Editor's note: The spending package referenced in this story was passed in the House on the evening of March 11.
Updated March 11, 11:00 a.m.
The House rules committee advanced Johnson’s continuing resolution Monday night, setting up a vote on the House floor on Tuesday afternoon.
The Republican leader's funding patch would extend expiring healthcare programs and funding until Sept. 30, but excludes provisions that were broadly negotiated in the latter half of 2024 on a bipartisan and bicameral basis, like a longer telehealth extension and pharmacy benefit manager reform.
Rep. Greg Murphy, M.D., R-N.C., posted on X Monday night that Johnson and Senate Majority Leader John Thune have agreed to include a doc pay fix in Congress’ budget reconciliation, which is expected to be finished in May to align with President Donald Trump’s first 100 days.
A doc pay fix, which would counteract a 2.83% cut to Medicare physicians’ payment rates that went into effect Jan. 1, has been a central focus for provider lobbying groups as well as for physician members of the legislature. It was seen as the driving force behind passing an expanded healthcare package.
The Energy and Commerce committee has an $880 billion deficit reduction target. E&C will identify those cuts from programs within its jurisdiction like Medicaid and other healthcare programs. It could identify some of those savings from items in the December healthcare package that did not make it into last year's funding bill, such as PBM reform.
Updated March 100, 3:00 p.m. ET
House package brought over weekend extends telehealth, excludes doc pay fix
Saturday, House Speaker Mike Johnson released a bill that would fund the government through Sept. 30, avoid a partial government shutdown and extend expiring healthcare programs such as Medicare telehealth, funding for community health centers and a pay adjustment for certain low-volume hospitals.
Because the funding patch doesn’t include a fix for the 2.83% Medicare physician pay cut that went into effect Jan. 1, Congress may face pressure to pass a broader healthcare package that Senate Democrats reintroduced Friday that was negotiated on a bipartisan and bicameral basis in the fall.
Johnson's six-month funding patch would extend certain Medicare telehealth flexibilities that are set to expire March 31, including removing geographic barriers to participating in telehealth, letting more types of practitioners furnish telehealth services and allowing federally qualified health centers and rural health clinics to continue to offer telehealth.
The bill also delays an in-person visit requirement for tele-mental health services, extends tele-mental health availability for FQHCs and RHCs, extends audio-only telehealth and allows telehealth to be used for hospice recertification.
Some telehealth flexibilities are excluded like a benefit for people with high-deductible health plans and telehealth as an excepted benefit for seasonal and part-time workers.
“We appreciate Congress taking action to prevent a lapse in these vital telehealth flexibilities,” Kyle Zebley, executive director of ATA Action, said in a statement. “While we would have preferred a longer extension, this step ensures uninterrupted access to telehealth services for patients and clinicians, as we continue working toward permanent solutions that reflect the needs of modern healthcare."
House appropriators also propose to extend funding for community health centers and teaching health centers that operate graduate medical education programs as well a to fund the special diabetes program through Sept. 30.
The bill also would extend increased inpatient hospital payment adjustment for certain low-volume hospitals, the medical dependent hospital program and the acute hospital at home program.
House Republicans also propose to delay Medicaid disproportionate share hospital reductions and temporarily include authorized antiviral drugs as covered drugs under Medicare Part D.
The House rules committee meets Monday night, when it will likely vote on whether to send Johnson’s C.R. to the House floor. This scenario would likely tee the vote up for Tuesday.
Rachel Stauffer, principal at McDermott+, said she expects House Democrats to oppose the legislation and said this version of the C.R. has a good chance at passing with the support of the Republican majority.
“House Democratic leadership was already giving some indications that they were not happy with the direction that they were going,” she said. The bill’s lack of language to rein in the spending power of President Donald Trump and its increased defense spending also pushed away Democrats.
Because the funding patch doesn’t include a fix for the 2.83% Medicare physician pay cut, Stauffer expects Congress will face pressure to pass the healthcare package that Senate Democrats released on Friday.
“Physicians across the country are outraged that Congress’s proposed spending package locks in a devastating fifth consecutive year of Medicare cuts, threatening access to care for 66 million Medicare patients,” Bruce A. Scott, M.D., president of the American Medical Association, said in a statement. “Despite repeated warnings, lawmakers are once again ignoring the dire consequences of these cuts and their impact both on patients and the private practices struggling to keep their doors open.”
Senate Democrats released a proposed funding package Friday that included a broad swath of healthcare reforms and would extend programs for multiple years. That package would extend expiring Medicare telehealth flexibilities to December 2026, bump doc pay by 3.5% and reform pharmacy benefit manager practices.
Medicare doc pay is routinely fixed by Congress if the Centers for Medicare & Medicaid Services (CMS) cuts payment rates through the annual physician fee schedule rulemaking. The CMS has cut physicians’ rates for the last five years, and Congress has enacted partial fixes to ease the financial belt-tightening.
Because of congressional precedent—and the importance of physician pay to members of Congress—Stauffer expects the issue to galvanize Congress to pass other healthcare reforms the 118th Congress negotiated in the fall but Trump and Elon Musk killed at the end of 2024.
“I think a lot of folks felt like that bipartisan package was the culmination of several years of bipartisan work and are really wanting that to get across the finish line and not have to start over or do a piece meal or something like that,” Stauffer said.
However, House lawmakers may be reluctant to pass the reforms because the spending offsets could be used later in the year during the FY2025 House Budget Reconciliation. The Energy and Commerce committee has an $880 billion deficit reduction target. E&C will identify those cuts from programs within its jurisdiction like Medicaid and other healthcare programs, the University of Pennsylvania’s Wharton business school said.
The Senate does not have these same constraints because it is opting for budget reconciliation across two bills, the first of which requires less offsets.
If Congress does not pass healthcare reforms at the end of March, Stauffer said she doesn’t expect there to be another window to pass healthcare legislation until September, by which point a doc pay fix would be significantly less impactful.