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A rare congressional resolution was introduced in the House of Representatives Tuesday that presents a new opportunity for federal lawmakers to block the nursing home staffing mandate.

Lawmakers can use the Congressional Review Act to nullify regulations enacted by executive branch agencies. Reps. Michelle Fischbach (R-MN) and Greg Pence (R-IN) introduced a measure calling for a review of the nursing home rule, which they have also moved to block through proactive legislation.

This new resolution signals significant opposition to the staffing rule finalized by the Centers for Medicare & Medicaid Services in April, said Brian Perry, vice president of government affairs at healthcare goods and services provider Direct Supply. 

“To see the House begin CRA proceedings on an executive rule this bad is a strong message from elected officials that they are increasingly prioritizing access to care for our nation’s seniors,” he told McKnight’s Long-Term Care News Wednesday. “It’s a loud and important message from the House that they will continue to fight when politics gets in the way [of] high-quality elder care.”

Long-term care sector leaders cheered the Representatives Tuesday, echoing sentiments they have vocally repeated since the mandate was finalized.

“The final rule, while well-intentioned, will not achieve the sought-after goal of ensuring older adults’ and families’ ability to access quality nursing home care,” said Katie Smith Sloan, president and CEO of LeadingAge. “Implementation could very well have unintended consequences of further exacerbating existing challenges … Mandates are the wrong approach. We thank Representative Fischbach for her leadership on this resolution.”

Perry told McKnight’s he was optimistic the review would pass through the House of Representatives, but raised doubts about its potential to progress further. 

Setting the stage for November

The Congressional Review Act was passed in 1996 as a tool for Congress to check executive power, but it is rarely used. Only 23 reviews were introduced in the 117th Congress that ended in January 2023 and only three were signed by the president, according to the American Action Forum.

Reviews need only a simple majority to pass but, like other bills, must be passed by both houses of Congress and then signed into law by the president before taking effect. The president can veto the results of a review, requiring Congress to override the veto with a two-thirds majority in both houses. 

Because Congress is usually attempting to nullify a regulation passed by a president’s own administration, presidents are unlikely to sign review acts. 

The Biden administration has been vocally supportive of the staffing mandate, with Vice President Kamala Harris joining with union leaders to promote the mandate at a publicly broadcast roundtable. 

Perry told McKnight’s he expects the review of the staffing mandate to run into roadblocks in the Senate and at the president’s desk. However, he noted that the act’s introduction is a sign the mandate is gaining steam as a nationally relevant election issue.

“This continued effort in Congress shows that the access to care for seniors and ability for providers to find, recruit and pay their workforce is becoming an election issue,” Perry explained. “As voters become more aware that public policy choices have consequences for our seniors, I would expect they’ll take those concerns to the ballot box in November.”