Dive Brief:
- Republicans in the House Appropriations Committee released a continuing resolution Tuesday that would preserve Medicare telehealth flexibilities for seven more weeks, narrowly averting an end-of-month deadline when the policy changes are set to expire.
- Under the bill, the pandemic-era flexibilities, which include policies that remove geographic restrictions for telehealth and expand the types of clinicians who can provide virtual care, would be preserved through Nov. 21.
- However, the continuing resolution makes no mention of extending more generous financial assistance for people who buy health plans on the Affordable Care Act exchanges. Extending the subsidies has been a major concern for Democrats, who have threatened to shut down the government if Republicans don’t preserve the enhanced premium subsidies.
Dive Insight:
Telehealth groups and providers have been urging lawmakers to take action for weeks, arguing that patients rely on telehealth services and providers need clarity on Medicare policy.
The flexibilities, popular with lawmakers on both sides of the aisle, were enacted during the COVID-19 pandemic to preserve access to care. Previously, coverage of telehealth in Medicare was largely restricted to beneficiaries living in rural areas or to certain types of facilities or services.
Though some changes have been made permanent, many still operate on temporary waivers that have been extended multiple times since 2022.
The latest resolution gives providers a fairly short runway before the flexibilities are set to expire again — a concern for telehealth advocates who say the policy uncertainty could prevent health systems from investing in virtual care.
The continuing resolution is also missing a key policy for Democrats: More generous financial assistance for people who buy coverage on the ACA exchanges. The enhanced subsidies are set to expire at the end of the year, significantly increasing out-of-pocket costs for beneficiaries and leading to millions becoming uninsured.
Democrat lawmakers have indicated they would not vote for a spending package unless Republicans negotiate with them on policy priorities, including healthcare issues like the looming expiration of the ACA subsidies. And in the Senate, Republican leaders need Democrat support to advance a spending package — leaving the possibility that the federal government could shut down unless they reach a deal.
“House Republican Leadership has decided they would rather take us to the brink of a shutdown instead of working with Democrats on a bipartisan continuing resolution to keep the government funded, protect Congress’ power of the purse, and improve health care,” Rep. Rosa DeLauro, D-Conn., ranking member of the House Appropriations Committee, and Sen. Patty Murray, D-Wash., vice chair of the Senate Appropriations Committee, said in a Tuesday statement.
House Republicans on the Appropriations Committee said in a statement that the continuing resolution is “clean and straightforward,” averting a government shutdown and simply extending current levels of government spending.
The continuing resolution also amends other healthcare policies. The bill extends the Acute Hospital Care at Home initiative, another pandemic-era program that allows approved Medicare-certified facilities to provide inpatient level care in patients’ homes, through Nov. 21.
It also extends funding for community health centers, which provide primary care for underserved populations. That funding was set to lapse at the end of the month.
Additionally, it delays scheduled cuts to Medicaid disproportionate share hospital payments, which Congress has repeatedly postponed.
House Republican leaders aim to vote on the resolution by the end of the week.
