December 31st, 2024
OVERVIEW
Bipartisan Deal that Almost Failed is Harbinger for the 119th Congress. The Continuing Resolution (CR) hit some speed bumps in what was expected to be a quick bipartisan vote for passage thanks to Elon Musk’s very prominent opposition to additional funding and President-elect Trump’s last minute push for a debt ceiling extension. Just as the hours until the CR expiration drew dangerously close, a new CR emerged and secured bipartisan passage in the House then the Senate. The key was level funding current programs, including $100 billion disaster relief and excluding a debt ceiling extension and other policy extensions in order to garner enough votes.
In 2025, with the Senate including 53 Rs and 47 Ds (including 2 Independents who caucus with the Democrats) and the House including 219 Rs to 215 Ds (with two selected as Trump nominees shrinking this margin to 217 Rs to 215 Ds in Q1) there won’t be room for Republicans to lack unity in their tax and spending legislation. Also, on December 30 President-elect Trump announced Speaker Mike Johnson (R-LA) has his "complete and total endorsement" — key for some in the GOP as some inner-party strife over his deal-making with Democrats is casting doubts on his ability to win his re-election to the same post on January 3.
FUNDING
The FY2025 appropriations legislation is the top issue of 2025. The fiscal year began October 1, 2024 and the latest Continuing Resolution (CR) level funds government until anges remain up in the air. The current CR expires March 28, 2025. Several programs expire next year that are shaping priorities for the new government-wide GOP majority.
Dates to Watch:
- By the end of April 2025, under the Fiscal Responsibility Act the FY2025 appropriations legislation must be enacted or a penalty kicks in. If still under a FY2025 CR then both defense and non-defense funding levels will be cut by 1% starting May 1.
- On October 1, 2025 when the FY2025 year ends, the statutory discretionary spending caps enacted by this Act expire.
- On December 31, 2025, the increased and expanded Affordable Care Act health insurance subsidies expire that were included in the American Rescue Plan. These included temporary increased premium tax credits for assistance in buying health insurance from state-based marketplaces created by the ACA and expanded eligibility for premium tax credits to individuals with incomes exceeding 400% of the federal poverty line. These were set to expire at the end of 2022 but the Inflation Reduction Act extended those subsidies for three years, through 2025.
- Also on December 31, 2025 the Tax Cuts and Jobs Act’s provisions expire, including the individual income tax provisions, paid family leave credit, employer-paid student loans income exclusion, tax exclusion for student debt forgiveness, multiple tax extenders such as Empowerment Zones incentives, film and live performances expensing, the wind energy investment tax credit, and the health extenders such as the Rural Community Hospital Demonstration program.
BIOSCIENCE
Rep. Dianna DeGette (D-CO) and Larry Bucshon, MD (R-IN) have released a discussion draft prioritizing areas for potential Cures 2.1 legislation to accelerate the development and insurance coverage of new therapies (i.e., gene therapies and preventative medicines), the expansion of real-world evidence utilization, and better integration of evidence into medical practice. It also recommends continued adoption of telehealth services and better CMS coverage of innovative, high-cost therapies. Cures 2.0 was introduced in 2021 to build on the 21st Century Cures Act enacted in 2016. Although Cures 2.0 did not pass, some of its provisions, including the establishment of the Advanced Research Projects Agency for Health (ARPA-H), became law. With Rep. Bucshon retiring and the committee of jurisdiction receiving a new Chair, Brett Guthrie (R-KY), these proposed changes remain up in the air.
WOMEN'S HEALTH
On December 11, the White House held a final event as part of their Initiative on Women's Health Research. Decorated for the holidays with elaborate ornaments, Christmas trees and menorahs, a full-size carousel, paper white doves hanging from the ceiling and a room full of national leaders advancing the health of women, the White House Conference on Women’s Health Research was an event to remember. Led by First Lady Dr. Jill Biden with remarks from President Biden along with Maria Shriver (the ignition for this one-of-a-kind initiative launched on November 13, 2023), the in-depth panels of experts provided an insightful look at several aspects of women's health and the opportunities for accelerating scientific understanding, innovation and better outcomes in the future. Speakers included physicians, researchers, investors, business executives and leaders of national women's health organizations spanning the country. You can see a summary here and the full recording of the conference here.
DEFENSE
On December 23, President Biden signed into law the H.R. 5009, the Servicemember Quality of Life Improvement and National Defense Authorization Act for FY2025 (NDAA). The bill authorizes $895 billion and gives junior enlisted servicemembers a historic 14.5% pay raise; boosts funding for housing; expands access to medical providers; supports programs that provide employment support to military spouses; and improves access to childcare. On December 30, President Biden announced almost $5.9 billion in military and economic aid for Ukraine will be disbursed in his final weeks before an expected shift in support by incoming President-elect Donald Trump. The military aid includes $1.25 billion in Presidential Drawdown Authority, which pulls weapons and ammunition from US stockpiles, and the final $1.22 billion from the Ukraine Security Assistance Initiative. The aid includes air defense, artillery and “other critical weapons systems,” according to President Biden. Also, the Treasury Department announced the last $3.4 billion disbursement in direct budget support under last year’s Ukraine Security Supplemental Appropriations Act.