On December 21, President Joe Biden signed into law the American Relief Act, 2025 (H.R. 10515), a continuing resolution (CR) that keeps the federal government funded at current levels through March 14. Passage of the bill narrowly avoided a government shutdown that was set to occur at midnight on December 20. The bill passed the House of Representatives with the support of 196 Democrats and 170 Republicans in 366-34 vote. The measure was passed by the Senate 85-11.
Negotiations over government funding hit a snag when President-elect Donald Trump and businessman Elon Musk pressured Congress to raise the national debt ceiling and cut federal spending. The original bipartisan bill, which was more than 1,500 pages long, included several provisions aimed at extending expiring health care related authorities and funding. Among these were an increase to Medicare physician payments of 2.5% for 2025, which would have averted nearly all the 2.83% cut to the Medicare physician fee schedule that took effect January 1, and an extension of incentive payments for qualifying participants in advanced alternative payment models through payment year 2027 based on performance year 2025, at an adjusted amount of 3.53%. A two-year extension of Medicare telehealth flexibilities that were scheduled to end on December 31, 2024, was also included in the bipartisan agreement, as were reauthorizations of the SUPPORT Act and the Pandemic and All Hazards Preparedness Act. The original package also contained reforms to the pharmacy benefit manager (PBM) industry aimed at increasing oversight of PBM services, preventing the use of spread pricing in Medicaid, and requiring PBMs to pass through 100% of rebates to sponsors of prescription drug plans in Medicare and the group health market. However, following objections from Trump and Musk, House Republican leaders sought to push forward a slimmer CR that included a suspension of the debt ceiling. This proposal was voted down 235-174, with 38 Republicans opposing it.
The CR that eventually passed did not include many of the health care provisions from the original bill. It did, however, extend certain telehealth authorities for three months, such as the removal of geographic restrictions and the expansion of the list of originating sites. It also includes short-term extensions of the National Health Service Corps, Teaching Health Center Graduate Medical Education program, and Community Health Centers through March 31.
Lawmakers returned to Capitol Hill on January 3 to commence the 119th Congress. Representative Mike Johnson (R-La.) was reelected as Speaker of the House, narrowly securing the position with 218 votes compared to House Democratic Leader Hakeem Jeffries’ (D-N.Y.) 215 votes. The only Republican to vote against Johnson was Rep. Thomas Massie (R-Ky.). While the GOP will control the White House and both chambers of Congress come Inauguration Day, Johnson will lead the House with the narrowest margin of control any party has had in nearly a century.
The House also adopted a rules package for the 119th Congress, which largely mirrors the rules of the 118th Congress. One notable change is the threshold for ousting the House Speaker being raised to nine members of the majority party. Previously, a single majority member could trigger a motion to vacate the chair – the process used to remove former Speaker Kevin McCarthy (R) from leadership in 2023.
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