Article
What the House passed
On July 21, the House approved a continuing resolution to fund the government through Dec. 4 on a 220-205 vote. It does not extend expiring health care provisions, which run until Dec. 31. The Senate is not expected to take up the House bill and is writing its own.
A day later, the House adopted a fiscal 2027 budget resolution by 216-214, with every Republican voting yes except two. The resolution clears a path for a new reconciliation bill focused on defense, farm aid and election-related items. It instructs four committees, Agriculture, Armed Services, House Administration and Intelligence, to produce up to $95 billion in spending by Sept. 11, without requiring offsets. No committee with health care jurisdiction received instructions.
Why it still matters to hospital boards
The absence of health care instructions means this reconciliation round, as written, is not a vehicle for new Medicaid or Medicare cuts. That is meaningful after last year’s law, whose Medicaid changes hospitals are still working through. But the House and Senate must adopt identical budget resolutions before reconciliation can move, and the scope could change in the Senate.
The more immediate issue is the calendar. Government funding now runs out Dec. 4, and several health care provisions lapse Dec. 31. That sets up a crowded end-of-year session in which health extenders, appropriations and other priorities compete for floor time. Late-year packages have historically been where both extensions and offsets affecting hospitals get decided.
What boards and executives can do now
- List your exposure to Dec. 31 deadlines. Ask the CFO to identify which expiring federal provisions affect your revenue or operations and what a lapse would cost.
- Prepare for two scenarios. Budget for both a timely extension and a short lapse, including cash flow effects.
- Watch the Senate version. Any change to reconciliation instructions in the Senate is the early signal that health care is back in play.
- Use the August recess. Members will be home. Invite them to see services that depend on the expiring provisions.
Archive entry for Jul 26, 2026, added Nov. 11, 2026.