(Nov. 21, 2023) Congress is not meeting this week as members are back home meeting with constituents and preparing to celebrate Thanksgiving with their families. They need the break, having just worked through a month and a half - quite literally unprecedented in all congressional history.
Technically, Oct. 1, 2023, marked the beginning of the federal fiscal year 2024, but like most years, Congress needed more time to pass its annual appropriations bills. Unlike most years, the House of Representatives now has a rule that a single member can bring a non-debatable motion to vacate the chair that, once made, forces a vote on removing the Speaker of the House. House conservatives never trusted former House Speaker Kevin McCarthy (R-CA) to make deep cuts to the federal budget. After he cut a deal with House Democrats to pass a continuing resolution to extend the previous year’s budget until mid-November, they had had enough. One of the House conservatives, Rep. Matt Gaetz (R-FL), moved to vacate the chair, and because the Republican majority is so small, the defection of a mere eight GOP representatives to vote with Democrats against McCarthy doomed his speakership.
Two weeks of uncertainty followed while the new deadline for passing a new federal budget (Nov. 17, 2023) loomed large. Finally, House Republicans agreed on elevating Rep. Mike Johnson (R-LA) to the speakership. Previously, Speaker Johnson led the House Republican Conference, the official policy arm of the body’s GOP. Known for his unquestioned conservative credentials, personal gentlemanliness and evangelical Christian beliefs, Speaker Johnson settled on a course of action regarding the budget by extending funding for some federal departments (Agriculture, the FDA, Veteran Affairs, Transportation, Energy, and other smaller agencies) until Jan. 19, 2024, and others (everything else including Health and Human Services) until Feb. 2, 2024. Simultaneously, he set a parallel course of action regarding considering individual appropriations bills on the floor in what is typically called “regular order” or allowing for votes on numerous amendments before voting on passage.
After some initial successes in getting three annual funding bills passed (Energy, Interior-EPA, and Legislative Branch), the plan hit the rocks. Last week, the Speaker won a test vote on the Labor-HHS-Education bill but then lost a similar test vote on the Commerce-Justice bill when the same conservatives who brought down Speaker McCarthy signaled their unhappiness with the proceedings. Speaker Johnson decided to send everyone home early for Thanksgiving break. When Congress returns next week, they will have much work and only a limited time to get things done.
The Kansas Hospital Association has worked during the budget process to see that the Medicare-dependent hospital program and the low-volume adjustment get extended, and the Disproportionate Share Hospital cuts are avoided. We felt that by getting these into the annual budget process, we could decouple them from bills that also contain site-neutral payment schemes like H.R. 3561 and the PATIENT Act of 2023. We will work to see what possibilities exist to make these extensions permanent, thereby taking them off the table for site-neutral “pay-for” chicanery in the future. As part of this effort, KHA’s Executive Committee will visit Washington DC Dec.12-14, 2023, to talk with our senators and representatives about these and other issues such as workforce and workplace safety.