Congress Funds the Government But Faces Another Shutdown Threat Before Christmas
NBC News / ByScott Wong and Syedah Asghar
WASHINGTON — Lawmakers averted a government shutdown 40 days before the election, but they’ll face another funding crunch right before the holidays and a new Congress and president take office.
Bipartisan negotiators have been trying to make progress on the 12 bills needed to fund federal agencies for the 2025 fiscal year.
Yet there's little time to pass those bills during the lame-duck session; House members and senators are scheduled to be in Washington for only five weeks between Election Day and the end of the year, and the two chambers haven’t reached agreement on any of the dozen measures, known as appropriations bills.
A more likely scenario is that Democrats and Republicans would strike an end-of-year deal on a massive, catchall omnibus spending package or punt the issue once again with another continuing resolution, or CR, that would extend funding into the new year on a short-term basis.
They’ll need a new funding agreement before federal funding runs out on Dec. 20.
House Speaker Mike Johnson, R-La., insisted this week that the days of the just-before-Christmas omnibus — loaded up with legislative priorities from both parties — are over.
“We are not going to return to the Christmas omnibus spending tradition, and that’s the commitment I’ve made to everyone,” Johnson told reporters after the House passed a stopgap funding measure Wednesday.
Pressed about whether he would promise not to put an omnibus on the floor in December, Johnson wouldn’t answer directly: “We’ve worked very hard to break that tradition ... and we’ll see what happens in December.”
Senior appropriators said Congress are likely to end up where they have before when they’ve faced a lame-duck, year-end funding deadline: with a sweeping omnibus spending package.
“I expect that we’ll negotiate an omnibus,” said Rep. Debbie Wasserman Schultz, D-Fla., a member of the Appropriations Committee, noting that Johnson had said there would be no more CRs, then a new CR passed Wednesday.
“The speaker, respectfully, doesn’t have the ability to draw lines in the sand when he can’t even control his own caucus. They continually need Democrats to actually get anything done, and we are governing from the minority,” she continued. “And so I’m pretty confident that at the end of the day, we’re going to make sure that we pass omnibus funding.”
Far more House Democrats than Republicans voted for Wednesday's CR that will prevent a shutdown from starting next week, continuing a pattern of the minority’s carrying must-pass legislation through the lower chamber this Congress.
House Appropriations Committee Chairman Tom Cole, R-Okla., predicted that the two parties could come to a deal and avoid a shutdown in December. But he said the results of the election will dictate what eventually happens…
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As CMS Cuts Payments, Home Health Patients Are Seeing Reduced Access To Care
Home Health Care News / By Joyce Famakinwa
Patients are receiving less access to Medicare-certified home health care in recent years, according to a new data analysis.
The data analysis – which comes from the Partnership for Quality Home Healthcare (PQHH) and CareJourney by Arcadia – examines Medicare home health fee-for-service claims from 2022 through 2023, in order to determine access to care, and how it has been impacted by payment rate cuts.
An analysis of 2022 data found that almost 35% of patients who leave the hospital, and receive a home health discharge, don’t access this care within a seven-day period.
Additionally, the findings show that patients who didn’t receive home health care had a death rate that was 41% higher than patients who accessed this care in a timely manner.
“There’s abundant data from all over the place about what kind of impact home health care has on a patient’s outcomes, their ability to stay out of the hospital, readmission rates, all of those things,” PQHH CEO Joanne Cunningham told Home Health Care News. “This was yet another confirming data point that actually looked at mortality rates. I found that very interesting, and not surprising at all for the home health provider community.”
The analysis also found that, in 2023, access to home health care led to a 34% decrease in hospital readmission rates. Despite this benefit, 35.7% of Medicare patients that were directed to receive this care after a hospitalization did not.
Plus, the home health referral rejection rate has seen a major increase, jumping from 49% in 2020 to 71% in 2022.
Broadly, the referral rejection rate tracks how often providers turn down new referrals, generally due to staffing or capacity constraints.
One of the main takeaways from the analysis was that these access-to-care issues are related to cuts made to home health care’s base rate in recent years…
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Top 5 Regrets People Have on Their Deathbeds: What They Can Teach Us About Living Healthy, Fulfilled Lives, From an Internal Medicine Doctor
CNBC / By Alex Koller
To live a meaningful, fulfilling life, you have to accept that it'll eventually come to an end, says Shoshana Ungerleider.
Over the years of caring for ill hospital patients, Ungerleider — a doctor who specializes in internal medicine — has observed regrets among people near the end of their lives, she tells CNBC Make It.
"Being proximate to the end of your life really allows you — pushes you — to be present because that's all you have," says Ungerleider, 44, host of the upcoming "Before We Go" podcast and founder of the nonprofit End Well Foundation. "That is true for all of us. Throughout our lives, this present moment is all we have."
Here are five regrets she says people often express:
- I didn't spend enough time with the people I love.
- I worked too much and missed out on life.
- I let fear control my decisions and didn't take risks.
- I wish I'd been braver in the face of uncertainty or opportunity.
- I focused too much on the future and lost touch with the present.
Ungerleider's advice for getting ahead of those regrets is simple: Remind yourself that your time is limited and unpredictable, and regularly ask yourself some big, important questions. How do I want to spend my time? What matters most to me in my life?
She particularly encourages young people, who often haven't yet faced significant health challenges — in themselves or their loved ones — to think of that reflection as "really integral to living for a long, healthy life — with good quality of life."
"As a doctor, I'd recommend eating a balanced diet, and exercising regularly, and avoiding things like smoking and high-risk activities. Reflecting on mortality should really be on that list," she says, adding, "Reflecting on our own mortality throughout life, whether you're 20, 50, 80, whatever, allows us to live better every day with more meaning and purpose in our lives."
The mere acknowledgment that you're going to die is a helpful way to find meaning in "the little things that bring us joy," author Alua Arthur told "The Happiness Lab" podcast in a July episode.
"Grounding in my mortality means that at some point I won't have access to all these senses anymore," said Arthur, who's also the founder of Going With Grace, a Los Angeles-based end-of-life planning and support organization. "And so, how cool is it that I can feel cold on my hands? How cool is it that I have plates for me to eat off of?"
'Happiness is a choice'
Ungerleider's observations are similar to those of Siddhartha Mukherjee, an oncologist and Pulitzer Prize-winning author, and Bronnie Ware, an author and former palliative care worker.
On their deathbeds, people often wish they'd expressed more love and forgiveness to people they care about, Mukherjee said in a commencement speech at the University of Pennsylvania in May. "Waiting [to express yourself] merely delays the inevitable," he noted.
In Ware's 2011 book "The Top Five Regrets of the Dying," she wrote that the most common regret she heard was "I wish I'd had the courage to live a life true to myself, not the life others expected of me."
"Many did not realise [sic] until the end that happiness is a choice. They had stayed stuck in old patterns and habits," she wrote in a blog post. "Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness." |
Hospice Fraud Prevention Toolkit
CMS press release; 9/24
People with Medicare should beware of scammers offering older Americans in-home perks, like free cooking, cleaning and home health services, while they are unknowingly being signed up for hospice services. The scammers then unlawfully bill Medicare for these services in your name. Criminals are using every avenue they can to sign people up including door-to-door visits, false advertising, phone, text and email. Hospice care is for people who are terminally ill and only the patient and doctor can make this serious decision about end-of-life care. This toolkit includes social media posts and a drop-in article to help educate beneficiaries and their loved ones on how to protect themselves against Medicare Hospice fraud.
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