Feb. 3
President Donald Trump on Tuesday afternoon signed a massive funding package that ends a brief government shutdown and provides full-year funding for the federal government through the end of the year.
The House voted earlier in the day to pass the package by a vote of 217-214.
As part of negotiations between Senate Democrats and the White House, the House moved forward to vote on a package that included five appropriations bills while splitting off a funding bill for the Department of Homeland Security (DHS). The legislation will provide temporary funding to DHS for two weeks to allow both parties to try to hash out a deal to impose new restrictions on federal immigration enforcement. Senate Democrats demanded time to negotiate new oversight policies for immigrant agents after two recent fatal shootings in Minneapolis.
The stalled funding package includes $116.6 billion in discretionary funding for the Department of Health and Human Services and reduces spending on "federal bureaucracy" at the agency by $100 million, according to a fact sheet (PDF) from the House Appropriations Committee.
The legislation also finalizes several key healthcare extenders including provisions of the Medicare telehealth program and the Acute Hospital Care at Home waiver as well as major supplementary funding programs for rural hospitals and those with high proportions of government-covered patients. The bill provides a five-year extension of the Acute Hospital Care at Home program and a two-year extension for Medicare telehealth flexibilities. The telehealth provisions in the bill include removing Medicare’s geographic requirements for telehealth and expanding the types of practitioners able to furnish telehealth services for the government health program.
The bill also introduces reforms to pharmacy benefit manager practices, including elements that would prevent PBMs from tying compensation in Part D to the list price of drugs and boost price transparency for employers in their PBM contracts.
Other provisions in the bill require that Medicare Advantage plans provide accurate provider lists, addressing so-called "ghost networks" that have come under fire in recent years. It would also require that health systems establish unique identification numbers for outpatient services, allowing the Centers for Medicare & Medicaid Services to track pricing in these facilities.
The National Community Pharmacists Association (NCPA) celebrated the law's signing and passage of the PBM reforms.
"Community pharmacy owners are the canary in the coal mine when it comes to federal or state prescription programs,” NCPA CEO B. Douglas Hoey, pharmacist, said in a statement issued Tuesday. “For years, our members and we have been telling anyone who will listen—and worked to convince others who wouldn’t listen—about the PBM-insurer conglomerates gobbling up market share, driving up drug costs, crushing small-business pharmacies, and making it more difficult for patients to receive the care they need. We’ve been warning that unless action is taken, more pharmacies will close, and more pharmacy deserts will grow. Unfortunately, as time passed, we were proven correct and finally, there is action to help reverse these trends."
The National Association of Chain Drug Stores (NACDS) also cheered the PBM reforms that will be enacted as part of the appropriations legislation.
“Congress and the Trump Administration are delivering a historic win for the American people and for the trusted pharmacies that serve as the face of neighborhood healthcare. These PBM reforms are integral to reducing people’s drug costs and keeping pharmacy care within reach, and they must be implemented swiftly, effectively, and as intended by Congress,” NACDS President and CEO Steven Anderson said in a statement. “The abuses of the dominant PBM middlemen are widely recognized, and this landmark federal action reflects the broad, bipartisan commitment to confront and remedy them. This is the most important federal achievement yet for PBM reform, and it will sustain and build momentum for further reforms where needed.”
A group representing community oncologists also applauded the PBM oversight and transparency measures.
“Reining in PBM abuses is a lifesaving measure for cancer patients. For too long, these middlemen have profited off of the backs of Americans with cancer by undermining patient care and leaving pharmacy and medical deserts in their wake,” said Ted Okon, executive director of the Community Oncology Alliance, in a statement.
The Pharmaceutical Care Management Association (PCMA), the leading lobbying organization for the PBM industry, said the government funding bill is a big win for pharmaceutical companies and asserts that the PBM measures will instead increase prescription drug costs.
In a statement, Brendan Buck, chief communications officer for the PCMA, said the PBM measures signed into law today are the culmination of a “years-long effort by drugmakers to convince Congress that PBMs are the problem with high drug costs.”
Buck also warned that new oversight of drugmakers’ actions is on the way.
“It is long past time for lawmakers to look into the ways the pharmaceutical industry games the system to block competition and artificially keep drug prices high. Patent abuse, shadow pricing, direct to consumer advertisements, pay for delay, switching … the tactics are many. All of them are in service of keeping prices high,” Buck said. “There are other players in the drug supply chain, such as the large wholesalers and their PSAOs, worthy of inquiry. But the time has come for drugmakers themselves to face the scrutiny they deserve.”
Many virtual care groups celebrated the Medicare telehealth and hospital-at-home provisions in the package. The five-year extension of the Acute Hospital Care at Home program marks a pivotal step in making hospital-level care in the home a long-term, sustainable part of the U.S. healthcare system, Moving Health Home said.
“This five-year extension is a critical step toward making hospital-at-home a durable part of our health care system,” said Krista Drobac, executive director of Moving Health Home, in a statement. “Long-term certainty allows providers to plan, invest, and scale these programs in ways that benefit patients, caregivers, and communities. Crucially, it also allows large scale collection of data and evidence that we feel confident will definitively convince lawmakers to make this program permanent. Moving Health Home is proud to have worked alongside Congress and our members to advance a model of care that delivers high-quality, patient-centered care where people want to be—at home.”
The five-bill minibus reinstates key telehealth flexibilities for multiple years.
“At a time of political volatility, telehealth continues to stand out as a core bipartisan priority ..." said Alexis Apple, deputy executive director of ATA Action, the affiliated policy and legislative advocacy arm of the American Telemedicine Association. “These extensions provide critical stability and certainty for patients and healthcare providers but also underscore the work still ahead."
ATA Action will continue to advocate for permanent telehealth policy solutions, Apple said, noting that the multiyear extensions will give government agencies, legislators and advocates needed time to hammer out the details of permanent provisions.
America's Essential Hospitals commended Congress for passing the funding package, which eliminates two years of Medicaid disproportionate share hospital cuts and extends the Medicare telehealth program and Acute Hospital Care at Home waiver.
"These policies are even more critical in light of the onerous hospital cuts passed by Congress last summer. However, we are disappointed that the bill increases administrative burden through unnecessary paperwork requirements for hospital outpatient sites of care," Jennifer DeCubellis, president and CEO of America’s Essential Hospitals, said in a statement.
Jan. 31
The Senate on Friday passed legislation that would fund most government departments through the end of September, including the Department of Health and Human Services.
The 71-29 vote came shortly after Senate Democrats and President Donald Trump made a deal to separate a funding bill for the Department of Homeland Security from five other spending bills. The agreement would fund DHS at existing levels for two more weeks to allow both parties to try to hash out a deal to impose new restrictions on federal immigration enforcement. Splitting off funding for DHS was a key demand from Senate Democrats.
The $1.2 trillion package now goes to the House, which is not expected to return to Washington until Monday. The House Rules Committee will consider the Senate-passed funding package during its meeting Monday at 4 p.m. ET, the first of several steps before the package can receive a full vote on the House floor, ABC News reported.
The delay in passing the funding package triggered a partial government shutdown Saturday. The impact of a partial shutdown will be minimal if the House is able to finalize the plan early this week.
Speaker Mike Johnson, R-La., told Fox News on Sunday that he is confident the package will pass by Tuesday.
The stalled funding package includes $116.6 billion in discretionary funding for the HHS and reduces spending on "federal bureaucracy" at the agency by $100 million, according to a fact sheet (PDF) from the House Appropriations Committee.
It also includes several healthcare extenders, among which are extensions of telehealth waivers and virtual care programs, as well as major supplementary funding programs for rural hospitals and those with high proportions of government-covered patients. Other extenders outline policy changes intended to boost transparency and oversight of pharmacy benefit managers, new requirements for Medicare Advantage plans to maintain accurate provider lists, and the establishment of unique identification numbers for health systems' outpatient services, among other changes.
Jan. 29 8:30 p.m.
President Donald Trump and Senate Democrats say they’ve reached a bipartisan funding deal to avoid a government shutdown, multiple media outlets reported Thursday night.
Under the deal, funding for the Department of Homeland Security will be separated from a larger spending bill, which had been a demand from Senate Democrats, the Washington Post reported.
The Senate will vote on five appropriations bills before the weekend that would provide funding through September 30 for most departments and agencies, including the Department of Health and Human Services.
The agreement would fund DHS at existing levels for two more weeks to allow both parties to try to hash out a deal to impose new restrictions on federal immigration enforcement, the Washington Post reported.
In a post on social media, Trump confirmed that "Republicans and Democrats in Congress have come together to get the vast majority of the government funded until September, while at the same time providing an extension to the Department of Homeland Security."
“Hopefully, both Republicans and Democrats will give a very much needed Bipartisan “YES” Vote,” Trump wrote.
A short-term shutdown seems likely as any changes need to be approved by the House which is currently on recess until Monday.
Jan. 29 1:45 p.m.
The Senate failed to advance a six-bill government spending package with key healthcare provisions, though negotiations are reportedly underway to break out contentious funding for the Department of Homeland Security so the rest of the package may move ahead before a Friday night funding deadline.
A procedural motion to open debate on the package, which required 60 votes, failed 45-55. All Senate Democrats voted in lockstep against advancement, as did some Republicans and Senate Majority Leader John Thune, R-S.D., the latter of whom did so to be able to bring the package up for a later vote.
Democrats withheld support for the bills over demands for new guardrails, policy changes and potentially leadership adjustments at DHS. Though the current package, which includes $64.4 billion for DHS and $10 billion for Immigration and Customs Enforcement (ICE), had already passed through the House under a bipartisan agreement, the weekend's fatal shooting of registered nurse Alex Pretti by federal agents has amplified pushback over the deployment of immigration officers, spurring Democrats to take a harder stance on the issue.
“Congress must act to rein in ICE and end the violence,” Senate Minority Leader Chuck Schumer, D-N.Y., said on the Senate floor ahead of the vote.
Amid the past weeks' heightened scrutiny and threats of no-votes, Republican leadership and the Trump administration resisted the precautionary measure of breaking DHS funding out of the package to limit the scope of a potential government shutdown. However, the president and Schumer reportedly opened talks Wednesday evening on such a measure, which would see DHS funded at current levels under a separate short-term stopgap.
That would give the sides time to negotiate on changes to the department, such as the Democratic caucus' calls for ICE agents to remove their masks and wear mandatory body cameras.
The stalled six-bill package includes $116.6 billion in discretionary funding for the HHS and reduces spending on "federal bureaucracy" at the agency by $100 million, according to a fact sheet (PDF) from the House Appropriations Committee.
It also includes several healthcare extenders, among which are extensions of telehealth waivers and virtual care programs, as well as major supplementary funding programs for rural hospitals and those with high proportions of government-covered patients. Other extenders outline policy changes intended to boost transparency and oversight of pharmacy benefit managers, new requirements for Medicare Advantage plans to maintain accurate provider lists, and the establishment of unique identification numbers for health systems' outpatient services, among other changes.
Jan. 26
Partial government shutdown looms, threatening to stall health funding package, telehealth extensions
Six annual spending bills for the current budget year are awaiting action in the Senate this week, including a key appropriations package that would fund the Department of Health and Human Services through Sept. 30.
But the sweeping government funding package is now in peril as Senate Democrats vowed to oppose it in the wake of the shooting death of a Minneapolis man by federal immigration agents, which would trigger a partial government shutdown. The number of agencies that would be affected by a shutdown remains unclear.
The House passed the HHS funding bill last Thursday, including Medicare telehealth and hospital-at-home extensions. The Medicare telehealth flexibilities, including no geographic restrictions and expanded provider types, and hospital at home flexibilities will expire on January 30, following an extension in late 2025. Unless Congress acts, restrictions on location and provider types will return on January 31.
The funding package, which includes outlays for other agencies, then advanced to the Senate, which returned to the Capitol today. The Senate now has four days upon its return to fund the government and avert another government shutdown.
Per a deal reached to end the last government shutdown, congressional leaders came together to temporarily authorize government funding through Jan. 30.
The remaining six appropriations bills for fiscal year 2026 includes $64.4 billion for the Department of Homeland Security, including $10 billion for Immigration and Customs Enforcement, the New York Times reported.
In a social media post after the Saturday shooting in Minneapolis, Senator Chuck Schumer, Democrat of New York and the minority leader, said that what is happening in Minnesota is "appalling" and that Democrats "will not provide the votes to proceed to the appropriations bill if the DHS funding bill is included."
If senators fail to act by midnight Friday, funding for Homeland Security and the other agencies covered under the six bills will lapse.
Schumer insisted that Republicans work across the aisle to rewrite DHS funding legislation but also signaled that Democrats would be willing to help advance the other five pending appropriations bills in the meantime, Politico reported.
“Senate Democrats have made clear we are ready to quickly advance the five appropriations bills separately from the DHS funding bill before the January 30th deadline. The responsibility to prevent a partial government shutdown is on Leader Thune and Senate Republicans. If Leader Thune puts those five bills on the floor this week, we can pass them right away. If not, Republicans will again be responsible for another government shutdown," Schumer said in a statement on Monday, referring to Senator Majority Leader John Thune, R-S.D.
The White House on Monday urged the Senate to move forward on the six-bill appropriations package to avert a partial government shutdown, signaling that it doesn't want the DHS funding separated out.
"At this point, the White House supports the bipartisan work that was done to advance the bipartisan appropriations package and we want to see that passed,” press secretary Karoline Leavitt said at a White House briefing when asked if the administration would be willing to separate DHS funding, Politico reported Monday.
Leavitt said that “policy discussions on immigration in Minnesota are happening,” pointing to President Donald Trump’s call with Minnesota Gov. Tim Walz earlier Monday. She said the discussions “should not be at the expense of government funding for the American people, according to Politico's reporting.
Any changes to DHS or other appropriations bills would have to go back to the House for approval, which does not return until February 2.
The healthcare funding package includes $116.6 billion in discretionary funding for the HHS and reduces spending on "federal bureaucracy" at the agency by $100 million, according to a fact sheet (PDF) from the House Appropriations Committee. The proposal would allocate $49 billion to the National Institutes of Health for research into key priorities such as cancer, Alzheimer’s disease, diabetes, rare diseases and chronic diseases impacting Americans.
The legislative package addresses several policy priorities that have taken shape for legislators over the past several years. For one, it aims to boost transparency and oversight of pharmacy benefit managers and would establish flat fees for their services.
It requires that Medicare Advantage plans provide accurate provider lists, addressing so-called "ghost networks" that have come under fire in recent years. It would also require that health systems establish unique identification numbers for outpatient services, allowing the Centers for Medicare & Medicaid Services to track pricing in these facilities.
The shift could set the stage for a move toward site-neutral payments, which the CMS has pushed for and had drawn outrage from the hospital industry.
Per the fact sheet, the package would allocate $418 million in funding for rural health, including rural hospitals, as well as maintain $1.9 billion in funding for community health centers.
Expiring telehealth and virtual care programs that have largely enjoyed bipartisan support join the list of healthcare extenders as well. The legislation would extend Medicare telehealth flexibilities by two years, until Dec. 31, 2027, and the acute hospital care at home program would continue through Sept. 30, 2030, just under five years.
Telehealth advocates are urging Congress to act quickly to prevent the Medicare telehealth waivers from expiring, noting that a telehealth shutdown will cause major disruption for patients, healthcare providers and hospital systems.
"Our most vulnerable patients who have integrated these models into their ongoing care – including millions of Medicare beneficiaries, individuals in rural areas, and those with mobility challenges – would suddenly lose access to virtual care and hospital at home services that have become standard practice,” Alexis Apple, deputy executive director of ATA Action and vice president of public affairs at the American Telemedicine Association, said in a statement issued Wednesday.
"We implore Congress to find a solution to extend these vital services before Friday’s deadline, to ensure continued access to telehealth services for patients and providers without disruption," Apple said.
ATA Action is the affiliated policy and legislative advocacy arm of the American Telemedicine Association.
Apple noted that telehealth has seen strong bipartisan support since President Trump enacted waivers to expand access to virtual care services during the pandemic.
"Policymakers view telehealth as a long-term solution for our nation’s healthcare challenges, with clinicians and patients embracing telehealth as an indispensable way to access quality care, and data continues to show the benefits of these technology-enabled services. Yet, despite unprecedented support across the board, telehealth is in jeopardy of falling victim to partisan debate," Apple said.
Editor's note: This story has been updated to include comments from ATA Action as part of the American Telemedicine Association.