02/13/2025

Staffing Rule Repeal, Medicaid Cuts Front and Center of Budget Resolution Plans

On February 12, the Senate Budget Committee began a two-day markup of its budget resolution. During the markup, Senator Mike Crapo (R-IA), who is on the Budget Committee, said the resolution’s budget reconciliation instructions to the Senate Finance Committee, which he chairs, is “to identify at least $1 billion in savings, which would unlock our ability to reverse a specific costly rule from the prior administration that threatens patients’ access to long term care in rural communities,” referring to the CMS nursing home staffing rule. Repealing the rule would save the federal government $22 billion over 10 years. Senator Crapo said the Finance Committee’s provisions would only target the nursing home staffing rule, not other healthcare rules.

In the House on February 12, leaders released their budget resolution to be marked up on February 13. As expected, it’s much larger than the Senate’s, which focuses on paying for about $520 billion in border control and defense efforts. The House’s resolution allows for up to $4.5 trillion for tax cuts and $300 billion on border control and defense efforts, with at least $1.5 trillion of it to be paid for through cuts. Given the budget reconciliation instructions in the House’s resolution, Medicaid is a prime target for the bill’s offsets. The bill instructs the House Energy and Commerce Committee, which has jurisdiction over Medicaid, to identify $880 billion in cuts, a level only achievable with deep Medicaid cuts. The House Budget Committee is considering a long list of ways to cut funding and access to the Medicaid program. Fiscally conservative House members are seeking additional cuts and are seeking adjacent deals to secure federal funding cuts as the House and Senate attempt to finalize long-delayed fiscal year 2025 appropriations bills.

Aging services stakeholders are urged to take action on budget reconciliation.