Week in Washington 03/21/2024


While Congressional leaders have agreed to budget bill that would fund the government through the rest of the year, it’s unclear if the bill will be passed before the funding expires Saturday. House leaders are expected to vote on Friday, with the Senate soon to follow.

Not included in the budget bill are any pay fixes for providers. While there was consideration on adjusting the index Medicare uses, increasing payments for durable medical equipment, and extending telehealth Medicare flexibilities, none of those provisions ultimately made it into this year’s budget bill. Given that this is an election year, no major legislation is expected until after the election at the end of the year.

Medicaid Unwinding

KFF provided an update on the status of Medicaid unwinding. As of March 20, states have disenrolled about 18.6 million, renewed coverage for 39.7 million, and have about 35.7 million renewals remaining. Approximately 70% of terminations were due to procedural reasons.

Georgia Update

Georgia released updated data on its Medicaid expansion alternative program, Pathways to Coverage. Rather than expand Medicaid for all based on income, Georgia created a program that offered coverage up to 100% of the federal poverty level if that individual meets certain work requirements (or other qualifying activities). However, the program has only enrolled 3,500 people and has cost about $26 million (of which 90% have gone to administrative costs). Work requirements could become an issue again as that have been part of Republican platforms, should they regain control of Presidency/Congress.

CBO and Obesity Drugs

CBO released a presentation on potential implications on weight loss drugs impact on Medicare. CBO noted that should Congress allow weight loss drugs to be covered for purposes of weight loss CBO’s  expectation is that it would increase the deficit over the next 10 years. They do note that the long-term trend is highly uncertain as its their expectation that the semaglutide would be selected for price negotiation and that generic competition would start in 10 to 20 years. CBO is also looking for more research, especially for how the drug might affect other spending.

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