Congress Stares Down Dec. 20 Deadline to Extend Federal Funding

Congressional leaders are reportedly planning to extend current federal funding via a continuing resolution (CR) for a short period of time into 2025. This would set up another funding deadline for the incoming Trump Administration to negotiate early in the year. There is also a concurrent negotiation regarding which policies will be “attached” to the CR, including extending current Medicare telehealth policies, providing a temporary Medicare physician pay bump, and extending funding for community health centers.

There is a risk that certain PBM reforms will be sought to help finance those extensions. The Congressional Budget Office has estimated that requiring PBMs to provide more transparency to plan sponsors in the commercial market and delinking PBM compensation from drug manufacturer list prices in Medicare Part D both result in federal budgetary savings (with transparency requirements resulting in higher savings than delinking). A number of stakeholders continue to demonstrate the risk of added costs as a result of these policies on patients, clients, and taxpayers. On Dec. 4, the Pharmaceutical Care Management Association (PCMA) issued a statement highlighting research estimating both higher premiums and a financial windfall to manufacturers as a result of delinking policies.