What House spending bill means for healthcare

House lawmakers approved a $460 billion spending bill on Wednesday in order to avoid a partial government shutdown. The proposal will support various government agencies, including the Department of Veteran Affairs and the Food and Drug Administration.

The spending bill contains provisions that directly impact physicians, hospitals, and healthcare organizations. Despite the bill’s passage, 85 Republicans remained opposed because it did not include the party’s most contentious policy demands, such as restrictions on abortion access, as reported by The New York Times.

The publication also noted that the bill is anticipated to clear the Senate smoothly and reach President Biden before the midnight deadline on Friday.

What the spending bill means for healthcare

• Medicaid Disproportionate Share Hospital (DSH) Cuts: The spending bill halts the planned cuts to Medicaid DSH for the fiscal year 2024 and postpones the reductions set for FY 2025 to January 1, 2025
• Medicare-Dependent and Low-Volume Hospital Programs: The legislation extends support for Medicare-dependent hospitals and enhances the low-volume hospital program until December 2024
• Physician Payment Reduction: The bill reduces the 3.34% cut in physician payments that began on January 1
• Community Health, National Health Service Corps, and Teaching Health Centers Programs: Extends funding for the Community Health Centers, National Health Service Corps, and Teaching Health Centers Graduate Medical Education programs through December

Additionally, the legislation:

• Avoids Site-Neutral Payment Cuts: The spending bill does not include provisions for site-neutral payment cuts, which would have equalized payment rates for certain services regardless of where they are provided
• Maintains Hospital Price Transparency Rule: The package does not amend the existing Hospital Price Transparency requirements

The legislation also aims to improve facilities to care for veterans and expand veteran cemeteries.

“We applaud Congressional leaders for agreeing on a package of health provisions that will protect patients’ access to care, especially those in rural and underserved areas. In today’s uncertain operating environment, it is critical that lawmakers act quickly to pass this legislation to avert damaging Medicaid cuts and extend critical rural health funding, measures that will provide much needed stability to hospitals and the patients they serve,” said Charlene MacDonald, executive vice president of public affairs at the Federation of American Hospitals in a statement.

AMA rebuts physician pay cut

While Congress was able to agree to reduce physician pay cuts, physician groups have been vocal that any pay cut is a blow to Medicare patients’ ability to access quality care.

“While we appreciate the challenges Congress confronted when drafting the current 2024 appropriations package, we are extremely disappointed that about half of the 2024 Medicare physician payment cuts will be allowed to continue,” said Jesse M. Ehrenfeld, MD, MPH in a response to the spending bill.

“Because of Congress’ failure to reverse these cuts, millions of seniors, like my parents, will find it more difficult to access high quality care and physicians will find it more difficult to accept new Medicare patients. This will become noticeable first in rural and underserved areas and with small, independent physician practices. Physicians are the only providers who do not receive automatic inflation updates to their Medicare payments, and they are the only group experiencing a payment cut this year despite high inflation.”

To fund additional segments of the government, including the Department of Health and Human Services, a second series of bills must be enacted prior to the March 22 deadline.