The funding bill House Republican leaders released on Saturday does not avert cuts for doctors who treat Medicare patients — a blow to Republicans who had pushed for the changes that also could risk alienating members whose support will be needed to pass the legislation.
Rep. Greg Murphy (R-N.C.), who co-chairs the GOP Doctors’ Caucus, said in recent months that Republican leadership was open to including the policy in the bill to keep the government funded through September, and that Trump administration officials had assured it would be addressed. Five health industry lobbyists, granted anonymity to share details of private negotiations, were also anticipating it would be a part of the funding measure to avoid a shutdown after March 14.
Murphy said in an interview its inclusion would be a “line in the sand” necessary for his support. A Murphy spokesperson did not immediately respond to a request for comment about whether the lawmaker was still adhering to that position.
Speaker Mike Johnson can only afford to lose two votes on his side of the aisle if all Democrats band together and oppose the government funding bill, a position the minority party could ultimately take.
Two lobbyists aware of the closed-door negotiations said the patch for doctors was ultimately not included amid broader concerns among Republican leadership that adding more than standard extensions of programs would open the door to more demands for other policies to be attached.
But the legislation released Saturday, which would hold most current spending levels through the end of the fiscal year, is far from “clean“: It would boost spending for illegal immigrant deportations while cutting — and in many cases completely zeroing out — money for a variety of non-defense programs. It’s not clear how leadership will justify the exclusion of one policy provision when other priorities are getting addressed.
The doctors’ pay fix would have prevented further cuts from going into effect that would slash deeply into salaries for doctors providing Medicare services based on an outdated formula. It was part of a larger health care overhaul package set to pass as part of a year-end government funding bill in December. Then-President-elect Donald Trump and Elon Musk complained that bill was overly broad, and the package got scrapped.
Members of both parties warn the stakes are high for not addressing this issue quickly: Decades of payment reductions in Medicare have put physician practices in difficult financial straits, doctors groups say — meaning they could be forced to close their practices and reduce access to care.
But while though there is no relief for doctors, the stopgap funding bill would — as expected — include an extension of eased telehealth rules until September, avoiding a potential disruption in access to care if adopted.
Those relaxed telehealth rules were first introduced by the Center for Medicaid Services during the Covid-19 pandemic when physical doctor offices were closed. Congress has extended those telehealth rules several times, but a permanent solution has remained elusive.
The stopgap bill would also extend hospital-at-home waivers that enable facilities to offer more care at home. It would, as well, extend funding for community health centers, alongside a delay in funding cuts to safety-net hospitals.
The Affordable Care Act called for such cuts, expecting such hospitals wouldn’t have to offer less care without getting paid as millions more got covered through the law, but Congress has never let them go into effect.
