The congressional to-do list for December is quite long, with the Senate looking to pass major tax overhaul and the looming threat of a government shutdown. Most important for the healthcare industry is the fact that the Affordable Care Act (ACA) and the Children’s Health Insurance Program (CHIP) have become one of the many items fighting for attention on Capitol Hill.

As POLITICO reports, the tax bill already has major implications for healthcare programs. Senate Republicans have included a repeal of the ACA’s individual mandate in order to bank on its $300 billion in deficit reductions for other tax cuts. The move could stir up hard feelings left over from the repeal-and-replace battles from earlier in the year.

Additionally, the bill would trigger billions of dollars in cuts to Medicare, according to the Congressional Budget Office.

Complicating the debate over the tax bill is a Dec. 8 deadline to pass a federal spending bill or, more likely, a short-term continuing resolution to avoid a government shutdown. An end-of-year spending deal could include a short-term stabilization measure for the ACA exchanges, as proposed by Sens. Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington, which may fund the law’s cost-sharing reduction subsidies for insurers.

The spending package may also reauthorize CHIP, which was allowed to expire at the end of September. Several states have said they’ll be out of CHIP funds sometime in January without congressional action.

Read more about the political and legislative factors complicating the end-of-year healthcare agenda by clicking on the link below: