As Democrats and Republicans continue work toward passing a debt ceiling deal, the senior living industry is waiting to see how some provisions could affect providers.
In a 314-117 vote Wednesday night, the House of Representatives voted to suspend the nation’s debt limit until Jan. 1, 2025. President Joe Biden urged the Senate to pass the agreement “as quickly as possible so that I can sign it into law.”
Wednesday afternoon during an Argentum Advocates briefing, Argentum Director of Government Relations Dan Samson said that it was “unclear how this will play out,” but he added that there would be “lots to watch” on Capitol Hill over the next few days.
The agreement — the Fiscal Responsibility Act of 2023 (HR 3746) — as written would keep federal nondefense discretionary spending roughly flat in fiscal year 2024, increasing it by 1% for 2025 — an amount that LeadingAge said is “sure to be insufficient” for program costs that rise with inflation. The bill’s date to suspend the debt limit would come after the next presidential election.
Additionally, the bill would incentivize Congress to pass appropriations bills by Jan. 1 or discretionary spending would temporarily be at 99% of fiscal year 2023 levels. And the bill would limit federal budget growth to 1% for the next six years, although that stipulation would be enforceable only beginning in 2025.
Among the measures potentially affecting senior living are a clawback of $28 billion in unspent and uncommitted COVID-19-related funding. That clawback potentially could affect providers seeking redeterminations of Provider Relief Fund awards.
Samson said that although House Republicans had sought to reclaim the remaining $80 billion in unallocated funds from the six prior COVID-19 relief packages, the $3 billion remaining in the PRF largely was spared.
The second issue that potentially could have affected senior living relates to the Inflation Reduction Act, which provided tax credits and incentives for energy efficiency projects. But the currently proposed debt deal does not affect the IRA, Samson said, so senior living remains eligible to seek those tax credits to modernize buildings.
The bill does remove COVID-19 funding from approximately 20 programs, including those at the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention and the National Institutes of Health. Also, the Department of Housing and Urban Development multifamily programs also would lose any unallocated Coronavirus Supplemental Payment funding, although the amount to be lost is unclear, according to LeadingAge.
Overall, the Congressional Budget Office projected, the bill would reduce budget deficits by $1.5 trillion over the next decade. And the deal as written would retain $5 billion in funding for the development of new COVID-19 vaccines and treatments. Defense, Social Security, Medicare and veterans’ programs also would not be affected.
The compromise bill, Samson said, is better for senior living than the Limit, Save, Grow Act passed by the House in April. It would have suspended the debt limit for about a year, cut discretionary spending by 8%, rescinded all remaining unspent COVID-19 relief funds, repealed much of the IRA and instituted federal Medicaid work requirements, he said.
