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Last week, the country watched as Congress continued to hit roadblocks finding consensus to fund the federal government. Heading into the weekend, House Speaker Kevin McCarthy crafted a Continuing Resolution (CR) bill to allow the government to stay open for 45 days, giving the House and Senate more time to finish their funding legislation. The Senate voted to pass the CR three hours before the shutdown. President Joe Biden signed the spending bill — officially called HR 5860 — into law late Saturday night. What is in the CR? Specifically, the CR:

• Extends FY 2023 funding levels for federal agencies and programs.
• Delays cuts to Medicaid payments for Disproportionate Share Hospitals (DSH) through Nov. 17^th.
• Reduces funding in the Medicaid Improvement Fund to $6.36 billion, from $7 billion.
• Extends several public health programs through Nov. 17^th at the following amounts:
  • $526 million for community health centers.
  • $40.8 million for the National Health Service Corps.
  • $19.7 million each for the Special Diabetes Program and the Special Diabetes Program for Indians.
  • $16.6 million for the Teaching Health Center Graduate Medical Education Program.

• Does not include supplemental funding for Ukraine, which hardline conservatives had opposed.
• Blocks an automatic cost-of-living adjustment for members of Congress.
• Extends disaster response activities through Nov. 17^th and provides $16 billion in emergency funding to FEMA for the Disaster Relief Fund, including $15.5 billion for major disasters declared under the Robert T. Stafford Disaster Relief and Emergency Assistance Act. It also gives $2 million to the Office of the Inspector General for audits and investigations of activities funded under the Fund.

What was excluded from the CR? The CR does not address funding for the Pandemic and All-Hazards Preparedness Act (PAHPA), the substance abuse disorder focused SUPPORT Act reauthorization, or several maternal health programs that will sunset without congressional action. Congress will still be able to fund these programs in future negotiations. An armistice for now but all eyes are on November 17^th. In theory, Congress should pass a full FY 2024 funding package by then, but there is the possibility that we see another short-term CR through the end of December. The debt ceiling agreement enacted in June requires an across-the-board 1% reduction in discretionary spending for the entire fiscal year if Congress does not pass legislation that funds the government for FY 2024 by Jan. 1, 2024. Per the debt ceiling bill, the prescribed sequester does not take effect until April 30^th 2024, so there remains the possibility that Congress could act later than the end of the calendar year.