Both the House and Senate will be in session next week.

FY25 Funding Talks Slow as Deadline Approaches. With three weeks until government funding runs out on March 14, stalled negotiations on topline numbers make another short-term funding bill, or possibly a government shutdown, seem likely. The Office of Management and Budget’s memorandum directing a federal funding freeze reportedly interrupted negotiations, casting doubt for Democrats on the usefulness of a congressional compromise if the White House would assert control over appropriated funds. It is now unclear whether Democrats will support funding bills absent significant concessions, and their support may be necessary to pass legislation because of the Republicans’ slim majority. Health care stakeholders are closely monitoring the funding negotiations for key health provisions expiring on March 31, including telehealth. In addition, there is still interest in a broader health package containing priorities from the end of 2024, including potential inclusion of the advanced alternative payment model incentive payment and a physician fee schedule fix.

House and Senate Move Forward on Reconciliation Process. Both the House and Senate have begun the process to advance a reconciliation package with key policy priorities for President Trump. A reconciliation package is a unique legislative vehicle with certain constraints that only requires a simple majority in the Senate instead of the typical 60-vote threshold. Republicans hope to deliver on extending significant tax cuts, strengthening border security, enhancing defense funding, and supporting energy policies. Notably, the House and Senate have taken different approaches to these goals, and will require further negations before any of these policies advance. The underlying budget resolutions also instruct key health care committees to identify spending reductions to pay for these policies or offset their costs. Health pay-fors like Medicaid cuts and site-neutral policies may be considered. Some Republican lawmakers have pushed back on extensive cuts to Medicaid. A4H will continue to provide updates on potential impacts to health programs as the reconciliation process moves forward over the coming months.

Secretary of Health and Human Services, Robert F. Kennedy, Jr. Sworn In. Following his swearing-in, President Trump signed an Executive Order (EO) establishing the Make America Healthy Again Commission, chaired by Secretary Kennedy. The Commission focuses on aligning federal health efforts on chronic illnesses and is tasked with increasing health research data transparency, prioritizing chronic disease funding for federal grants, coordinating with the agricultural industry on nutritional food production, and expanding treatment options and coverage flexibilities for chronic diseases. The EO directs the Commission to submit a strategy to the President within 180 days. 

DOGE Implementation EO Requires Staffing Reductions and Hiring-to-Separations Ratios. On February 11, President Trump signed an executive order implementing the Department of Government Efficiency (DOGE) “Workforce Optimization Plan.” The plan requires agencies to limit new hires to one for every four employees departing, to promptly prepare to initiate large-scale reductions in force, and, within 30 days, to prepare plans identifying possible reorganization, consolidation, or organizational downsizing within the agencies. On February 14, HHS, in coordination with DOGE, began dismissing thousands of probationary employees, typically employees in their first year of service or existing employees recently promoted or transferred. These dismissals included several CMS Innovation Center employees. While there is little detail on specific employees terminated, there has been some reporting that folks working on the Transforming Maternal Health (TMaH) Model were dismissed. On February 19, President Trump signed another EO that directed federal agencies to collaborate with DOGE to review all regulations subject to their jurisdiction and begin scaling back unnecessary regulations. A4H will continue to monitor the regulatory actions that impact accountable care.

Next week is Health Care Value Week! Accountable for Health is pleased to work with over 70 stakeholder organizations to support Health Care Value Week, a week of action to support value-based care education and advocacy. We look forward to seeing you at our events next week:

• A4H In-Person Value Week Event, February 25. A day-long in-person conference in conjunction with Health Care Value Week in Washington, DC. Hear Congressional, community and provider perspectives on accountable care. Sessions include state approaches to affordability, data and health information technology, and clinical perspectives to advance health care delivery. This event is complimentary and open to members and non-members of Accountable for Health. You can register and view the agenda and full list of speakers on our website.
• A4H In-Person Innovation Showcase, February 26. A4H and the House Health Care Innovation Caucus will host a showcase at the Rayburn House Office Building from 11am to 1pm. Attendees can walk through the Rayburn foyer and visit A4H member displays to hear first-hand their approaches to accountable care. Register here.
• Virtual Value-Based Payment Summit, February 24-28. The Virtual Health Care Value week conference is a week-long series of sessions featuring speakers on a variety of value-based care topics. You can register and view the full list of sessions on their website.