The Remainder of the Year in Congress

Health Highlights

November 07, 2024

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For the time being, members of Congress are collectively focused on the outcome of the November 5 elections. However, when they return to Washington on November 12, the lame duck session of Congress will face a number of outstanding items. At the top of that list is government funding which—absent Congressional action—will expire on December 20. The continuing resolution (CR) that Congress enacted in September included several extensions of funding for expiring health programs, but a slew of “non-extender” health policies that this Congress has considered remain unaddressed. These include policies on:

Telehealth. Several pandemic-era Medicare telehealth flexibilities are set to expire on December 31, a number of which have become commonplace in telehealth delivery. In September, the House Energy and Commerce Committee (E&C) unanimously approved the Telehealth Modernization Act (H.R. 7623) to extend expiring flexibilities for an additional two years—through 2026.
Pharmacy benefit managers (PBMs). Policymakers have focused a great deal of time and attention during this session of Congress on policies to reform PBM practices in both federal and commercial payer markets. The Lower Costs, More Transparency Act (H.R. 5378) passed the House with strong bipartisan support in December 2023 and included several policies to enhance PBM transparency. The Senate Health, Education, Labor, and Pensions (HELP) and Finance Committees also advanced legislation covering similar territory in the PBM space.
Provider payments. On November 1, CMS finalized a 2.93 percent reduction in payments to physicians for services provided to Medicare enrollees for 2025. As has become commonplace, physicians are likely to petition Congress again this year for relief from these payment cuts.

The power dynamics of the incoming Congress will certainly influence the year-end negotiations, including which “non-extender” health policies will be included in a government funding bill. Early speculation in Washington indicates that the likelihood of a short-term CR into early 2025 may eclipse prospects of an end of year longer-term omnibus funding bill and accompanying policies.

For more information on how to subscribe and to activate a complimentary one week trial to Manatt on Health, please reach out to Barret Jefferds.    