The stopgap spending bill signed Nov. 12 by President Donald Trump halts a looming $536 billion Medicare cut and temporarily extends several key health programs, avoiding deeper disruptions from the now-ended government shutdown.
The legislation keeps most federal agencies funded through Jan. 30 and fully funds the Department of Agriculture, the FDA and the VA through the end of the fiscal year, according to Politico. HHS is among those operating under temporary funding until the end of January.
One of the bill’s most consequential provisions waives automatic cuts to Medicare that were triggered by Republicans’ tax legislation passed earlier this year as part of the One Big Beautiful Bill Act. Under the Statutory Pay-As-You-Go Act, the legislation’s addition of $4.1 trillion to the national debt would have prompted an automatic $536 billion reduction in Medicare spending over the next decade, according to the Congressional Budget Office.
In addition to the PAYGO waiver, the bill retroactively extends several health programs that lapsed when the shutdown began Oct. 1. These include the National Health Service Corps, community health centers, the Teaching Health Center Graduate Medical Education program, and $8 billion in funding for disproportionate share hospitals, which receive additional payments from Medicare and Medicaid to help cover the costs of caring for a large number of low-income and uninsured patients. The hospital-at-home and Medicare telehealth waivers were also restored, with coverage and payments backdated to the start of the fiscal year.
“Ending the shutdown and restoring telehealth services is a necessary first step, but the real test will come next month,” California Medical Association President René Bravo, MD, said in a Nov. 11 news release. “Congress cannot claim victory while millions of Americans stand to lose their health coverage. Extending the ACA premium tax credits isn’t optional — it’s essential to protecting access to care and preventing the destabilization of our health system.”
Those enhanced tax credits, a key component of the ACA, are set to expire Dec. 31, 2025, unless Congress acts. The credits have been a flashpoint in negotiations and were not included in the latest stopgap package. As open enrollment continues, advocates are urging lawmakers to act swiftly.
“No more posturing, no more politics — it is time for pragmatic lawmakers to come together, focus on lowering costs for their constituents, and extend the health care tax credits,” Charlene MacDonald, executive vice president of public affairs for the Federation of American Hospitals, said in a statement. “A bipartisan extension of the tax credits is the only mechanism to immediately cut costs for hardworking families already struggling to make ends meet. The solution to this cost-of-living crisis is simple and urgent: Congress must extend the tax credits now.”
While the stopgap measure avoids immediate disruptions and averts a significant Medicare cut over the coming years, hospital leaders argue that more decisive, long-term action is needed in December to protect coverage and shore up stability across the health system.