Congress seems likely to exclude PBMs and other health priorities from spending package

Sources say Congress is unlikely to include many major health priorities in the next government funding package.

It is increasingly likely that the bill needed to fund the government by March 8 will only be able to include a small number of programs with looming deadlines. Examples include reversing funding for community health centers and Medicaid cuts to hospitals that treat low-income and uninsured patients. At least a partial reduction in Medicare physician payment cuts.

Reauthorizing federal pandemic preparedness programs and sweeping legislation to address opioids and substance use disorder are among the policies likely to remain on the chamber floor, officials said. Approval of these bills expired at the end of September.

Potential reforms to pharmacy benefit manager (PBM) practices also appear unlikely to be included in the funding package, although officials stressed that no final decisions have been made.

PBM reform is a bipartisan priority for both chambers, with bills advancing through the Senate Finance Committee and the Senate Health Committee. But competing priorities in the House and Senate have created complications, and the two sides have been unable to hammer out an agreement.

A partial government shutdown is looming after Congressional negotiators failed to reach an agreement over the weekend on the first four spending bills that expire March 1, including one funding the Food and Drug Administration.

Funding for other government agencies is scheduled to expire on March 8th. House Speaker Mike Johnson (R-Louisiana) faces pressure from the right to hold the line on spending cuts in ongoing bipartisan talks and push through a lengthy list of related policy riders. From abortion to diversity initiatives to border issues and other Republican priorities.

It is unclear what the path forward will be if PBM reform and other reauthorizations are not included, but sources speculate that the bill is likely to pass in a lame-duck session after the November election. .