As the calendar gets ready to flip to 2021, Congress remains in DC (virtually) to finish up 2020. The one “must-pass” legislative item remaining is the fiscal year (FY) 2021 appropriations funding bill.  The federal government is currently operating under a continuing resolution (CR) through December 11, 2020.  Congress will pass a one week extension to extend FY ’20 funding through December 18, 2020 with hopes of including COVID related funding to the omnibus appropriations bill.

In November, Senate Republicans released their fiscal year (FY) 2021 Labor-HHS funding bill.  This release kicked off negotiations with House Democrats who announced their FY 21 funding levels this summer. The Senate proposal contained an increase of $500,000 for the State Offices of Rural Health program for FY 21 which would fund the program at $13 million.  House and Senate appropriations staff are in the process of working out the difference between the Senate bill and the House bill.  The House bill had the SORH program at its authorized level of $12,500,000.  Other funding in the Senate bill includes $54,000,000 for Medicare Rural Hospital Flexibility grants.  And $19,981,000 for the Small Rural Hospital Improvement Grant Program.  NOSORH has weighed in with the Senate and House Appropriations committee on supporting rural health funding for FY 21.

Congress continues to negotiate and discuss the inclusion of a nearly $1 trillion COVID-19 relief package.  A bipartisan group of members have called for a $908 billion package which includes additional funding to rural providers through the provider relief fund.  Any COVID proposal that moves forward is expected to make permanent a number of the CARES Act telehealth flexibilities, as well as increasing access to the Paycheck Protection Program (PPP) for rural providers.

Despite the growing interest in passing a year end COVID-package, It remains more likely than not that Congress is unable to move the massive funding package before the new Congress.  Divide over issues like liability reform and state and local funding will most likely punt the issue to the beginning of the next Congress and new White House administration.