The Latest: The U.S. Senate and U.S. House reconvened for the fall legislative session the second week of September. Three issues have dominated the legislative agenda: a continuing resolution (CR) to extend funding into the 2014 federal fiscal year (FFY), the debt limit, and the implementation of the health care law. The 2013 FFY ended on September 30. Congress failed to meet the deadline to enact legislation to keep the government funded and as a result the government shutdown.
Congress is currently embroiled in a debate over how to move forward with the 2014 fiscal year. Additionally, Congress is considering policies to increase the debt ceiling, the distribution of sequestration spending cuts, and averting the scheduled physician payment cut. Hospitals may be at risk for payment cuts in the context of these major fiscal battles.
Background: Four major deadlines are driving the policy agenda for Congress this fall and winter:
September 30: End of FFY 2013 and expiration of key Medicare provisions (the Medicare Dependent Hospital Program and the Low-Volume Adjustment).
October 1: Health Insurance Exchange (Marketplace) begin enrollment.
Mid October: The debt ceiling must be raised to provide additional borrowing authority.
January 1, 2014: The sustainable growth rate (SGR) formula will require a 24.4 percent cut to physician reimbursement under Medicare.
In order to reopen the federal government, the U.S. Senate and U.S. House will need to pass a CR to extend funding for the government into FFY 2014. Three major issues are being considered; the length of the CR, the funding level—whether the CR will maintain current spending or reflect the lower sequester cap, and funding for the implementation of the Affordable Care Act.
In addition, Congress has started debating how to address the debt ceiling. The U.S. House is unlikely to accept a straight debt ceiling increase without any concessions. They will be looking for: significant spending cuts—potentially dollar for dollar equal to the debt limit increase; entitlement or tax reform; and/or repeal/defund/delay provisions of the health care law. Additional Information: