This week, Congress is in session to hash out the final details of the year-end partial spending deal. Congress has completed five of the twelve spending bills for fiscal year 2019. With FY 2019 funding already completed in the health care space, stakeholders have their eyes on Money Follows the Person and the ACE Kids Act. The House is expected to vote on the legislation titled, Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act, this week. This legislation would include a version of ACE as well as provide temporary funding for the MFP program.

The ACE Kids Act would allow states to create a home health model for children in Medicaid with medically complex conditions. It has 40 bipartisan cosponsors in the Senate. The MFP extension has been hanging in the balance since the end of the fiscal year, but looks on pace for a short-term extension. The bill also includes legislation introduced by the Senator Chuck Grassley (IA) and Senator Ron Wyden (OR) to recoup Medicaid rebates from drug companies that misclassify brand drugs as generics. This is one of the pay-fors used in the legislation, which allows provisions such as ACE Kids and MFP to get done.

Additionally, stakeholders are still tracking a potential doughnut hole fix, although it seems unlikely at this juncture. There's also those who believe the window to repeal the medical device tax is now, given the bipartisan support when the House overwhelmingly passed it this summer. It's not clear at this time that the Senate will vote on it.

The next two weeks will also shed light on what 2019 has in store for the incoming majority. House Democrats, led by soon-to-be Speaker Pelosi, are not in the majority yet. Will they, working with Senator Schumer and Senate Democrats, provide votes on appropriations bills, continuing resolutions, or any other bills during the next two weeks? They do have the ability to hold bills over to force the next Congress to consider them under a Democratic majority in the House. Of course solving funding issues now takes them off the table for much of 2019. Time will tell but the next two weeks have significant implications for the agenda in 2019.