On Tuesday, the House, absent much debate, passed an appropriations bill that will fund the Department of Homeland Security through the rest of the fiscal year.  The action to adopt a “clean” bill—without any restrictions on the President’s executive order regarding immigration—was adopted 257 to 167 with Democrats providing the bulk of the vote (182 Democrats and 75 Republicans).  The bill went to the President for his signature and now shuts the door on FY 2015 appropriations.

The next big challenge for Congress is the Medicare SRG (Sustainable Growth Rate) bill or “doc fix” which is an almost annual fix to the way physicians are paid through Medicare.  The fix generally replaces lower reimbursements with higher payments.  It is the result of the 1998 balanced budget law. Congress generally extends the provision without any offset or way to pay for the extension.  As health care costs have decreased over the past four years, some in Congress want to use the lower health care cost projections to provide a permanent fix.

The SRG extension is significant to child advocates because as part of fix there are a number of health care provisions that are extended.  In the last SRG extension the home visiting program, Early Childhood Home Visiting Program (Home Visiting Program/MIECHV) was extended. Congress created the MIECHV program in 2010 to improve health and developmental outcomes for children and families in vulnerable communities through the implementation of evidence-based voluntary home visiting programs. The original authorization provided $1.5 billion for fiscal years 2010 – 2014. The SRG extension passed last year was very short term and expires on March 31. The MIECHV was extended along with it for six months however Congress provided the full one-year allocation of $400 million for FY 2015.

The Senate is in session all month but the House is out this week and both chambers are then off for two weeks for the spring break. After the Medicare bill the other two impending must-do areas is an increase in the debt ceiling which hits its limit on March 15. The Treasury Department has indicated it can patch together various payment options until October or perhaps November. In May the Congress will also have to deal with an extension of the highway/transportation reauthorization with a trust fund that is running short and that has taken from the general fund (instead of the highway trust fund) for parts of several years. The short term extension adopted by last year’s Congress runs out at the end of May.