Healthcareโ funding on the โฃBrink: What Hospitals Need to Know About theโ Looming Congressional Showdown
Washington D.C. โค- As Congress races against aโ September 30th deadline to avertโ a government shutdown, the โฃfuture of key healthcare policies โขhangs in the balance. Decisions made in theโข comingโ weeks could dramatically reshape hospital and health system strategies for years to come, impacting everything โfrom patient access toโ financial stability.โ
House Republicans are currently preparing a โฃshort-term continuing resolution to fund the government thru November 20th. However, Democrats are signaling they will notโค support any dealโ that fails to address critical healthcare provisions, โespecially the extension of enhanced affordable Care Act (ACA) premium tax credits, โset to expire at the endโ of 2025.
Beyond the ACA credits,โค a series of โregulatory changes from the Department of Health and Human โServicesโ (HHS)โ and the potential fate of pandemic-era flexibilities are adding further complexityโฃ to the landscape.Here’s a breakdown ofโข the key issues hospital and โhealth โขsystem โleaders must monitor this month:
ACA premium Tax Credits: A Potential Coverage Crisis
The expiration ofโค the enhanced ACA premium tax credits poses an immediate โand meaningful threat. These credits have fueled โa surge in marketplace enrollment, reaching over 24 โmillion in 2025, with theโ vast majority of enrollees receiving financialโ assistance.
Without anโฃ extension, insurers โขare already preparing for a substantial increase in premiums. Proposed rate hikes for 2026 average 18%, with many already approved as open enrollment approaches. The American Hospital Association (AHA) warns that losing these credits will overwhelm emergency departments, โขworsen provider burnout, andโ exacerbate health disparities as more individuals โฃdelay or forgo care. The AHA estimates this could lead to a $28 โbillion reduction in hospital spending over the next decade.
While a bipartisan effort is underway to extend the credits – the Bipartisan Premium Tax Credit Extension Act would extend them through January 1, 2027 – its fateโค remains uncertain. Theโ Centers for Medicare & Medicaid Services (CMS) is proactively preparing for a potential lapse by expanding eligibility โขfor โคcatastrophic health coverage in 2026.
HHS Funding Cuts on the Horizon
The Houseโข Appropriations Committee recentlyโฃ advanced a funding bill that proposes a 6% reduction in HHS’s budget for โขfiscal year 2026,โค bringing it to $108 billion. This cut will โคlikely impact a wide range of programs and โinitiatives crucial to hospitals and health systems. Details on specific program cuts are still โคemerging, but leaders shouldโ anticipate potential โimpacts to areas like publicโฃ health funding, research grants, and support for safety-net hospitals.
Pandemic Flexibilities: Permanentโ or Temporary?
Two bipartisan bills โare currently under consideration that could determineโ theโ future of key pandemic-era flexibilities:
* Medicare Telehealth: Expanded telehealth coverage, which proved vital โคduring the pandemic, is set to expire. Legislation is being debated to make these changes permanent, allowing for continued access to remote care.
* Hospital-at-Home Waiver: This waiver allows hospitals to provide acute care services in patients’ homes. โคโ Its future is also uncertain, with lawmakers weighing whether to โฃextend or sunset the program.
What This Means for Hospitals
The coming weeks will be critical. Hospital and health system leaders โฃshould:
* Engage with โฃpolicymakers: Advocate for policies that protect access toโค care and ensure financialโ stability.
* Monitor legislative developments: Stay informed about the progress of the โcontinuing resolution, theโ ACA tax credit extension, and โthe โHHS funding bill.
* โข Prepare for potential scenarios: โ Develop contingency plans to address potential changes in coverage,โฃ reimbursement,โข and program funding.
The decisions made inโฃ Washington this month will have far-reaching โconsequences for the healthcare industry. World-Today-News.com willโ continue to provide updates as this critical situation unfolds.
Sources:
* Politico
* โ Becker’s Hospital Review – ACA Subsidyโ Expiration
* Becker’s Payer – ACA Enrollment Data
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