Axios Pro Exclusive Content

Ways and Means moves to block nursing home rule

Mar 6, 2024
Illustration of an older man walking with a cain assisted by a cutout, empty space for a nurse

Illustration: Natalie Peeples/Axios

House Ways and Means Republicans today pushed through a bill that would block the the Biden administration's rule to impose minimum staffing requirements for nursing homes.

Why it matters: Nursing facilities have vigorously fought the mandate, saying it will be impossible to comply without more funding.

  • The bill passed 26-17, largely along party lines, with Republicans criticizing the additional layers of regulation the rule would bring.
  • They were joined by some Democrats who also said the requirement would hit rural nursing facilities especially hard.

State of play: Under the rule, nursing homes would have to ensure they provide each patient at least 33 minutes of care a day from a registered nurse.

  • It comes amid a health care workforce shortage across the country, which has been exacerbated by the pandemic.
  • President Biden has said the rule is needed to provide high-quality service and supports to the frail elderly population.

Between the lines: Several committee Democrats at the markup expressed concern about the lack of qualified health care workers to fulfill the staffing standard and called the rule an "unfunded mandate."

  • But Rep. Terri Sewell was the lone Democrat voting with Republicans to approve the bill.
  • Moderate Democratic lawmakers, including those in tight congressional races, such as Sen. Jon Tester, have previously joined Republicans in disavowing the rule when it came out last fall.

Reality check: Even if the bill passes the House (which would be an interesting vote to watch), it likely doesn't stand much of a chance of getting a vote in the Senate.

  • But it doesn't mean the issue is going away. This mark-up is the latest in a showing of renewed interest from Congress in long-term care and how to reckon with the issue in light of a rapidly aging population.

The committee also approved an amended version of a bipartisan bill that would delay the inclusion of oral drugs to treat end-stage renal disease being moved into the Medicare Part B ESRD prospective payment system until 2027.

Go deeper