Academy Responds to FY23 Omnibus Bill

December 22, 2022 – The Academy commends the provisions included in the fiscal year 2023 omnibus, released this week by the 117th U.S. Congress, that support health care and key nutrition security efforts, but was deeply disappointed that Congress did not fully prevent cuts to Medicare payment rates and that more child nutrition priorities were not addressed in the bill.

A win for equity and nutrition security, the Senate's bill included two Academy priorities: the Providing Urgent Maternal Protections for Nursing Mothers Act and the Pregnant Workers Fairness Act Amendment. These provisions will positively impact the lives of pregnant and lactating workers by ensuring more flexibilities during their workday.

Many health agencies received funding increases in the omnibus legislation including the Centers for Disease Control and Prevention (a $760 million increase to $9.2 billion) and the National Institutes of Health (a $2.5 billion increase to $47.5 billion). Older Americans Act congregate and home-delivered nutrition services programs received a collective $100 million increase and $2 million was provided to create a Food as Medicine pilot program.

The bill also provided $5.129 billion in advance appropriations to the Indian Health Service for fiscal year 2024. This historic first ensures that the Indian Health Service — which provides care for 2.5 million Americans — will be sheltered for at least the next 21 months from the harmful effects of government shutdowns or short-term funding. For fiscal year 2023, the IHS also received a small increase from $6.63 billion to $6.95 billion.

Unfortunately, the 8.5% payment cut facing Medicare providers was only partially offset, with Congress delaying one 4% cut for two years and partially offsetting a 4.5% Medicare fee schedule conversion factor cut. Unless further action is taken next year, payments made in the Medicare Part B program will be reduced by 2% starting January 1, 2023, and will decline an additional 1.25% in 2024. The Academy will continue to push to stop these cuts and for permanent Medicare payment reform to stop this annual uncertainty.

There were a mix of wins and losses for nutrition security in the bill. The summer EBT program was made permanent, and flexibilities were granted to the summer meals program that will allow providers to operate mobile and grab-and-go meal services. These investments were offset by moving up the date that Supplemental Nutrition Assistance Program benefits will revert to the standard benefit level from the higher pandemic emergency allotment level. Policies were also put into place to protect SNAP participants from skimming scams and to ensure they can seek relief from their state when it occurs. Permanently reinstating healthy school meals for all was unfortunately not included in the bill, but this remains an Academy priority.

Other provisions in the bill will ensure continued access to Medicaid and CHIP for nearly 40 million children by providing at least 12 months of continuous coverage. In addition, the option for states to extend Medicaid coverage for 12 months postpartum was made permanent.

Academy members interested in adding their support to these initiatives and more are encouraged to join the Academy’s monthly affinity groups. The affinity groups meet once a month and are a forum-based event where staff, policy leaders and members discuss Academy advocacy priorities and strategies, share their experience and determine how they can become involved in advocating.