This story will be updated as the Senate vote proceeds.
Updated March 14, 6:20 pm
Senate sends CR extending telehealth, hospital priorities to Trump's desk
The Senate has narrowly avoided a government shutdown.
Senators voted 54-46 on Friday evening to pass the full-year continuing resolution to fund the federal government until September 30, 2025. The bill now goes to President Donald Trump, who has said he will sign it into law.
The vote extends healthcare services and programs that were set to expire on March 31. The extensions include key wins for Medicare telehealth providers, hospitals and rural health clinics.
The funding bill, which runs to the end of the government's current fiscal year, extends support for community health centers, national health service corps and teaching health centers that operate graduate medical education programs. It extends the special diabetes program for type 1 diabetes.
For Medicare telehealth providers and Medicare beneficiaries, Congress extended the removal of geographic requirements and expanded originating sites for telehealth services; expanded practitioners eligible to furnish telehealth services; and, extended telehealth services for federally qualified health centers (FQHCs) and rural health clinics (RHCs).
The bill also delays the in-person requirements under Medicare for mental health services furnish through telehealth, including at rural health clinics and federally qualified health centers. The C.R. extends the use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care
For hospitals, the funding bill extends increased inpatient hospital payment adjustment for certain low-volume hospitals, the Medicare-dependent hospital program, and permits hospitals to decline re-classification.
The bill includes an extension of add-on payments for ambulance services, extension of funding for quality measures endorsement, input and selection, extension of funding outreach and assistance for low-income programs, and an extension of the work geographic index floor.
Another key pandemic-era program that Congress extended through September is the Centers for Medicare and Medicaid Services’ acute hospital care at home waiver authorities. It also extended the temporary inclusion of authorized oral antiviral drugs as covered Medicare Part D drugs, the Medicare Improvement Fund and Medicare sequestration.
Sens. Angus King, I-Maine, and Jeanne Shaheen, D-New Hampshire, voted in favor of the bill's final passage. Sen. Rand Paul, R-Kentucky, voted against.
While the key healthcare provisions have been given another six months to live, Congress has still avoided advancing a larger healthcare package that would reverse the pay cut Medicare physicians were subjected to on Jan. 1 and reform the practices of pharmacy benefit managers.
Congress rarely passes major funding legislation without its back to the wall. The next deadline Congress will be up against is to fund the government for fiscal year 2026, which must be done by Oct. 1.
Democrats broadly opposed the Republican-drafted package because they said it provides Trump and his ally Elon Musk too much leeway to continue their work downsizing the federal government. Democrats in both chambers said they would prefer a one-month C.R. that would avoid the shutdown but provide more time for negotiations.
While House Democrats voted in near lockstep against the C.R. earlier this week, a spattering of Democratic Senators including Minority Leader Chuck Schumer, D-New York, chose to support the bill during a key procedural vote that required 60 votes. In statements that sparked criticisms from fellow party members, the lawmakers said they viewed a shutdown as the worse of two evils and worried that the administration would use the shutdown to push forward its more controversial priorities.
Separately, a push to bring forward a "long-shot" healthcare package first floated by Democrats over the weekend was also shot down on the Senate floor just ahead of a key procedural vote.
Updated March 14, 5:05 pm
Senate clears a procedural vote to advance C.R., with Dem support
The Senate has cleared a key procedural hurdle to advance the GOP-led government funding bill to a full vote later today. The Senate voted 62-38 to move forward with the continuing resolution.
Nine Democrats sided with Republicans to advance the bill to a full Senate vote. Senate Minority Leader Chuck Schumer, D-New York, flipped his position on voting for the bill Thursday night. He said while he does not support the bill, he wants to avoid a government shutdown. Most Democrats did not follow suit.
Senate Majority Leader John Thune, R-South Dakota, has now set the Senate up to vote on four amendments to the bill, which are expected to fail. The Senate will also vote on a separate bill, S. 1077, dubbed the "Collins and Van Hollen DC fix," so named to avert cuts to the District of Columbia's funding. The continuing resolution, as drafted, would cut funding to the District of Columbia by $1.1 billion, the Washington Post reported, by reverting the District back to its 2024 spending levels, prompting the additional legislation.
The House passed the continuing resolution on Tuesday, which extends expiring healthcare programs like Medicare telehealth and extends funding for community health centers. Republicans' continuing resolution extends teaching health centers that operate graduate medical education programs and the acute hospital at home program.
Also for hospitals, the C.R. again delays Medicaid disproportionate share hospital reductions while extending increased inpatient hospital payment adjustment for certain low-volume hospitals, the Medicare-dependent hospital program and a 1.0 floor on the work Geographic Practice Cost Index.
It does not include a rollback of the 2.83% Medicare physician pay cut that went into effect Jan. 1, a major pain point for physician lobbying groups like the American Medical Association. Republican congressional leaders promised Rep. Greg Murphy, M.D., R-North Carolina, they would include a doc pay fix in its budget reconciliation later this year, the lawmaker said in a post on X, formerly called Twitter.
Schumer affirms decision to support Republican's government funding bill
The Senate is expected to vote on the GOP’s full-year continuing resolution this afternoon to avert a government shutdown at midnight. The top Senate Democrat, Chuck Schumer, New York, said he will support the bill.
It is unclear what other Senate Democrats will do. Schumer indicated on the Senate floor Friday morning that senators differ on how to approach the issue. The CR, which the House approved on Tuesday, needs 60 votes in the Senate to pass. Senate Republicans need eight Democrats to support the bill.
“Our caucus members have been torn between two awful alternatives, and my colleagues and I have wrestled with which alternative would be worse for the American people," Schumer said. "Different senators come down on different sides of this question, but that does not mean that any Senate Democrat supports a shutdown.”
Within healthcare, the CR will extend expiring Medicare telehealth flexibilities, the acute hospital at home program, funding for community health centers and Medicaid disproportionate share hospital cuts. Those flexibilities expire at the end of this month.
Schumer’s support is a major shift from his stance two days ago that Senate Democrats would oppose the bill because it didn’t support middle class Americans or rein in the power of President Trump and Elon Musk. Schumer and other Democrats previously said they would not pass the bill and preferred a one-month extension of current funding levels.
“This is a Hobson's choice,” Schumer said. “The CR is a bad bill. But as bad as the CR is, I believe allowing Donald Trump to take even much more power via a government shutdown is a far worse option. A shutdown would allow Doge to shift into overdrive.” A Hobson’s choice refers to the illusion of a choice where there is no real alternative.
Schumer reaffirmed his decision to vote for the CR, a shocking shift that came to pass after Democratic meetings Thursday night.
Schumer explained that a government shutdown gives the executive branch virtually unchecked authority to make more aggressive cuts in government agencies, services, and employment. He pointed to a directive (PDF) by the director of the White House’s Office of Management and Budget on Feb. 26, which directed agency leaders to make a list of non-essential workers to cut. The first phase of agency reorganization plans were due Thursday.
Schumer contends that Musk and Trump want a shutdown and have been preparing to make aggressive moves if the opportunity arises.
Trump took to Truth Social Friday morning to congratulate Schumer’s decision to support the C.R.
“Congratulations to Chuck Schumer for doing the right thing—Took 'guts' and courage!” the President wrote. “The big Tax Cuts, L.A. fire fix, Debt Ceiling Bill, and so much more, is coming. We should all work together on that very dangerous situation. A non pass would be a Country destroyer, approval will lead us to new heights. Again, really good and smart move by Senator Schumer. This could lead to something big for the USA, a whole new direction and beginning! DJT.”
But Schumer and Democrats assert that the bill is “lousy” and does not offer adequate support to the American public.
Healthcare organizations are urging lawmakers to extend Medicare telehealth policies through the end of the year to provide certainty for clinicians and their patients.
In a letter to Senate and House leadership, the College of Healthcare Information Management Executives (CHIME), along with nearly 100 other organizations, called out the fact that healthcare providers have made significant investments in telehealth.
"We simply cannot return to pre-pandemic telehealth policies," the letter said.
"Acting now to extend the policies initially enacted under the pandemic through the end of the year (at minimum) will bring much-needed stability to patients and clinicians. The deadline for the end of these policies comes at a time when patients are struggling with inflationary pressures, clinician burnout and recording setting Baby Boomer retirements," the organizations said in the letter.