Congress is advancing the Continuing Appropriations and Extensions Act, 2026, a short-term measure that would fund the government at fiscal year 2025 levels through November 21, 2025. While this Continuing Resolution (CR) avoids an immediate government shutdown, it represents only a temporary solution and leaves unresolved a series of health policy issues, like the extension of the enhanced premium subsidies, that will come due before year’s end. 

The legislation includes a range of extensions designed to preserve stability across federal health programs. This includes an extension of the Low-Volume Hospital payment adjustment, the Medicare-Dependent Hospital program and the ground ambulance add-on payments until November 21st. The geographic practice cost index (GPCI) floor, which adjusts physician reimbursement to account for regional cost differences, is also extended through the duration of the CR. Community Health Centers, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education program are all reauthorized through November 21st as well.  

The CR continues the telehealth flexibilities that emerged during the COVID-19 public health emergency as well as the hospital-at-home program until November 21st. This includes preserving the removal of geographic restrictions, the expansion of originating sites, the ability of additional practitioner types to furnish telehealth services, audio-only service access, delayed in-person requirements for mental health visits, and the use of telehealth for hospice recertifications.  

The CR also delays cuts to Medicaid Disproportionate Share Hospital (DSH) payments, which were scheduled to begin on October 1st. Those reductions are now pushed back until November 21st, at which point they will begin phasing in and extend through fiscal years 2027 and 2028.  

Despite these measures, the CR doesn’t include any provision to extend the enhanced premium tax credits, which are scheduled to expire at the end of this year. Their future will be the subject of negotiation as Congress turns toward a year-end package. In contrast to a few months ago, AHPA is hearing increasing interest from Republican leaders to extend this premium support. However, concerns about the cost of extending them remain.  

The political environment surrounding this CR remains highly uncertain. In the House, Republican leadership is aiming to secure passage with minimal defections, relying on their majority to advance a relatively “clean” bill. In the Senate, the dynamics are more complicated. Majority Leader Chuck Schumer and Senate Democrats have indicated they are unlikely to support cloture on a measure that omits their health priorities, including the enhanced premium tax credits. Senate Republicans, led by Minority Leader John Thune, have emphasized the need for rapid passage, with an eye toward exerting pressure on Democrats before the fall holidays. AHPA will continue to advocate for an extension of these key health care priorities.