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  • Washington Highlights

    Biden Signs Government Funding Extension, Congress Fails to Avoid Medicare Cuts


    Brett Roude, Legislative Analyst
    Christa Wagner, Manager, Government Relations
    Allyson Perleoni, Director, Government Relations

    On Dec. 3, President Joe Biden signed the Further Extending Government Funding Act (H.R. 6119), a continuing resolution (CR) that extends government funding at fiscal year (FY) 2021 levels through Feb. 18, 2022. This follows a 221-212 vote in the House of Representatives and a 69-28 vote in the Senate. Federal government funding was set to expire on Dec. 3 [refer to Washington Highlights, Oct. 1].

    The CR delays congressional decision-making on finalizing FY 2022 spending levels for all federal government programs, including those at the National Institutes of Health (NIH), the Health Resources and Services Administration (HRSA), and the Centers for Disease Control and Prevention (CDC). If lawmakers do not reach a compromise by mid-February, they must fund the government through additional CRs, which would be disruptive to medical research progress, public health efforts, and health workforce programs.

    The CR does not address the impending 4% Medicare cut through a statutory Pay-As-You-Go (PAYGO) provision, the 2% Medicare sequester cut, or the 3.75% cut to the physician fee schedule. The AAMC sent a letter on Nov. 30 to congressional leadership urging them to eliminate these cuts and “finalize FY 2022 funding levels for discretionary health and research programs as soon as possible.” The AAMC also joined several other hospital and health system groups — including the American Hospital Association, the Federation of American Hospitals, and America’s Essential Hospitals — in sending a letter on Nov. 29 that urged congressional action to eliminate the PAYGO and the Medicare sequesters.

    Upon release of the CR text, AAMC President and CEO David J. Skorton, MD, and Chief Public Policy Officer Karen Fisher, JD, released a statement noting, “The AAMC is dismayed that policymakers have not yet addressed upcoming devastating cuts to hospitals and providers or completed appropriations legislation to fully fund programs vital to patients and communities in fiscal year 2022.” The statement went on to urge Congress and the administration “to work in a bipartisan manner to eliminate cuts to providers by the end of the year and pass the fiscal year 2022 appropriations bills without further delays. This important work is needed to help promote the health of patients, families, and communities across the country.”

    The Ad Hoc Group for Medical Research, convened by the AAMC, also released a Dec. 3 press statement citing the harms of CRs to medical research supported by the NIH. “While stopgaps serve an important purpose in maintaining federal operations, prolonged continuing resolutions create uncertainty that is disruptive to the longterm endeavor of medical research and impose unnecessary inefficiencies and delays in harnessing scientific opportunity toward the development of new treatments, diagnostics, preventive measures, and cures for patients. … The cost of postponing investments in research is one that patients cannot afford,” the statement read.

    Prior to the release of the CR, the AAMC-led Health Professions and Nursing Education Coalition (HPNEC), which advocates for increased funding for the HRSA Title VII and Title VIII programs, sent a Nov. 22 letter to appropriations leaders that highlights how “current funding levels for the chronically underfunded HRSA Title VII and Title VIII programs will hinder our nation's ability to educate current and future providers to serve the needs of all patients” and “urges members to finalize the FY 2022 spending packages as soon as possible.”

    The AAMC also joined the CDC Coalition in a Nov. 30 letter and the Friends of HRSA Coalition in a Dec. 3 letter echoing the concerns about the impact of CRs to public health and the need to complete the FY 2022 appropriations process as soon as possible.

    The AAMC previously reinforced the detrimental effects of stopgap funding measures to the research enterprise in coalition letters to Congress urging swift passage of FY 2022 spending bills. The Ad Hoc Group for Medical Research warned about the impacts to the NIH, the Friends of VA Medical Care and Health Research outlined consequences for the Department of Veterans Affairs research program, and the Coalition for National Science Funding described challenges for the National Science Foundation [refer to Washington Highlights, Nov. 19, Nov. 12, and Nov. 12].