With the clock ticking on the current stop-gap bill that funds the federal government through Feb. 8, Congress is steeling itself to consider another must-pass budget bill. And, once again, health care could be caught in the crosshairs.
During previous debates over government funding, it was the high-profile Children’s Health Insurance Program that went months without reauthorization and became a bargaining chip in January. That program has since been extended for six years.
But the future of a host of other programs remains unsettled. Among them, funding for the nation’s 1,400 community health centers and a delay on capping Medicare coverage of physical and outpatient therapy.
The specific provisions behind these initiatives expired last fall. Advocates now are pressing lawmakers to keep them operational by including language in the broader spending bill that must pass next week to prevent another government shutdown.
Some of the items in this eclectic legislative mix are often left to the last minute to catch a ride on another bill — known as “extenders” by Washington insiders, because they extend funding that is set to expire or delay funding cuts that would otherwise take effect.
On the surface, these efforts may sound like wonky, inside-the-Beltway machinations, but program advocates say they have real-life implications for many of the nation’s neediest patients. For them, the congressional delay is causing concern. Here are some things you should know:
The provisions are important and wide-ranging.
Renewing federal funding for community health centers is the biggest ticket item — the clinics cost $3.6 billion per year, and provide basic health care for about 27 million low-income people. Also at stake is the Maternal, Infant and Early Childhood Home Visiting Program, through which trained home visitors teach poorer, at-risk mothers healthy parenting strategies to new mothers who are deemed at-risk and have low incomes.
Another provision forestalls planned reductions put in place by the Affordable Care Act — in federal funds given to particularly vulnerable hospitals that serve a particularly high rate of low-income patients, known as Disproportionate Share Hospitals.
And yet another would prevent limits, put in place by earlier budget bills, from being applied to Medicare’s coverage of physical therapy, outpatient therapy and speech-language pathology treatment. Without action, coverage would be cut off after $2,010 of occupational therapy is provided and another $2,010 for the combination of physical therapy and speech-language pathology. Each limit would translate into Medicare reimbursement for fewer than 20 visits.