# 117-hr-1868: To prevent across-the-board direct spending cuts, and for other purposes.

117-hr-1868, To prevent across-the-board direct spending cuts, and for other purposes., is a 117th Congress bill sponsored by Rep. Yarmuth, John A. [D-KY-3] (D-KY); status became_law; PRIA reads it as touching household money (as of 2026-01-05).

- Canonical: https://policyrisk.com/legislation/117-hr-1868
- As of: 2026-01-05
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 117-hr-1868
- Congress: 117
- Title: To prevent across-the-board direct spending cuts, and for other purposes.
- Status: became_law
- Introduced: 2021-03-12
- Sponsor: Rep. Yarmuth, John A. [D-KY-3] (D-KY)
- Cosponsors: 7
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-01-05

## Summary

**Extends the suspension of Medicare sequestration through December 31, 2021.** It changes how the sequester paybacks are recovered so initial cuts are smaller and a final half-month has no reduction. - Hospitals and other Medicare providers see a modified recovery schedule. The law makes the first 5.5 months tied to a 2.0 percent reduction, the next 6 months tied to a 4.0 percent reduction, and the remaining half-month tied to a 0.0 percent reduction, which smooths temporary payment disruptions through 2021. - Rural Health Clinics and high-disproportionate-share hospitals get technical payment fixes. Per-visit payment updates for 2020 and 2021 are redefined based on whether a clinic had a 2020 rate and the primary care market update percentage on January 1, 2021. Eligibility for higher clinic payments is tied to hospitals with fewer than 50 beds as of December 31, 2020 and to enrollment under section 1866(j). The law also preserves a grandfathered transition rule for high-DSH hospital payment adjustments.

## Cosponsors (7)

- Rep. Neal, Richard E. [D-MA-1] (D-MA), 2021-03-12T00:00:00.000Z
- Rep. Pallone, Frank [D-NJ-6] (D-NJ), 2021-03-12T00:00:00.000Z
- Rep. Scott, David [D-GA-13] (D-GA), 2021-03-12T00:00:00.000Z
- Rep. Larson, John B. [D-CT-1] (D-CT), 2021-03-17T00:00:00.000Z
- Rep. Schakowsky, Janice D. [D-IL-9] (D-IL), 2021-03-17T00:00:00.000Z
- Rep. Panetta, Jimmy [D-CA-19] (D-CA), 2021-03-17T00:00:00.000Z
- Rep. Green, Al [D-TX-9] (D-TX), 2021-03-19T00:00:00.000Z

## Votes

| Date | Chamber | Question | Result | Yea | Nay |
| --- | --- | --- | --- | --- | --- |
| 2021-04-13T00:00:00.000Z | house | On Motion to Suspend the Rules and Concur in the Senate Amendment | Passed | 384 | 38 |
| 2021-03-25T14:54:00.000Z | senate | On Passage of the Bill H.R. 1868 | Bill Passed | 90 | 2 |
| 2021-03-19T00:00:00.000Z | house | On Passage | Passed | 246 | 175 |
| 2021-03-19T00:00:00.000Z | house | On Motion to Recommit | Failed | 202 | 216 |

## Provisions PRIA read

- Grandfathered Medicaid payment rules for hospitals: benefit, medium. The law keeps earlier rules for checking Medicaid disproportionate‑share hospital (DSH) payment adjustments in certain States. It uses the rules that were in effect on September 30, 2021 for those hospitals. This protects how those payment checks are done under federal limits.
- Medicare payment cuts paused, then reshaped: mixed, high. The law extends the pause on Medicare sequestration through December 31, 2021. Medicare payments are not cut during this period. It also changes how sequester cuts are spread in a fiscal year: 2.0% for the first 5.5 months, 4.0% for the next 6 months, and 0.0% for the final half month. This timing…
- New pay and rules for rural clinics: mixed, low. Rural health clinics get updated 2021 per‑visit payments. If a clinic had a 2020 amount, its 2021 rate is that amount increased by the 2021 primary‑care MEI, up to the statutory cap. If not, its 2021 rate is the applicable 2021 amount, up to the cap. Higher payments apply only to clinics tied to ho…

## Related bills

- 117-hr-1319: American Rescue Plan Act of 2021
- 117-hr-263: Big Cat Public Safety Act
- 117-hr-1842: Harriet Tubman Bicentennial Commemorative Coin Act
- 117-hr-6015: Benjamin Berell Ferencz Congressional Gold Medal Act
- 117-hr-5723: Social Security 2100: A Sacred Trust
- 117-hr-5577: To designate the facility of the United States Postal Service located at 3900 Crown Road Southwest in Atlanta, Georgia, as the "John R. Lewis Post Office Build…

## Sources
- [117-hr-1868 on Congress.gov](https://www.congress.gov/bill/117th-congress/house-bill/1868)

## Related
- [117-hr-1319: American Rescue Plan Act of 2021](https://policyrisk.com/legislation/117-hr-1319)
- [117-hr-263: Big Cat Public Safety Act](https://policyrisk.com/legislation/117-hr-263)
- [117-hr-1842: Harriet Tubman Bicentennial Commemorative Coin Act](https://policyrisk.com/legislation/117-hr-1842)
- [117-hr-6015: Benjamin Berell Ferencz Congressional Gold Medal Act](https://policyrisk.com/legislation/117-hr-6015)
- [117-hr-5723: Social Security 2100: A Sacred Trust](https://policyrisk.com/legislation/117-hr-5723)
- [117-hr-5577: To designate the facility of the United States Postal Service located at 3900 C…](https://policyrisk.com/legislation/117-hr-5577)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/117-hr-1868 (as of 2026-01-05).