President Trump signed a two-day spending bill passed by lawmakers late Friday, Dec. 18 avoiding a midnight government shutdown. The measure gives Congress until Sun., Dec. 20 to resolve differences in the latest coronavirus relief package.

Following a series of delays, including last-minute objections based on military policy, lawmakers’ pay, and tax rebate checks during the COVID-19 pandemic, the Senate approved and President Trump signed into law a one-week temporary funding measure to avoid a government shutdown before a midnight deadline Friday, Dec. 11. The measure passed the House of Representatives Wednesday, Dec. 9. 

Key Takeaways

  • The budget extension passed and signed into law Dec. 11 expires Dec. 18, 2020.
  • The new law contains no specific provisions for COVID-19 relief including a new round of stimulus checks.
  • The law extends funding to most government programs through Dec. 18, 2020 to give lawmakers time to negotiate a more long-term budget agreement and additional coronavirus relief.
  • Late Fri. Dec. 18, lawmakers passed a two-day spending bill that will expire Dec. 20.

Not Much Time to Act

The one week budget extension gives Congress little time to hammer out differences over longer-term funding and a long hoped for COVID-19 stimulus package.

Meanwhile, passage of H.R. 8900, "Further Continuing Appropriations Act, 2021, and Other Extensions Act" into law avoids an immediate shutdown and continues funding of the government for seven days.

The goal is to negotiate an omnibus spending package for the fiscal year that began Oct. 1 and include whatever coronavirus relief Congress can agree to before the Dec. 18 expiration of the new law and to provide relief for a variety of COVID-19-related programs set to expire by the end of the year.

What’s in (and Not in) the Budget Extension

The budget extension signed into law Dec. 11 contains no specific COVID-19 relief, including no stimulus payments. It does provides funding for several important social services and public health programs to help manage the spread of the coronavirus disease.

Specifically, the law does the following:

Continuing appropriations

The law amends H.R. 8337: “Continuing Appropriations Act, 2021 and Other Extensions Act,” which was signed into law Oct. 1, 2020 as Public Law 116–159, by changing the expiration date from Dec. 11, 2020, to Dec. 18, 2020.

This section of the new law essentially allows government funding to continue in fiscal year 2021 at the same levels as in fiscal year 2020. This gives Congress until Dec. 18 to either negotiate a full government funding bill, pass another continuing resolution, or allow the government to shut down.

Medicare and Medicaid extensions

Under the law signed Dec. 11, several provisions apply to Medicare and Medicaid including. All of these provisions expire Dec. 18, 2020, unless Congress acts.

Medicare Extension of the Work Geographic Practice Cost Index Floor.

This provision provides continuing adjusted reimbursement to Medicare physicians to keep them in rural areas.

Medicare Extension of Funding Outreach and Assistance for Low-Income Programs.

This provision extends funding for certain low-income Medicare activities provided through State Health Insurance Assistance Programs, Area Agencies on Aging, Aging and Disability Resource Centers, and the National Center for Benefits and Outreach and Enrollment.

Medicare Extension of Funding for Quality Measure Endorsement, Input, and Selection.

This part of the law extends funding for quality measure selection and support for the Department of Health and Human Services.

Medicaid Extension of Community Mental Health Services Demonstration Program.

This provision continues authorization for certified community behavioral health clinics.

Medicaid Extension of Spousal Impoverishment Protections.

This provision extends protections for anyone whose spouse receives home- and community-based services (HCBS).

Medicaid Delay of DSH Reductions.

This provision delays through Dec. 18, 2020, the implementation of scheduled cuts to payments to hospitals with a disproportionate share of Medicaid patients.

Medicaid Extension of Money Follows the Person Rebalancing Demonstration.

This provision extends funding of the Money Follows the Person Rebalancing Demonstration program through Dec. 18, 2020. MFP makes it possible for people on Medicaid to transition to a safer environment and still maintain Medicaid funding during the COVID-19 crisis.

Public health

Specific public health programs are also addressed by the one week budget extension:

Community Health Centers, National Health Service Corps, and Teaching health centers that operate graduate medical education.

This provision extends funding for certain community health centers, the National Health Service corps, and teaching health centers.

Diabetes Program.

Two programs—including one for Indigenous people, the Special Diabetes Program and the Special Diabetes Program for Indians—now have funding through Dec. 18, 2020.

Personal Responsibility Education. 

This provision extends the authorization of the Personal Responsibility Education Program (PREP) through Dec. 18. The extension is on a pro-rata basis at the amount appropriated for fiscal year 2020. 

Sexual Risk Avoidance Education.

The new law also extends funding and authorization for the Sexual Risk Avoidance Education (SRAE) program on a pro-rata basis based on fiscal year 2020.

Rare Pediatric Priority Review Voucher Extension.

The Food and Drug Administration (FDA) Rare Pediatric Priority Review Voucher (PRV) program is also extended.

Additional Provisions

Under Title III - Offsets, the new law has two additional provisions:


The Centers for Medicare and Medicaid Services (CMS) agency is required to share Medicare Advantage and Medicare prescription drug benefit enrollment information with insurers when those insurers initiate Medicare secondary payer inquiries.

Narcotic drug dispensing

The Drug Enforcement Administration (DEA) is required to allow a medical practitioner to dispense up to a three-day supply of narcotic drugs to a patient (or for a patient's use) for the purpose of maintenance treatment or detoxification treatment, or both.