation over what's not included, such as site-neutral payments and the Improving Seniors' Timely Access to Care Act. The Regulatory Relief Coalition is outraged that the electronic prior auth bill was left out despite positive evaluations.