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Congress Passes Slimmed-Down Spending Bill, Cutting Key Health Measures
Dec
In a race to prevent a government shutdown, Congress has passed a lean three-month spending bill, stripping down several major health care provisions. The bill, passed with overwhelming bipartisan support in both chambers — 366-34 in the House and 85-11 in the Senate — now awaits President Biden’s signature.
While essential funding for public health programs and a short-term extension of telehealth for older adults survived, several high-priority health initiatives were left out, marking a disappointing end to this legislative session for many advocates.
Key Cuts and Omissions
- Pharmacy Benefit Manager (PBM) Reform: Despite two years of deliberations and 95 proposed bills, Congress failed to pass legislation targeting PBMs, middlemen who play a major role in drug pricing. The largest PBMs, including Optum Rx, CVS Caremark, and Express Scripts, will continue to operate under existing regulations.
- Medicare Physician Pay: Physicians will face a 2.8% cut in Medicare payments starting January 1, as lawmakers declined to extend the pandemic-era bonuses many doctors had hoped to retain.
- Drug Competition Delays: Efforts to curb pharmaceutical companies’ legal tactics to delay generic competition fell short, marking another lost opportunity in a debate that has stretched over five years.
- Pandemic Preparedness and Opioid Crisis Measures: Provisions of a pandemic prevention law and legislation addressing the opioid epidemic both lapsed, raising concerns about Congress’ ability to address ongoing public health crises.
- Cancer Screening and Pediatric Cancer: Medicare coverage for blood tests to detect cancer early was excluded. Funding for pediatric cancer research, however, was salvaged as the Senate unanimously passed a standalone bill.
Winners and Losers
- Hospitals: Subsidy programs for hospitals were extended, and a measure pushing for greater billing transparency, which faced strong industry opposition, was removed from the final package.
- Disaster Relief and Farm Aid: The bill includes over $100 billion for disaster relief and $10 billion for emergency farm aid, providing much-needed support to affected communities.
Future Prospects
Some of the omitted measures could be revisited. Both Speaker Mike Johnson and President-elect Donald Trump have recently voiced interest in addressing the role of PBMs in the drug pricing system. Trump, during a recent press conference, stated, “We’re going to knock out the middleman… I don’t know who these middlemen are, but they are rich as hell.”
Still, the difficulty of passing any legislation that doesn’t fully unite House Republicans was underscored by the contentious negotiations to avoid a shutdown.
Outlook
While the bill ensures the government remains operational, it highlights the growing challenges of achieving bipartisan consensus on health care reforms. The failure to address pressing health care issues leaves uncertainty for providers, patients, and advocates, signaling potential hurdles in the months ahead.
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