Congress returned to Capitol Hill this week to face a long list of must-pass legislation with short deadlines. Topping the agenda is agreement on a budget deal to raise strict funding caps on spending for defense and non-defense programs (including the NIH). If a deal is not reached by the end of January, steep funding reductions will go into effect across all programs. But resolution on the budget has become intertwined with reaching a bipartisan agreement with the President on young undocumented immigrant "Dreamers" and border security, complicating negotiations.

In addition to agreement on an overall budget deal, Congress must pass a fiscal year (FY) 2018 spending measure to fund all government programs, including the NIH and CDC, by Jan. 19, when the current "continuing resolution" measure expires, or the government will shut down. It is looking likely that Congress may need to pass another short-term government spending bill to extend federal spending until February 2018 to permit more time to finalize a budget deal.

Among the other urgent items on the congressional agenda are a five-year funding restoration for the Children's Health Insurance Program (CHIP), funding for community health centers and stabilization measures for the individual health insurance market.

The CHIP legislation is particularly critical as funding for all CHIP state programs will expire by the end of March 2018, at which point states will be forced to consider shutting down their programs, which would terminate health insurance coverage for nearly 9 million children around the country. CHIP insures children in families that earn too much to qualify for Medicaid.

Senate leaders also want to pass the Alexander-Murray Bipartisan Health Care Stabilization Act, which would help stabilize the individual insurance market by reinstating Affordable Care Act (ACA) cost-sharing reduction payments (CSR)’s for health insurers that the President cut off in October, but House Republicans have expressed opposition to this bill. If the insurer CSR’s are not restored, more instability in the individual insurance market and health insurance premium increases across all markets are expected in 2018.