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Federal fiscal year (FY) 2026 kicked off on October 1 amid a congressional stalemate resulting in a government shutdown. Without congressional authorization of appropriations, federal agencies have ceased operations of programs that rely on discretionary government funding and furloughed affected workers. Core activities at the Centers for Medicare & Medicaid Services (CMS)—including operation of and payments for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP)—remain uninterrupted due to their mandatory funding. However, many activities across other Department of Health and Human Services (HHS) agencies have been temporarily paused until negotiators find a path forward. Additionally, several health policy "extenders," including many of the Medicare telehealth flexibilities adopted in 2020 in response to the pandemic, have expired as of September 30.
On Capitol Hill, Senate Majority Leader John Thune (R-SD) has sought to exert pressure on Democrats by repeating votes on H.R. 5371—the continuing resolution (CR) that House Republicans passed largely along party lines on September 19 to provide "clean" government funding until November 21.1 The Senate has now rejected this measure six times, with a vote as recent as October 8. Meanwhile, the House is not expected to be back in session until October 14, but, pending negotiations and votes related to government funding, members have been advised that they will have 48 hours notice to return to Washington.
As it currently stands, both parties remain firmly entrenched in their positions. Congressional Democrats have doubled down on their demands that Republicans come to the negotiating table with a willingness to address the "looming health care crisis" of the December 31 expiration of the enhanced premium tax credits (PTCs) which will raise premiums for most Marketplace enrollees. Congressional Republican leaders insist they will not negotiate while Democrats are "holding the federal government hostage." And throughout it all, the President has not weighed in with his position on extending the PTCs. In the absence of current negotiations between the parties or between congressional leaders and the White House, the stalemate continues for the time being.
Footnote
1. In the House, H.R. 5371 passed by a vote of 217–212 with two republicans, Representatives Thomas Massie (R-KY) and Victoria Spartz (R-IN), voting against the measure and one Democrat, Representative Jared Golden (D-ME), joining the rest of the House Republicans in passing the bill.
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