Communications

(Nov. 12, 2025) - Last night, President Donald Trump signed a bill to reopen the federal government after the longest partial government shutdown in the country's history. This bill is a continuing resolution extending fiscal year 2025 funding levels for affected departments and agencies until Jan. 30 of next year. It includes the health care extenders but, importantly, does not contain an extension of the Affordable Care Act's Enhanced Premium Tax Credits. 

The EPTCs played a key role in the shutdown debate. The credits expire at the end of the calendar year. Democrats wanted to include them in the CR, while Republicans pushed to keep the two issues separate. Politically, Republicans won this round. Too many key Democratic constituencies were being harmed by the ongoing shutdown, and enough of them eventually switched sides to give the Republicans the votes needed to pass the CR. 

The issue with the EPTCs remains unresolved. Although there is no must-pass vehicle to which they can be attached before their expiration, the issue still holds political significance. One of the key concessions Democrats secured from Senate Republican leadership to gain their votes to pass the CR was a guaranteed vote on extending the credits. This means Republicans are now scrambling to develop an alternative plan to avoid a potentially politically dangerous scenario to vote no on the EPTCs without offering anything in return. 

Recent reports, including statements from Kansas Senator Roger Marshall, indicate Republicans are considering various compromises, such as adjusting eligibility limits, changing the size of the credits and possibly shifting the program funding to a health savings account model. All of this will come to a head in the next few weeks, but the reality is that those who oppose extending the EPTCs, and many members of Congress do, can run out the clock. If nothing passes, they will expire Jan. 1. 

Throughout the year, the Kansas Hospital Association has been advocating for extending the EPTCs while opposing the idea that any Medicare site-neutral payment scheme should fund them. Next week, KHA President and CEO Chad Austin and members of KHA's Executive Committee will meet with members of the Kansas Congressional Delegation to discuss this along with other timely issues such as the need for their help in securing the Centers for Medicare & Medicare Services approval for Kansas' 2026 provider tax program changes. They are meeting at a pivotal time to advocate for Kansas hospitals as Congress considers its 2025 legislative endgame.