• Disaster assistance. Allocates over $110 billion for disaster relief efforts across various states, including North Carolina, Georgia, Florida, Oklahoma and regions in the Western United States.   

• Farm Bill extension. Provides a one-year extension of the Farm Bill, ensuring continued support for agriculture and food policy programs.   

• Medicaid funding. Allocates $27.1 million to address Medicaid funding shortfalls for the Commonwealth of the Northern Mariana Islands (CNMI).   

The CR also upholds existing policy provisions, including pro-life and Second Amendment protections. The House approved the resolution with a 366-34 vote, and the Senate followed with an 85-11 vote. President Biden signed the bill into law on Dec. 21, 2024, ensuring the continuation of federal government operations into the new year.   

House Budget Committee 10-Year Plan

On Jan. 10, 2025, the House Budget Committee unveiled a 10-year fiscal plan focused on balancing the federal budget, reducing deficits and enhancing economic stability. The blueprint aims to achieve a balanced budget within a decade by cutting deficits by $14.2 trillion and lowering the debt-to-GDP ratio by over 40 percentage points compared to current forecasts. Key to this plan is a reduction in discretionary spending, expected to save $2.5 trillion over the next 10 years. 

A major portion of the savings comes from health-related reforms, with $8.7 trillion in mandatory spending reductions planned. For Medicare, the proposal targets $486 billion in savings by enhancing efficiency, primarily through site-neutral payments that standardize government reimbursement rates regardless of the health care setting. The plan also addresses hospital uncompensated care payments, bad debt and graduate medical education (GME) funding. Additionally, it proposes dismantling the Inflation Reduction Act (IRA) and scaling back enhanced Affordable Care Act (ACA) subsidies. 

In Medicaid, the Committee seeks $2.2 trillion in savings by offering states more flexibility and implementing per-capita caps to control federal spending based on the number of enrollees. The plan introduces work requirements for able-bodied adults and aims to standardize the Federal Medical Assistance Percentage (FMAP) for Medicaid expansion, ending the higher federal reimbursement rates for states that expanded Medicaid. It also proposes blocking certain eligibility rule changes and eliminating special FMAP treatment for Washington, D.C. 

Beyond health care, the plan includes measures to reduce waste and fraud, and to promote economic growth. It targets a 50% reduction in improper payments, anticipated to save $1 trillion over the next decade, through improved data sharing and stricter eligibility verification. Additionally, welfare reforms are expected to save $800 billion by tightening work requirements for Medicaid and food assistance programs and revising the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF). 

Expected Changes from the Senate Finance Committee

On Jan. 7, 2025, Senator Mike Crapo (R-ID) was appointed chairman of the Senate Finance Committee for the 119th Congress, a pivotal role overseeing over half of the federal budget. The Committee’s jurisdiction includes federal tax policy; social safety net programs; and health care initiatives such as Social Security, Medicare, and Medicaid, as well as the implementation of foreign trade agreements. In a press release, Chairman Crapo outlined his priorities, focusing on expanding access to affordable health care, promoting pro-growth tax policies and enhancing U.S. competitiveness in global trade. 

Key health care initiatives include improving primary and chronic care management by stabilizing and streamlining clinician payments, encouraging alternative payment models and expanding chronic care benefits under Medicare. Chairman Crapo highlighted efforts to improve rural health care access, enhance telehealth and mental health services, and prevent rural hospital closures. He also called for reforms in the pharmacy benefit management (PBM) system to lower consumer costs and support financial stability for pharmacies.