As the Jewish holiday of Purim is this weekend, there will be no Digest next week. We will return on Monday, March 24^th.

WHITE HOUSE:

The White House focused this week on the President’s first Joint Address to Congress of his second term (clocking in at a robust 1 hour, 40 minutes, the longest address on record), establishing the “Strategic Bitcoin Reserve”, designating English as the official language of the United States, and continuing to levy, and modify, tariffs on Canada and Mexico to stem the flow of illegal drugs. One item of interest for us:

• • The President issued an Executive Order directing the Department of Education to revise the Public Service Loan Forgiveness program to focus on its core mission of encouraging folks to participate in “essential public service roles, such as nursing”. In theory, this can help with the workforce shortage in critical healthcare areas.

CONGRESS:

Now that the first stage of Reconciliation is past (more on that in a bit), focus has shifted in earnest to the government funding deadline. Unless Congress can come to an agreement, the government will run out of money this Friday night, March 14^th. In hopes of finding a funding path forward, GOP House Speaker Johnson released a “clean” Continuing Resolution (CR) that is about as limited as government funding deals in Washington ever get. Clocking in at a relatively svelte 99 pages (PDF), the bill would keep the government funded at, more or less, the current numbers through September 30^th. While Republicans can, in theory, pass the CR in the House without Democratic support, which appears unlikely following a letter from Minority Leader Jefferies to his members this week, they will need at least 8 Democrats to support the bill in the Senate. It’s a race against the clock to avoid a government shutdown:

• • As the battle in Reconciliation shifts to the Senate, the process has slowed down considerably. Even with the House Ways & Means Committee slated to get started this week on drafting the tax provisions, the Senate doesn’t plan on taking up the budget resolution until the end of the month.

• • Rollcall goes deep onto the different perspectives of the parties about what is actually on the table for Medicaid. Meanwhile, the non-partisan Congressional Budget Office found that there’s no way for the Energy & Commerce Committee to get to $880 Billion without touching Medicaid. You can access a copy of the report here (PDF).

• • The Democratic members of Congress Joint Economic Committee put out a state-by-state breakdown of how many Medicaid beneficiaries there are. The numbers are staggering, with nearly 25% of Americans receiving their healthcare via Medicaid. You can access a copy of the report here (PDF).

• • The Senate met with Elon Musk to discuss his efforts to slash federal spending, even as the President appears to be limiting Elon Musk’s control. The NY Times did a deep dive into the behind the scenes that led to the President pulling back.

• • As NY Congressman Mike Lawler toys with a gubernatorial run, he’s navigating the fine line of being a Republican in NY in the Trump era. Meanwhile, Democrats are searching for ways to become more…. relatable.

• • Perhaps only the politically wonky among us will find this entertaining, but Politico did a deep dive into what it’s really like in Congress.

• • It’s taking longer for Congressional bills to appear online.

• • A good look at some of the state level races that are shaping up as competitive, including the gubernatorial race in Florida.

• • With all the talk about Reconciliation, the CRS broke it down. You can download a copy of the report here (PDF).

AGENCIES:

CMS is delaying the implementation of the new guidelines for surveyors another month, this time to April 28^th. You can download a copy of the QSO here (PDF).

No official word on this, but reports are emerging that HHS is offering employees a buyout to leave the agency.

Even as DOGE continues to promote their efforts, it’s important to remember that the real dollars in government spending are driven by Congressional programs, not the contracts that DOGE continues to cancel.

United Healthcare announced that they’re no longer requiring prior authorization for home health services in almost all states.

FROM THE NOTEBOOK:

• • The Kaiser Family Foundation released another poll highlighting just how favorable Medicaid is among the public, including significant numbers of Republicans and rural Americans.

• • AHCA released their new policy agenda, titled “The Better Way”, laying out a smarter way forward in regulating the long-term care industry. You can download a copy here (PDF).

• • Another perspective on how Republicans are trying to bring DOGE to the states.

• • The Minnesota Legislature is looking at the state’s Nursing Home Workforce Standard Board amid efforts to repeal it.