Six annual spending bills for the current budget year are awaiting action in the Senate this week, including a key appropriations package that would fund the Department of Health and Human Services through Sept. 30.
But the sweeping government funding package is now in peril as Senate Democrats vowed to oppose it in the wake of the shooting death of a Minneapolis man by federal immigration agents, which would trigger a partial government shutdown. The number of agencies that would be affected by a shutdown remains unclear.
The House passed the HHS funding bill last Thursday, including Medicare telehealth and hospital-at-home extensions. The Medicare telehealth flexibilities, including no geographic restrictions and expanded provider types, and hospital at home flexibilities will expire on January 30, following an extension in late 2025. Unless Congress acts, restrictions on location and provider types will return on January 31.
The funding package, which includes outlays for other agencies, then advanced to the Senate, which returned to the Capitol today. The Senate now has four days upon its return to fund the government and avert another government shutdown.
Per a deal reached to end the last government shutdown, congressional leaders came together to temporarily authorize government funding through Jan. 30.
The remaining six appropriations bills for fiscal year 2026 includes $64.4 billion for the Department of Homeland Security, including $10 billion for Immigration and Customs Enforcement, the New York Times reported.
In a social media post after the Saturday shooting in Minneapolis, Senator Chuck Schumer, Democrat of New York and the minority leader, said that what is happening in Minnesota is “appalling” and that Democrats “will not provide the votes to proceed to the appropriations bill if the DHS funding bill is included.”
If senators fail to act by midnight Friday, funding for Homeland Security and the other agencies covered under the six bills will lapse.
Schumer insisted that Republicans work across the aisle to rewrite DHS funding legislation but also signaled that Democrats would be willing to help advance the other five pending appropriations bills in the meantime, Politico reported.
“Senate Democrats have made clear we are ready to quickly advance the five appropriations bills separately from the DHS funding bill before the January 30th deadline. The responsibility to prevent a partial government shutdown is on Leader Thune and Senate Republicans. If Leader Thune puts those five bills on the floor this week, we can pass them right away. If not, Republicans will again be responsible for another government shutdown,” Schumer said in a statement on Monday, referring to Senator Majority Leader John Thune, R-S.D.
The White House on Monday urged the Senate to move forward on the six-bill appropriations package to avert a partial government shutdown, signaling that it doesn’t want the DHS funding separated out.
“At this point, the White House supports the bipartisan work that was done to advance the bipartisan appropriations package and we want to see that passed,” press secretary Karoline Leavitt said at a White House briefing when asked if the administration would be willing to separate DHS funding, Politico reported Monday.
Leavitt said that “policy discussions on immigration in Minnesota are happening,” pointing to President Donald Trump’s call with Minnesota Gov. Tim Walz earlier Monday. She said the discussions “should not be at the expense of government funding for the American people, according to Politico’s reporting.
Any changes to DHS or other appropriations bills would have to go back to the House for approval, which does not return until February 2.
The healthcare funding package includes $116.6 billion in discretionary funding for the HHS and reduces spending on “federal bureaucracy” at the agency by $100 million, according to a fact sheet (PDF) from the House Appropriations Committee. The proposal would allocate $49 billion to the National Institutes of Health for research into key priorities such as cancer, Alzheimer’s disease, diabetes, rare diseases and chronic diseases impacting Americans.
The legislative package addresses several policy priorities that have taken shape for legislators over the past several years. For one, it aims to boost transparency and oversight of pharmacy benefit managers and would establish flat fees for their services.
It requires that Medicare Advantage plans provide accurate provider lists, addressing so-called “ghost networks” that have come under fire in recent years. It would also require that health systems establish unique identification numbers for outpatient services, allowing the Centers for Medicare & Medicaid Services to track pricing in these facilities.
The shift could set the stage for a move toward site-neutral payments, which the CMS has pushed for and had drawn outrage from the hospital industry.
Per the fact sheet, the package would allocate $418 million in funding for rural health, including rural hospitals, as well as maintain $1.9 billion in funding for community health centers.
Expiring telehealth and virtual care programs that have largely enjoyed bipartisan support join the list of healthcare extenders as well. The legislation would extend Medicare telehealth flexibilities by two years, until Dec. 31, 2027, and the acute hospital care at home program would continue through Sept. 30, 2030, just under five years.