Congress Heads Into Recess With Healthcare Issues Waiting After the Midterms

With Congress in recess until after the November midterm elections, lawmakers will return to Washington facing a crowded year-end agenda that includes several expiring healthcare funding provisions and ongoing debate over federal healthcare spending and Medicaid oversight.

Both chambers are scheduled to return the week of Nov. 9, leaving lawmakers with a relatively short window to address several priorities. Government funding will be among the most immediate issues, with current funding set to expire Dec. 11.

For healthcare organizations, another deadline follows just weeks later. Several federal healthcare programs and payment provisions expire Dec. 31, including the Medicare-Dependent Hospital program and Medicare Low-Volume Hospital Payment Adjustment, as well as funding for community health centers, the National Health Service Corps and teaching health centers. A Medicare physician payment provision also awaits congressional action. Whether Congress addresses those measures individually or as part of a broader year-end legislative package is likely to depend in part on the political environment following the elections.

Adding to appropriations tensions, the White House recently transmitted a package of proposed funding rescissions to Congress. The package includes more than $500 million in funding for programs serving unaccompanied children within the Department of Health and Human Services, along with $27.7 million from the Agency for Healthcare Research and Quality and approximately $5 million from the Office of Minority Health. The timing of the request, just days before the end of the federal fiscal year, is expected to fuel continued debate over congressional spending authority as lawmakers turn their attention to fiscal year 2027 funding.

Medicaid Oversight Also remains in Focus

Republicans on the House Energy and Commerce Committee recently released a majority staff report following an investigation into Medicare and Medicaid fraud and introduced 14 related bills addressing program integrity. The investigation included three oversight hearings and review of more than 100,000 pages of documents.

The report concluded that some state Medicaid agencies are not making full use of provider risk classifications, audits and investigative authorities. The legislation is not expected to attract significant bipartisan support, but the activity signals that fraud, waste and abuse in federal healthcare programs will remain an area of congressional attention.

States, meanwhile, face a more immediate Medicaid change beginning Oct. 1. Under the federal budget law enacted last year, federal Medicaid and CHIP matching funds will be limited to U.S. citizens and nationals and specified categories of eligible noncitizens. Guidance from the Centers for Medicare & Medicaid Services (CMS) notes that federal funding remains available for emergency treatment and that the change does not eliminate states’ option to cover lawfully residing children and pregnant women.

For healthcare leaders, the congressional recess may provide a temporary lull in legislative activity, but several consequential issues are waiting on the other side of the elections. The post-election session will bring government funding negotiations, expiring healthcare provisions and continued debate over Medicaid oversight into a compressed year-end legislative calendar.