Republicans in the House are offering several health care extensions and delays in cuts that are apart of the larger continuing resolution to keep the federal government open past October 1. The seven week funding bill includes extensions to certain Medicaid programs that provide money to rural hospitals and others facilities that see less patients. The $8 billion-per-year Medicaid disproportionate share hospital cuts are delayed as well. This cut would impact payments for differences between Medicaid payments and the total cost of care for 2,500 hospitals.
The GOP proposal also extends (again) Medicare telehealth flexibilities and acute hospital care at home programs; with both programs set to expire by October 1. Noticeably, there is no ACA subsidy funding in the current continuing resolution proposal, a provision that Democrats have demanded to support the bill.
For hospital and health system leaders, this continuing resolution provides short-term stability but underscores the need for long-term advocacy. The delay in disproportionate share hospital cuts will offer temporary financial relief for safety-net and rural hospitals, but uncertainty remains if these funds are eventually reduced. Likewise, the extensions of Medicare telehealth and hospital-at-home flexibilities give leaders more time to invest in digital care models and expand patient access. However, the absence of Affordable Care Act subsidy funding is a warning sign that coverage gaps could widen, leading to higher uncompensated care. Leaders should use this reprieve to engage policymakers on sustainable funding solutions while preparing contingency plans for potential financial and operational disruptions.