Congress Again Delays Budget Decision: The Ongoing Saga



Congress recently avoided a federal government shutdown by passing a two-part continuing resolution, extending spending levels and federal agency funding. However, the difficulty of obtaining long-term care for seniors was highlighted by investigations indicating the financial burden on families and the use of artificial intelligence by insurers to deny necessary rehabilitation care for Medicare patients. A class-action lawsuit in California alleges that UnitedHealth Group uses algorithms to deny rehabilitation care to enrollees in its Medicare Advantage program, and it is reported that over 10 million people have lost Medicaid coverage since states began reviewing eligibility.

Government Shutdown Averted and Long-term Care for Seniors Investigated

In a narrow escape, a federal government shutdown was avoided for the second time in as many months, with new House Republican Speaker Mike Johnson receiving the necessary votes from House Democrats. However, funding the federal government may become more complex when the latest temporary patches expire in early 2024, given that House Republicans have not come to terms with their inability to effect significant spending cuts while Democrats control the Senate and the White House.

This week, two investigations highlighted the challenges in securing necessary long-term care for seniors. One investigation by KFF Health News and The New York Times revealed the financial impact on families of individuals needing assistance for daily living activities. Another investigation by Stat reported on insurance companies’ use of artificial intelligence algorithms to refuse necessary rehabilitation care for Medicare patients.

Panel Discussion Highlights

The week’s panel included Julie Rovner of KFF Health News, Rachel Cohrs of Stat, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Alice Miranda Ollstein of Politico. Key takeaways from the panel discussion include:

  • A two-part continuing resolution passed by Congress will prevent a federal government shutdown when the current CR expires on Nov. 18. This extends some current spending levels, including FDA funding, till Jan. 19, and the rest of federal agencies until Feb. 2.
  • House Speaker Mike Johnson plans to finalize individual appropriations bills in the next two months. However, these bills propose deep cuts to several popular federal programs and include changes to abortion restrictions and transgender policies, highlighting the division within the GOP.
  • Amid growing concerns about the use of artificial intelligence in healthcare, a California class-action lawsuit alleges that UnitedHealth Group is using algorithms to deny rehabilitation care to its Medicare Advantage program enrollees.
  • Since states began reviewing eligibility earlier in the year, over 10 million people have lost Medicaid coverage. Advocates worry that the Biden administration has not done enough to ensure that eligible individuals, especially children, are not mistakenly terminated.

In addition to these topics, the panelists also recommended several health policy stories for further reading, which include:

Julie Rovner: KFF Health News’ “How Lawmakers in Texas and Florida Undermine Covid Vaccination Efforts

Alice Miranda Ollstein: The New York Times’ “They Wanted to Get Sober. They Got a Nightmare Instead

Rachel Cohrs: Stat’s “UnitedHealth Pushed Employees to Follow an Algorithm to Cut Off Medicare Patients’ Rehab Care

Joanne Kenen: ProPublica’s “Mississippi Jailed More Than 800 People Awaiting Psychiatric Treatment in a Year. Just One Jail Meets State Standards

Other mentions in this week’s episode:

KFF Health News’ “Facing Financial Ruin as Costs Soar for Elder Care

JAMA Internal Medicine’s “Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

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