This is the week. Congress needs to fund the government by Friday to avoid a government shutdown. It’s all but certain that the government will be funded, despite the dysfunction on display in getting through this week. The House is expected to release the text of the omnibus sometime late this afternoon, which will provide some insight into how much work the Senate side will have to do. The question is: what’s in and what’s out?

Market stabilization talks hit a snag following an op-ed from conservative lawmakers calling stabilization a move that “would snatch defeat from the jaws of victory by shoveling billions of additional dollars in deficit spending into the pockets of insurance companies.” The group also argue that the stabilization packages lack pro-life protections, a major sticking point in the negotiations. The weight of the view of this group is dependent on the need for their votes on the omnibus. The latest market stabilization proposal would fund the ACA’s cost-sharing reduction payments as well as fund a new reinsurance program, according to Axios.com.

It remains quiet on the drug pricing front which should stay on your radar this week as PhRMA makes its final push for changes in the spending deal. In addition to donut hole changes, PhRMA is also lobbying to remove biosimiliars from pass-through payments.

Congressional negotiators may also provide a window into how $6 billion in opioid money will be spent to address the epidemic. The House Energy & Commerce Committee will be marking up 25 proposals this week.

Short term Plans

Among proposals being discussed in the final spending package, codifying short-term health plans is being put on the table with stabilization. The move is being pushed by Wyoming Senator John Barrasso and remains a top priority of the White House. While top ranking Democrats have said they would not support any spending deal that codified short-term plans, Senate Majority Leader Mitch McConnell signaled interest in the proposal.

Several health care think tanks have sounded the alarm at the assertion that only 200,000 people would switch to short-term health plans, as outlined in the Administration’s STLDI proposed rule. The Urban Institute concluded that as many as a 4.2 million people could enroll in short-term plans should the rule be approved.

The support for a stabilization package has never been overwhelming. If stabilization backers can only get their provisions by adding something they don’t like (STLDI renewability), they will likely forego the effort.

There are a number of moving pieces this week as members and stakeholders make last ditch efforts to include provisions on the must-pass spending bill. We will continue to closely monitor these developments.