With the 2024 elections in the rear-view mirror, let’s talk “health care extenders.” Umm, what’s that, what are they, what’s the outlook? We are glad you asked!
Health Care Extenders
“Health care extenders” is an inside-baseball term in Washington, DC for health care-related policies that are set to expire at the end of December. Absent Congress (or in some cases, the administration) taking up these provisions in the next few weeks, parts of the Medicare or Medicaid statute will expire, leaving critical programs in the lurch.
But Wait, I’ve Heard This Before
Yes, you’re right, you remember. Health care extenders, and the anxiety that comes along with temporary policymaking, is not new. Many of these provisions were extended earlier in March 2024. In fact, some of these temporary policies started as far back as 2003 – I’m looking at you GPCI floor – and have been perennially extended ever since.
So What’s on This Year’s List
With so many extenders lingering out there, we wanted to make sure you had Congress’ “shopping list” at the ready. (Yes, we have holiday shopping on our mind. Maybe it’s retail therapy after this past election cycle?)
Expiring: 12.20.2024
- Pediatric Disease Priority Review Voucher Program
- Programs related to autism and other developmental diseases
Expiring: 12.31.2024
- Teaching Health Center Graduate Medical Education (THC GME) Program
- National Health Service Corps (NHSC) Program
- Special Diabetes Program (SDP)
- Special Diabetes Program for Indians (SDPI)
- COVID-19 Telehealth Flexibilities
- Moratorium on disproportionate hospital share cuts
- Community Health Center Program
- Acute Hospital Care at Home Program
- Medicare Low-Volume Hospital Adjustment
- Medicare Dependent Hospital
- Add-on payments for ambulance services
- Work Geographic Index Floor Under Medicare
- Sexual Risk Avoidance Education Program
- Personal Responsibility Education Program
- Waiving in-person visits to prescribe controlled substances (this is a pending rule at DEA)
- Emergency Medical Services for Children State Partnership Program
- Bring Education & Awareness to Encourage the Use of Mental Health & SUD Services/Health Care Professionals
- Mental Health Programs Among the Health Professional Workforce
What’s the Outlook
Now that you have the list, you probably want to know what’s gonna happen. There’s good news and bad news. Let’s go with the bad news first. Bad news is that savvy Congressional committee staff are always scrutinizing these policies to see which ones really need to be extended and which ones don’t. So the adage of – always on a list, always extended – doesn’t hold true for extenders. Good news is that lawmakers on both sides of the aisle and both sides of the Capitol support extending these provisions.
We expect Congressional action on these provisions in December, likely tied to a much larger piece of legislation that must go through before Congress closes out this session. The big question is how long will they be extended this time? Part of that answer depends on Congressional mood when members come back. We see 2 scenarios. The first scenario is that Congress extends the policies for a handful of months – maybe end of March – just to get by for a few weeks and not run up a big price tag on how much spending Congress would have to approve. Extending tiny policies, even for a few months, is expensive. The second scenario is a “clear the deck” scenario where Congress extends the policies through 2025 so that the new administration and new Congress have more time to either tend to other non-health care-related business (like tax reform) or to dig in on these provisions and make more thoughtful decisions on policy (like telehealth).
So there you have it. Let the lame duck sausage-making begin!
