November 10, 2025

Good afternoon,

In addition to the info in the article below from Modern Healthcare, reporting on the funding deal from We Make Progress and Becker’s Hospital News includes the following: 

Here’s what’s in the government funding deal for healthcare

ByMichael McAuliff
November 10, 2025 01:53 PM, Modern Healthcare

Senators agreed Sunday to a deal to reopen the federal government and to temporarily extend expired health programs.

Even though Democrats gave up on their key demand of renewing the enhanced Affordable Care Act subsidies in return for a promise of a vote in December, community health centers, telehealth companies and safety-net hospitals will get a reprieve until Jan. 30.

The Senate was expected to pass the measure Monday, with the House taking it up later in the week.

Here are the major healthcare-related policies getting extended through January:

• Funding for community health centers, the National Health Service Corps, and teaching health centers that educate graduate medical students
• Telehealth flexibilities in Medicare allowing doctors to bill for remote services.  On this point, Becker’s Hospital News states the following: says:  The agreement would likely reimburse healthcare providers for Medicare telehealth visits that haven’t been paid during the stoppage, InsideHealthPolicy reported Nov. 10. Telehealth claims would be paid retroactive to Oct. 1, and claims reimbursed at a lower rate because of geographic rule changes would likely be reprocessed.
• The deal would also fund the Supplemental Nutrition Assistance Program through fiscal 2026, CNN reported Nov. 10. SNAP benefits expired Nov. 1 and have been subject to a legal fight regarding short-term funding. On Nov. 9, a federal appeals court denied the Trump administration’s bid to avoid fully funding the program through November, The Wall Street Journal reported Nov. 10.  The ruling means the government will have to make the payments within 48 hours unless the Supreme Court intervenes. Amid funding uncertainty for the program, many health systems have pledged donations to local food banks.  (Note: Without getting into the weeds, this full-year funding guarantee should insulate the program from this kind of weaponization should the government shut down again before September 30.) 

Here are additional measures that will last until Jan. 30.:

• Medicaid disproportionate share hospital payment cuts enacted under the ACA are delayed. Remaining cuts for fiscal years 2026 through 2028 will remain on the books, worth $8 billion a year.
• Increased inpatient payments for Medicare low-volume hospitals resume.
• Medicare-dependent hospital payments resume.
• The work geographic index floor boosting Medicare physician pay resumes.
• Add-on payments under Medicare for certain ground ambulances resume.
• Funding for implementation of the No Surprises Act is resumed and boosted by $14 million.
• Funding is restored to the Centers for Medicare and Medicaid Services for its quality measures program and to hire a contractor to carry out related work.
• Pending payment reductions to the clinical laboratory fee schedule are delayed. The reductions were enacted under the Protecting Access to Medicare Act.
• Funding for Medicare hospice surveys under the IMPACT Act of 2014 is resumed.

The bill would pay for the short-term costs by extending 2% Medicare sequestration cuts under previous budget law by one month, and by cutting $400 million from the Medicare Improvement Fund.

Whether or not the bill will pass the House and get sent to President Donald Trump remains unclear.

Although Senate Democrats failed in winning an extension of the enhanced marketplace tax subsidies, the bill would restore jobs cut in the shutdown and to protect against further unilateral cuts by the White House.

Senate Majority Leader John Thune (R-S.D.) also promised to give Democrats a vote on the expiring marketplace subsidies in December.

The enhanced subsidies helped push enrollment in ACA plans to 24 million people, but expire at the end of the year. Congress’ nonpartisan budget office has estimated more than 4 million people will lose insurance if the more generous subsidies are not renewed.

With open enrollment already underway, enrollees are seeing dramatic spikes in their premiums. The longer Congress waits to address the matter, the harder it gets for insurers to adjust rates. The Congressional Budget Office has also estimated insurance premiums will remain higher even if the subsidies are extended retroactively.

——————-

Politico, 11/10 – New York is hoping the roadmap it’s laid out to invest in the state’s 47,000 square miles of rural land will garner a generous share of the competitive $50 billion Rural Health Transformation program, POLITICO’s Katelyn Cordero reported first.

State Health Commissioner James McDonald confirmed to POLITICO that the agency submitted its application to the federal government late Tuesday, seeking $200 million every year for the next five years.

Advocates and providers for rural health that worked with the Health Department in the seven-week application process say they are eager to work with the state once awards are announced.

“The $50 billion Rural Health Transformation Fund presents an opportunity for New York to secure much-needed support for our healthcare system amid chronic challenges and in light of the significant negative impacts from H.R. 1,” Healthcare Association of New York State President Bea Grause said in a statement to POLITICO. “We look forward to continued partnership with DOH as this process progresses.”

The federal program was included in President Donald Trump’s One Big Beautiful Bill Act enacted in July. Half of the allotment will be divided equally among states that apply. The other half will be distributed at the discretion of Centers for Medicare and Medicaid Services Administrator Mehmet Oz.

The amount New York receives will likely depend in part on whether the state implements policies pushed by the Trump administration, such as barring low-income people from using food aid to purchase “non-nutritious foods,” mandating schools to reestablish the Presidential Fitness Test and requiring doctors to take continuing education classes on nutrition.

McDonald said his agency connected with more than 170 health care industry stakeholders in the seven weeks they were given to draft their application. He noted that traditionally, this type of grant application would require a six-month application period.

The four areas of focus: 

— Create rural health partnerships: The state laid out plans to establish partnerships between rural hospitals and other health care organizations to create a hub of medical and social services in areas where access is limited.

— Improve access to primary care: The state aims to bolster access through use of artificial intelligence and a patient-centered medical care model that brings together a team of professionals to ensure continuity of treatment for a patient.

— Build a sustainable workforce: The application includes plans to use the money to strengthen workforce development and the hiring pipeline.

— Bolster technology infrastructure: Rural providers cite gaps in technology as a barrier to access for patients. The state is looking to close those gaps through investments aimed at improving telehealth networks and strengthening cybersecurity in rural facilities.

—