Full-Year Continuing Appropriations and Extensions Act, 2025

This legislation, titled the Full-Year Continuing Appropriations and Extensions Act, 2025, provides appropriations for most federal government departments and agencies for the entirety of fiscal year 2025. Division A establishes funding levels generally based on fiscal year 2024 appropriations, with specific modifications and exceptions detailed throughout the text. These appropriations are available through September 30, 2025, ensuring continued government operations.

Agencies are required to submit detailed spending plans for fiscal year 2025 within 45 days of enactment, reflecting any potential sequestration orders. The Act also clarifies that earmarks from fiscal year 2024 appropriations acts or accompanying reports have no legal effect on funds provided by this division. Furthermore, it includes provisions for advance payments for certain mandatory programs, such as Medicaid and Supplemental Security Income, for the first quarter of fiscal year 2026.

Significant adjustments are made to Department of Defense accounts, including specific levels for military personnel, operation and maintenance, procurement, and research, development, test, and evaluation. The Act also includes rescissions of unobligated balances from prior defense appropriations and provides additional funds for U.S. military operations, force protection, and deterrence led by specific commands. These detailed adjustments ensure targeted funding while maintaining overall operational capacity.

Beyond defense, Division A specifies funding levels and conditions for numerous other departments and agencies. These include the Departments of Agriculture, Commerce, Justice, Energy, Homeland Security, Interior, Labor, Health and Human Services, Education, Legislative Branch, Military Construction, Veterans Affairs, State, and Transportation, Housing and Urban Development. Many sections adjust specific account levels or modify provisos from prior appropriations acts to align with current needs.

Division B focuses on critical health program extensions. It extends funding for Community Health Centers, the National Health Service Corps, and Teaching Health Centers through September 30, 2025. Additionally, it prolongs the Special Diabetes Programs for Type I Diabetes and for Indians, and extends several National Health Security authorities, including those related to public health emergencies and medical countermeasures.

Key Medicare provisions are also extended, such as increased inpatient hospital payment adjustments for low-volume hospitals and the Medicare-Dependent Hospital (MDH) program. The Act continues add-on payments for ambulance services, funding for quality measure endorsement, and outreach and assistance for low-income programs. Importantly, it extends various telehealth flexibilities, including removing geographic requirements, expanding originating sites and eligible practitioners, and allowing audio-only services, through September 30, 2025. The Medicare Improvement Fund receives an increase, and Medicare sequestration is adjusted.

In human services, the Act extends funding for Sexual Risk Avoidance Education, Personal Responsibility Education, and Family-to-Family Health Information Centers for fiscal year 2025. For Medicaid, the legislation delays scheduled Disproportionate Share Hospital (DSH) reductions through fiscal year 2028. These extensions aim to maintain essential health and social services.

Division C addresses other governmental matters, extending several authorities. These include the Commodity Futures Trading Commission whistleblower program, protections for certain facilities and assets from unmanned aircraft, and the National Cybersecurity Protection System authorization. The temporary order for fentanyl-related substances is also extended through September 30, 2025, ensuring continued efforts to combat the opioid crisis. The budgetary effects of Divisions B and C are explicitly excluded from PAYGO scorecards.