The nastiest fights I’ve seen in 23 years of health policy are when providers fight over limited pots of needed money to show who is needier/neediest. This would set up the mother of all food fights. Talk about waste.

I’ll keep going…

are there quality metrics associated with receiving funding? Do providers have to demonstrate actual/relative need to qualify or just lost revenue? What fraud controls are in place to ensure it’s used as directed? What definition of rural? How do HPSA/MUA shortages factor in?

Also…what formula will they use to distribute? Does it go to states or directly to providers? Are expansion state and non-expansion state providers all eligible? Just rural or all safety net? What’s in statute vs up to the Secretary to decide? Strong MOE so it’s not just raided as a future offset?

They can do whatever’s allowed in the budget resolution in the first 10, but can’t raise the deficit in the period beyond the first 10

Sahil, have you seen that Hawley and Wyden are teaming up on an amendment to strike the E&C 880b instruction? Would welcome your reporting on implications of that. If it has a chance, what happens if it passes, etc

How do you assess the risk of that not happening, especially in the DOGE era, since the JES is not technically the letter of the law?

Based the leg text you quote (“the requirements, authorities, etc”) it sounds like your view is that as written, the CR should (?) mean that the FY24 Joint Explanatory Statement (including the tables) will be active for the remainder of FY25? And related,

David, thanks for 2 things: 1) this clear writeup, it’s the best of the many I’ve read. And 2) for your brown bag lunch talk to the 2002 class of us CBPP interns, which you’ve probably long forgotten, but 2 decades-plus later, I haven’t.

A question:

Quite possibly. See Bill Hoagland here:

insidehealthpolicy.com/daily-news/b...

It’s probably more “could be” than “would be” and would depend on how you rewrite the scorekeeping rules. Is my understanding. Lots of unanswered questions.

Support that decision but decided to cancel my Amazon prime instead - too many good folks doing good work at the post like @ddiamond.bsky.social

Such an important point and one that’s getting missed, both intentionally and unintentionally, by both policymakers and media. The interactions mean you’ll need to cut DEEPER to hit targets like the $880b in the House budget resolution.

Thanks for all your hard work, it’s so important

It’s been out for like 30 minutes. And Schumer on the record in post story.

You could still become SecDef!

Would love if you’d do a deep dive writeup of the “current law” vs “current policy” scoring debate that seems to be headed our way—what would be needed to make that change, who might line up where, and what the implications are. Appreciate your commentary, it’s been really valuable.

No shade - it’s a tough beat. Sad story overall. I think a lot of blame lies with her staff and with leadership if they knew.

Big miss by local media but a HUGE miss by the Capitol Hill press corps. Who, in general, are a talented, diligent bunch of reporters. Especially you, Sahil. But someone might want to set an algorithm that monitors Congress.gov and sends up a flare when a sitting member doesn’t vote for six months.

How long do we expect it to be that close? Is there a timeline somewhere for special elections?