With a little more than three weeks to go, chances are dimming to revive the health care package that fell out of the year-end funding deal and add it to the next spending package.
Why it matters: Long-delayed measures that would overhaul PBM business practices, target drug company “patent thickets” and start to address Medicare hospital spending will probably remain in limbo.
Driving the news: There is disarray around the broader government funding talks ahead of the March 14 deadline, with Democrats looking to ensure President Trump doesn’t impound appropriated funds and a possible shutdown looming. Adding a health care package to the mix could further complicate things.
Between the lines: Democrats do not want to reopen the deal and pick and choose which parts to advance.
Yes, but: Some influential industry groups are still eager to see a more robust health package and could try to revive it.
But much of the GOP focus remains on the party-line reconciliation process, which could include major Medicaid or other health care changes.
House Republicans from competitive districts are raising concerns about the prospect of large Medicaid cuts — and are pointing to recent comments from President Trump to reinforce their case.
Why it matters: House GOP leaders’ hopes of passing a reconciliation package could be sunk with two defections, assuming Democrats are unified in opposition.
Driving the news: With the House budget calling for as much as $2 trillion in cuts to mandatory spending, moderates are sounding the alarm that they don’t want their constituents’ Medicaid benefits harmed.
One vulnerable freshman, Pennsylvania Rep. Rob Bresnahan, fired a public warning shot on X. “If a bill is put in front of me that guts the benefits my neighbors rely on, I will not vote for it,” he wrote.
What they’re saying: Trump made waves at the end of January by telling reporters that he wanted only to cut “abuse or waste” in Medicaid, not anything that would “affect” beneficiaries.
Between the lines: The budget sets only the overall goal for cuts, so the specifics of what changes would be made to Medicaid to reach that number are not yet clear.
Introduction
Congress is currently considering budget resolutions in both the House and Senate to establish spending and revenue frameworks for fiscal year 2025 through fiscal year 2034. These resolutions will guide the development of legislation that will be advanced using the budget reconciliation process, which allows for expedited passage of certain fiscal policies. The primary motivation behind these resolutions is to accommodate the extension of the 2017 Trump-era tax cuts, which are set to expire on December 31, 2025. Republicans, who control the House, are prioritizing tax reductions, spending caps, and cuts to entitlement programs, while Democrats argue for maintaining social safety net programs and increasing revenue through corporate tax adjustments.
Senate Budget Committee Chairman Lindsey Graham (R-SC) and House Budget Committee Chairman Jodey Arrington (R-TX) are leading efforts to pass their respective resolutions, which serve as blueprints for future legislative action. The political landscape is highly contentious, as Democrats control the Senate, and any final budget reconciliation bill will require careful negotiations to secure passage. The deadline for passing a budget resolution is March 7, 2025, when committee chairs must submit their reconciliation instructions. Both the Senate and House resolutions passed on strict party-line votes.
Understanding Budget Reconciliation
Budget reconciliation is a legislative process that enables Congress to adjust spending, revenues, and the federal debt limit with a simple majority vote in the Senate, bypassing the 60-vote filibuster threshold. This process is particularly significant when controlling party leadership seeks to implement budgetary priorities without requiring bipartisan support.
The House and Senate are taking different approaches to reconciliation. The Senate is considering two separate reconciliation bills. The first will focus on border security, military funding, and energy policy, while the second, expected later in the year, will address extending tax cuts and enacting additional spending reductions. This strategy is intended to secure passage of politically favorable provisions first while allowing more time for negotiations on tax and spending policies. The House, on the other hand, is taking a more comprehensive approach by consolidating its reconciliation provisions into a single bill that covers tax cuts, spending, and deficit reduction.
Current Status of the Budget Resolutions
Senate Budget Resolution
– Finance Committee: No specific dollar amount assigned, but expected to propose tax changes and spending adjustments. – Homeland Security Committee: Propose up to $175 billion in border security funding. – Armed Services Committee: Allowed up to $150 billion in military spending increases. – Energy and Natural Resources Committee: Propose at least $1 billion in reductions related to federal energy programs. – Health, Education, Labor, and Pensions (HELP) Committee: No specific dollar target, but tasked with proposing cost-saving measures in healthcare and education programs. – Agriculture Committee: Cut at least $1 billion in agricultural subsidies and nutrition assistance programs.
The resolution sets a March 7, 2025, deadline for committee recommendations.
House Budget Resolution
– Energy and Commerce Committee: Propose a minimum of $880 billion in Medicaid and Medicare cuts. – Ways and Means Committee: Identify revenue-neutral tax adjustments while preserving Trump-era tax cuts. – Armed Services Committee: Allowed up to $150 billion in defense spending increases. – Homeland Security and Judiciary Committees: Each allowed to propose up to $175 billion in spending increases. – Transportation and Infrastructure Committee: Propose up to $20 billion in spending increases. – Agriculture Committee: Cut $1 billion from nutrition assistance programs.
Key Budget Provisions and Policy Changes
Proposals Under Consideration Include:
Next Steps
Next Steps in the Budget Reconciliation Process
With both the House and Senate budget resolutions approved along party lines, the focus now shifts to the reconciliation process. The next major deadline is March 7, 2025, when committees in both chambers must submit their recommendations for spending cuts and tax policy adjustments as outlined in their respective resolutions.
– The Senate Budget Committee will begin reconciling the proposed spending and revenue frameworks to ensure compliance with procedural rules. – Senate committees with reconciliation instructions—including Finance, Homeland Security, Armed Services, Energy and Natural Resources, HELP, and Agriculture—must finalize and report their recommended changes by the March 7 deadline. – Once committee recommendations are compiled, Senate leadership is expected to introduce the first reconciliation bill focusing on border security, military funding, and energy policy by mid-March. Debate and a floor vote are anticipated before the March 14 government funding deadline. – A second reconciliation bill addressing tax cuts and broader spending reductions will follow later in the year, with negotiations expected to intensify in the summer and fall ahead of the December 31, 2025, expiration of Trump-era tax cuts.
– The House Budget Committee will continue refining the reconciliation package, incorporating spending cuts and revenue provisions mandated by committee instructions. – The Energy and Commerce Committee is expected to advance proposals for $880 billion in health care-related cuts, likely triggering significant debate over Medicaid and Medicare policy. – The Ways and Means Committee will finalize tax policy proposals, ensuring preservation of Trump-era tax cuts while identifying potential offsets to maintain revenue neutrality. – House leadership aims to bring a single, comprehensive reconciliation bill to the floor by early April, with passage expected along party lines.
Reconciliation Bill Passage and Final Negotiations
The reconciliation process remains fluid, with ongoing political negotiations influencing the final scope of tax and spending measures. Both parties will be positioning for broader fiscal debates in the run-up to the 2026 elections, further shaping the legislative trajectory of budgetary policies.
Congress is currently considering budget resolutions in both the House and Senate to establish spending and revenue frameworks for fiscal year 2025 through fiscal year 2034. These resolutions will guide the development of legislation that will be advanced using the budget reconciliation process, which allows for expedited passage of certain fiscal policies.
The House Budget Committee just released its budget resolution for Fiscal Year 2025, laying out a Republican-led fiscal blueprint aimed at advancing tax cuts, spending reductions, and debt management over the next decade. While the resolution does not contain specific policy changes, it provides broad fiscal targets and reconciliation instructions to House committees, directing them to develop detailed spending cuts and policy changes within their jurisdictions. This allows for increased spending in some areas—such as defense and border security—while mandating deep reductions in mandatory spending, particularly in health programs.
This one-bill House approach stands in contrast to the Senate’s two-part reconciliation strategy, setting the stage for intense negotiations between the two chambers. The resolution is expected to be marked up in committee this week before moving to the full House for a vote.
The House Budget Committee just released its budget resolution for Fiscal Year 2025, laying out a Republican-led fiscal blueprint aimed at advancing tax cuts, spending reductions, and debt management over the next decade. While the resolution does not contain specific policy changes, it provides broad fiscal targets and reconciliation instructions to House committees, directing them to develop detailed spending cuts and policy changes within their jurisdictions.
Republicans say work requirements are the most likely Medicaid change in a reconciliation bill, though a conservative push for deeper cuts could force more changes to the safety net program.
Why it matters: Medicaid is caught in the middle as House Republicans debate the extent of budget cuts, with conservatives pushing for as much as $2.5 trillion in spending reductions.
Driving the news: Lawmakers leaving a House GOP Conference meeting this morning said that work requirements could be the likeliest Medicaid change to make it into reconciliation and win support across the caucus.
Guthrie said his committee discussed offering up a minimum of $200 billion in savings during the recent GOP retreat in Florida.
State of play: But hardliners are pushing for more. Conservative Budget Committee member Ralph Norman told reporters this morning that he wants $2.5 trillion in cuts, a hard target to reach.
Between the lines: President Trump’s comments last week about not wanting cuts to “affect” Medicaid beneficiaries are also complicating the discussion, since major cuts could lead to coverage loss.
The bottom line: Winning over conservatives and moderates for any cuts is a major challenge.
President Trump appeared to extend his pledge not to cut Social Security and Medicare benefits to Medicaid on Friday — a change that could complicate Republicans’ plans for a reconciliation package.
Why it matters: House Republicans are discussing significant cuts to the safety net program to pay for an extension of tax cuts. But Trump, in his remarks, left enough wiggle room to keep the option alive in some form.
What they’re saying: “We’re going to love and cherish Social Security, Medicare, Medicaid,” Trump told reporters Friday in wide-ranging remarks.
Between the lines: A lot obviously depends on the definition of “abuse or waste.”
Yes, but: Much will still come down to how much of the roughly $4 trillion tax cut package Republicans look to offset.
The bottom line: Raymond James analyst Chris Meekins wrote in a note that the definition of “abuse” and “waste” is “really in the eye of the beholder.”
Robert F. Kennedy Jr., President Donald Trump’s nominee to serve as Secretary of Health and Human Services (HHS), appeared before the Senate Finance Committee on January 29 for his confirmation hearing, followed by a courtesy hearing before the Senate Health, Education, Labor & Pensions (HELP) Committee on January 30. The Finance Committee holds the authority to advance the nomination, while the HELP Committee hearing served as an opportunity for senators to further question the nominee without voting on his confirmation.
Kennedy’s testimony covered a range of issues, including his commitment to addressing chronic disease, promoting transparency in healthcare, and reforming the nation’s regulatory and policy approach to public health. While some Republican senators praised his focus on patient empowerment and reducing bureaucratic inefficiencies, Kennedy’s responses to key policy questions—especially regarding Medicare, Medicaid, and vaccines—raised concerns about his preparedness for the role.
The hearings revealed significant gaps in Kennedy’s understanding of fundamental Medicare and Medicaid operations. Key misstatements included:
Kennedy proposed several changes to healthcare payment systems:
Despite the breadth of the hearings, Kennedy did not address several critical policy issues relevant to the healthcare sector:
Sen. Bill Cassidy, a crucial vote on the Senate Finance Committee, remained undecided following the hearings. If the nomination reaches the full Senate, Kennedy could face significant challenges. With most Democrats expected to oppose him, he can afford to lose only a few Republican votes and still be confirmed.
The committee has set a deadline of 5:00 PM on January 31 for additional questions for the record, with responses expected to provide further clarity on Kennedy’s positions and plans. If confirmed, Kennedy would become the 28th Secretary of Health and Human Services.
Robert F. Kennedy Jr., President Donald Trump’s nominee to serve as Secretary of Health and Human Services (HHS), appeared before the Senate Finance Committee on January 29 for his confirmation hearing, followed by a courtesy hearing before the Senate Health, Education, Labor & Pensions (HELP) Committee on January 30.
A congressional bid to trim Medicaid costs by curbing state taxes on health-care providers stands to face pushback from governors over concerns it would shift more of the program’s cost burden to states.
States use taxes on providers such as hospitals and nursing homes to generate state Medicaid funding, which is used to generate federal matching payments to the states. The financing method, which is adopted by 49 states and the District of Columbia, is criticized by some policy observers as a creative maneuver that artificially boosts the amount of funding states receive from the federal government.
Republican members of the House Budget Committee this month circulated a menu of potential spending reform options, one of which would limit Medicaid provider taxes with hopes of yielding about $175 billion in savings.
House Republicans floated the changes for possible inclusion in a reconciliation bill that could help pay for an eventual extension of expiring Trump tax cuts. Lawmakers aim to hash out the details of what will be in the package over the coming weeks.
Other changes include over $2 trillion in cuts to Medicaid through the introduction of a per capita cap, in which states would receive a fixed amount of federal funding on a per-person basis, work requirements, and various other reductions.
However, policy analysts like Matt Salo, former executive director of the National Association of Medicaid Directors, predict that the most aggressive cost-cutting measures like per capita caps will be less likely to make it through the finish line than more modest reforms like reining in provider taxes.
“There will be a very strong motivation to do that. However, I think it will run into equally as aggressive opposition from a lot of very, very, well-connected political stakeholders for whom they simply could not afford to have that money go away like that,” Salo said.
Per capita caps have been singled out by organizations like the National Association of Counties, KFF, and the Center on Budget and Policy Priorities as untenable, largely because the move would force states to set rates well below what’s needed to keep pace with rising health-care costs. Medicaid is already a “lean” program by federal insurance standards, with providers receiving reimbursement at rates over 22% lower than Medicare, based on an analysis of payment rates conducted by the Medicaid and CHIP Payment and Access Commission.
This leaves provider taxes as one of the most likely cost-cutting approaches to make headway with lawmakers, according to Mary Mayhew, CEO of the Florida Hospital Association and former deputy administrator and director of the Center for Medicaid and CHIP Services under the first Trump Administration.
“At the end of the day, regardless of whether it’s a Democratic administration or a Republican administration, there has been a focus on Medicaid spending, at least in terms of how states have drawn down federal funds. I expect that will continue to be part of the equation, Mayhew said.
According to Salo, Medicaid provider taxes have drawn criticism from some stakeholders as contributing to the program’s rising costs due to there being no cap on the amount of federal matching funds a state can theoretically accumulate. The Committee for a Responsible Federal Budget estimates that in 2018, the most recent year for which data is available, provider taxes funded 17% of states’ contributions to Medicaid, equaling $37 billion.
“Whether the state pays a million dollars or the state pays $100 billion, as long as it’s doing so appropriately, the federal government has to put in its share,” Salo said.
Although a recent analysis from the Congressional Budget Office determined that ending this financing scheme could save the federal government billions, David Machledt, a senior policy analyst at the National Health Law Program, cautioned that the move would do more to shift the burden of high health-care costs to states than address the root cause of the problem.
“There’s not a lot of places you can cut Medicaid,” he said. “The options are cutting provider rates, which reduces access; cutting eligibility, or cutting optional services. And those optional services are really important—they include long-term community-based care for people with disabilities and other things like that. So it doesn’t end in a good place when you shift the cost onto states,” Machledt said.
Machledt says some of the loudest opposition to a ban on provider taxes could come from Republican-led non-expansion states such as Texas that lean more heavily on provider taxes to fund their Medicaid program. Those states often have greater populations relying on care from a shrinking pool of rural hospitals that are more vulnerable to cuts in Medicaid reimbursement.
For example, a 2020 proposed rule that would have tightened restrictions on provider taxes was eventually pulled after governors expressed concern that the rule would “result in decreased access to care for many vulnerable Americans.”
This time around, Mayhew expects renewed opposition from states to prevent a downstream increase in health-care costs.
“At the end of the day, it’s about how well these Medicaid programs throughout the country are meeting the needs of the individuals who depend on the program,” said Mayhew.
“This is at the heart and should be front and center in all of these discussions,” she added.
Providers are bypassing Medicare requirements to set up scaled-down hospital-at-home programs they say save money by reducing hospitalizations.
Ochsner Health, Los Angeles General Medical Center and TRU PACE in Colorado are among those offering home-based hospital programs that are less expensive and quicker to set up than the Acute Hospital Care at Home program, which has an uncertain future. Providers say the programs free up hospital beds for sicker patients and save money by keeping some patients in risk-based care plans out of the hospital. However, most of the in-home hospital programs don’t have the rigorous guardrails mandated in the Medicare waiver program.
Delivering hospital-level care in the home makes sense if patients prefer it, it’s safe and it’s cost-effective, said Matthew Notowidigdo, a healthcare economics professor at the University of Chicago’s Booth School of Business who studies hospital-at-home. However, he said the savings generated by these programs should not dictate where a patient receives care.
“There is always a concern that the insurers are going to respond to those incentives and try to manipulate the system in a way that is not great for patients,” Notowidigdo said.
The Medicare Acute Hospital Care at Home program requires hospitals to send nurses to patients’ homes twice a day, remotely monitor them at all times, provide meals and provide some nonmedical services for two to five days. Medicare reimburses at the same rate for hospital-at-home as it does for a facility stay. The Centers for Medicare and Medicaid Services has approved waivers for nearly 380 hospitals, but some haven’t launched hospital-at-home programs because they can be costly and hard to scale.
Those were among the reasons New Orleans-based Ochsner Health opted not to apply for the Medicare waiver, said Dr. Logan Davies, medical director of hospital access and throughput at Ochsner Medical Center. Instead, the nonprofit health system partnered last year with myLaurel, a New York-based home healthcare company, to offer its own hospital-at-home program called Acute Care at Home.
Davies said approximately 500 patients enrolled in the program last year and they had fewer emergency room visits and hospital admissions, which resulted in a $1,400 return on investment per enrollee.
Patients enrolled in Ochsner’s accountable care organization are eligible for the program and get referred to it from the emergency room. Then myLaurel sends a nurse or paramedic to the patient’s home within a day of admission and provides additional visits over a 15-day period, depending on the patient’s condition. Patients also receive supplemental telehealth support and prescriptions.
myLaurel bills Ochsner a flat fee for the first home visit and bundles fees for other services based on a patient’s length of stay, said Lisa Sasko, myLaurel’s chief growth officer.
Ochsner launched the program in March at its flagship medical center in New Orleans and expanded it to three more hospitals over the last two months. Davies said the system’s program is more flexible, and allows the system to provide only the services patients actually need.
“We can gauge what the patient’s clinical needs are and spec out a care delivery program that is specific to that patient’s condition,” Davies said.
The Medicare waiver’s rigid requirements — particularly the twice-daily nurse visits —prompted Los Angeles General Medical Center to develop its all-virtual Safer@Home program in 2020, said Dr. Brad Spellberg, the hospital’s chief medical officer.
“We don’t have enough staff to be sending them all over the county of Los Angeles,” Spellberg said.
Safer@Home provides home-based hospital care to eligible patients, who are mostly uninsured or on Medicaid. Patients receive virtual clinical visits, remote vital sign monitoring and oral or inhaled medications rather than intravenous therapy. Nurses and physicians are on hand for virtual care 12 hours a day, 7 days a week. Patients are released from the program when their conditions either improve or escalate, requiring in-person care.
In a study published last year in JAMA Network Open, Los Angeles General found patients enrolled in Safer@Home were released from care sooner than similar patients with in-facility stays and were less likely to return to hospital emergency rooms within 30 days of discharge.
Spellberg said Los Angeles General enrolls about three patients a day on average in the program and bears all costs for its patients. He said even with that expense, the health system still comes out ahead financially.
“It is expensive to be in the hospital and Medicaid reimburses below the cost of a hospital stay, so it is actually a cost savings for us to send people home if they have Medicaid,” said Spellberg. “We need those beds for patients with traumas, heart attacks and strokes.”
Another limitation of the Medicare waiver is that only hospitals can participate in Acute Hospital Care at Home.
DispatchHealth, an in-home medical treatment company, lets value-based care providers and health plans admit patients directly to its Hospital-Alternative Care program without visiting a hospital. The Denver-based company offers the program in seven mostly western cities and has treated approximately 3,500 patients since it launched in 2019, said a spokesperson.
“Our readmission rate is 8.4% where the industry average is about 20%,” Diana Verrilli, DispatchHealth’s chief growth officer, said. “From a payer lens that is significant in terms of the ability to keep that patient out of the hospital for any exacerbation that they may have.”
Patients receive either in-person or virtual nurse visits daily, remote monitoring, lab work, intravenous medications, meals and physical therapy for up to 30 days at home.
DispatchHealth charges value-based care organizations and health plans a negotiated rate for an entire episode of care based on the patient’s condition, said Verrilli.
TRU PACE in Lafayette, Colorado, has been using the Hospital-Alternative Care program for about four years for some elderly adults in the PACE program. TRU PACE takes on full-risk for Medicare and Medicaid dually-elgible older adults who get health services at home and in a neighborhood center. The nonprofit could not provide an estimate on how much the Hospital-Alternative Care program has saved the organization, but medical director Dr. Lisa-Marie Brown said it has resulted in fewer hospitalizations for patients with congestive heart failure, chronic obstructive pulmonary diease and other infections.
“Sometimes patients are kept [in the hospital] longer than they need to be and they can decline because they aren’t in their own beds or their own environment. There is also increased risk for delirium,” Brown said.
Ochsner Health, Los Angeles General Medical Center and TRU PACE in Colorado are among those offering home-based hospital programs that are less expensive and quicker to set up than the Acute Hospital Care at Home program, which has an uncertain future.
Health-minded lawmakers are in conversations with House leadership on reviving health legislation that failed to make it into a December government funding bill.
Rep. Buddy Carter (R-Ga.), chair of the Health subcommittee on Energy and Commerce, told reporters on Thursday he’s in conversations with leadership to pass the more than 500-page health package, either in a stand-alone vote or included in a reconciliation package.
“I’d like to do it as a standalone, get it done, and have it behind us, personally,” Carter said. “If we did it through suspension, we could probably put it on the floor. I mean, it was an agreement. It was bipartisan, bicameral.”
The large health care package that was eventually stripped out of the end-of-the-year government spending deal held a number of notable provisions, including language that would rein in pharmacy benefit managers for the first time, boost Medicare doctor payments, and extend telehealth services for multiple years. However, the package was ultimately stripped out and replaced with a standard three-month extension of funding after President-elect Donald Trump rejected the bipartisan deal with Democrats, and made additional demands.
Rep. Greg Murphy (R-N.C.), chair of the Doctors Caucus, confirmed there have been conversations about putting the package up for a suspension vote.
“Given the bipartisan nature of” PBM reform, “and a few other things, I think it would pass,” Murphy told Bloomberg Government in a written statement Thursday. “Obviously, it will be up to the Speaker.”
The December-passed government funding deal extended existing health authorities for three months, but stripped out principal health provisions, such as a regular “doc pay fix” provision that would’ve staved off a 2.8% Medicare payment cut for doctors that took place at the beginning of January. Murphy had previously told Bloomberg Government he secured an agreement with the Trump transition team to include a retroactive “fix” in the next government funding deal.
A spokesperson for Speaker Mike Johnson did not immediately respond to a request for comment.
House Energy and Commerce Chair Rep. Brett Guthrie (R-Ky.) had told reporters Jan. 3 the policies in the killed health package are “alive again.” Lawmakers, however, are still trying to find the right vehicle for it, with reconciliation measures being a possibility.
The collapse of the continuing resolution has seriously threatened an elaborately negotiated health care package that touches virtually every medical industry.
Why it matters: After weeks of intense bipartisan and bicameral talks, and months of laying the groundwork, the package’s major reforms, reauthorizations of existing laws and extensions of funding streams could all be scrapped.
Driving the news: The sources we talked to today do not see a clear path forward for the health care package, and no one’s sure what will happen.
What they’re saying: “Members got greedy and tried to hang too many ornaments on the tree; now it seems to have fallen over,” Raymond James analyst Chris Meekins told Axios.
Options for what happens next include a pared-down CR with some disaster relief for farmers and language raising the debt ceiling, as President-elect Trump is insisting.
Friction point: Don’t discount that Democrats will likely still need to deliver some votes on any compromise, considering the unruliness and potential defections of the House Republican conference and the 60-vote threshold in the Senate.
If another bipartisan compromise emerges, that would leave some opportunity for health items to catch a ride.
What’s next: If the health package is dropped, another chance could arise in March if there is another government funding bill. But it’s unclear if the odds would be any better, or if priorities shift.
Hospitals dodged the most substantial efforts in the year-end spending package to reform their industry, but advocates tell Peter the door has at least been cracked opened by a limited measure on outpatient billing.
Why it matters: After years of focusing on drug costs, this Congress started to train more attention on hospitals, which constitute a much larger share of U.S. health spending.
Driving the news: The CR includes a measure that would require off-campus hospital outpatient departments to have a unique identifier number, known as an NPI.
What they’re saying: The NPI provision “is a sign that a small victory can be won,” said Sophia Tripoli, senior director of health policy at Families USA.
Between the lines: Although hospitals opposed the NPI provision, site-neutral was more of an industry focus and a much bigger threat because of the way it addressed how hospital-owned providers charge Medicare more for the same services that independent doctors deliver in their offices.
Still, hospitals realize they need to remain on guard heading into next year.
The big picture: Hospitals are a powerful political force, given that they’re major employers in many members’ districts.
The other side: Hospitals argue that site-neutral payments do not account for higher costs at hospital outpatient departments and would especially harm rural areas — a particularly potent potent argument in the Senate.
What’s next: Backers of hospital cost reforms are hoping Congress will take broader action on site-neutral next year.
As 2024 comes to a close, we are looking ahead to the 119th Congress and opportunities for our clients to engage with their federal representatives and other decision makers in Washington, DC.
• View House and Senate calendars
• Questions? Contact Tony Wyatt: anthony@wscdc.com
Congressional Swearing-In Day Friday, January 3rd, 2025 | 9:30 AM – 3:00 PM U.S. Capitol, Washington, D.C.
Join us for a day of celebration as Members of the 119th Congress are sworn into office. Many lawmakers welcome visitors for informal open house style receptions throughout the day in their Capitol Hill offices. WSC will provide a schedule of events as details emerge.
Dinner Reception for Congressman Tom Kean (R-NJ-07) Tuesday, January 7th, 2025 | 5:00 PM – 8:00 PM Winning Strategies, 409 7th St NW Suite 450
Garden State Inaugural Gala Sunday, January 19th, 2025 | 7:00 PM – 11:00 PM Grand Hyatt Washington, 1000 H Street Northwest Washington
Join the New Jersey State Society at the Garden State Inaugural Gala for the best of New Jersey’s food and entertainment. Don’t miss this chance to celebrate with fellow New Jerseyans in the heart of the nation’s capital. Register here
Reception for Congressman-Elect Herb Conaway (D-NJ-3) Wednesday, January 22nd, 2025 | 6:00 PM – 8:00 PM Winning Strategies, 409 7th St NW Suite 450
Reception for Congressman-Elect Nellie Pou (D-NJ-9) Thursday, January 23rd, 2025 | 5:30 PM – 7:30 PM Winning Strategies, 409 7th St NW Suite 450
Reception for Congressman Jeff Van Drew (R-NJ-2) Wednesday, February 5th, 2025 | 11:00 AM – 2:00 PM Capitol Hill Club, 300 First St SE
The Walk to Washington & Congressional Reception February 6th – 7th, 2025 Hosted by: New Jersey Chamber of Commerce
After a five-year hiatus, the 84th Walk to Washington will feature more networking opportunities and fewer speeches, bringing together 900 New Jersey leaders on a chartered Amtrak train traveling from Newark through Wilmington, DE, to Washington, D.C. Register here
Related Walk to Washington Events:
WSW-PPAG NJ Chamber of Commerce Dinner Thursday, February 6th | 7:00 PM – 9:00 PM The Palm, 1225 19th St NW
Irish Breakfast Reception Friday, February 7th | 8:00 AM – 10:00 AM The Dubliner, 4 F St NW
Reception for Congressman Rob Menendez (D-NJ-8) Thursday, March 6th, 2025 | 12:00 PM – 1:00 PM Winning Strategies, 409 7th St NW Suite 450
We look forward to seeing you at these events! If you have any questions or need additional details, please don’t hesitate to reach out.
Key Updates:
• 2025 Congressional calendars now available
• Multiple January events including Congressional Swearing-In Day
• Walk to Washington returns in February after 5-year hiatus
• Several opportunities to meet with New Jersey delegation members
Language addressing insurer prior authorizations in Medicare Advantage that was holding up a year-end health care deal is likely to be dropped by negotiators.
Why it matters: Insurers’ requirements for their sign-off on some physician-ordered care is a big tension point with patients and providers, and measures to streamline the system have been a focus of Congress and the Biden administration.
Inside the room: One sticking point is whether to codify a prior authorization rule the Biden administration issued this year, or to include a prior authorization reform bill known as the Improving Seniors’ Timely Access to Care in the package.
Friction point: There’s a slight difference in transparency requirements for insurers, and where information on prior authorization denials and related information would be posted.
What they’re saying: Over the weekend, Democrats characterized Republicans’ efforts as “watering down” the prior authorization requirements.
Context: The bill has the bipartisan support of majorities in both the House and Senate.
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