/ en Fri, 25 Apr 2025 14:48:41 -0500 Fri, 11 Apr 25 08:25:31 -0500 /news/perspective/2025-04-11-we-must-urge-congress-protect-access-medicaid-patient-care-and-247-hospital-services <p>Congressional lawmakers are heading home for a two-week district work period after both the Senate and House passed a revised budget resolution for fiscal year 2025, allowing the chambers to move forward with the <a href="/issue-landing-page/2025-02-07-budget-reconciliation-process-resource-page" target="_blank" title="Reconciliation Process">reconciliation process</a> and begin drafting the specific policies that will be included in the reconciliation bill. This is where the hard work begins.</p><p>The revised resolution still includes instructions for the House Energy and Commerce Committee to cut spending by $880 billion, which means cuts to Medicaid and other health programs are very much still on the table.</p><p>However, this week’s budget action is another step in a long process and no specifics on anything have been decided. It’s important to note that the House Energy and Commerce Committee includes broad jurisdiction over many sectors of the economy beyond health care, and the Senate seems inclined to take a more modest approach. In the meantime, we have been building momentum with lawmakers and the public to demonstrate that devastating cuts to the Medicaid program — and the 72 million individuals who rely on it for coverage — should not be used to pay for the reconciliation bill.</p><p>We can use the next two weeks while representatives and senators are in their districts and states to drive this point home and explain how significant cuts to Medicaid would stress the availability of health care services for everyone and jeopardize access to the 24/7 care and services that hospitals provide.</p><p><strong>New Polling Shows Widespread Support for Medicaid.</strong> New <a href="https://modernmedicaid.org/wp-content/uploads/2025/04/MMA-Poll-Memo-4-2-25.pdf" target="_blank" title="New polls show widespread support for Medicaid">polling</a> released this week from President Trump’s 2024 pollster showed that 74% of all voters and 61% of Trump voters have a favorable view of Medicaid. In addition, 70% of total voters, including a majority of Trump voters, opposed cutting Medicaid to pay for tax cuts. “Our recent survey shows there is no appetite across the political spectrum for cutting Medicaid to pay for tax cuts,” the poll memo said. “Medicaid is well-liked by most voters, in large part due to the broad impact it has across the electorate and the high level of importance voters place on as many Americans as possible having health insurance.”</p><p><strong>Advocacy Resources and Advertising.</strong> The AHA continues to share new resources that hospitals and health systems can use to assist their advocacy efforts. Visit our <a href="/advocacy/advocacy-issues/medicaid" target="_blank" title="Medicaid Advocacy webpage">Medicaid advocacy webpage</a> for fact sheets, blogs pushing back on misguided reports and other resources you can use in conversations with your lawmakers. And watch for an Action Alert soon with additional resources.</p><p>At the same time, the <a href="https://strengthenhealthcare.org/" target="_blank" title="Coalition to Strengthen America's Healthcare">Coalition to Strengthen America’s Healthcare</a>, of which the AHA is a founding member, continues to run its <a href="https://strengthenhealthcare.org/coalition-launches-national-ad-campaign-to-protect-medicaid-patients-from-cuts-to-care/" target="_blank" title="Faces of Medicaid national ad compaign">Faces of Medicaid</a> national ad campaign that highlights Medicaid’s critical impact on the tens of millions of people who rely on the program for access to care. During the last two weeks, the Coalition launched two new ads, “<a href="https://strengthenhealthcare.org/coalition-launches-national-ad-highlighting-president-trumps-promises-to-protect-medicaid/" target="_blank" title="Coalition to Strengthen America’s Healthcare Promises Ad">Promises</a>,” which underscores President Trump’s public commitments about protecting Medicaid and Medicare and calls on Congress not to cut Medicaid, and “<a href="https://www.youtube.com/watch?v=qAglo-JZzdY&t=1s" target="_blank" title="Coalition to Strengthen America’s Healthcare 30 Million ad">30 Million</a>,” focusing on Medicaid coverage for children. The ads are running on national cable and digitally. In addition, the Coalition continues to engage its 2.6 million advocates in a grassroots campaign to send letters, make phone calls and send social media posts to their legislators urging them to protect access to care and services.</p><p><strong>Make Your Voices Heard.</strong> While the AHA and Coalition provide the air cover in Washington, nothing is more powerful than your voice — and the voices of your team members, trustees, patients and community members — with your senators and representatives. You live, work and, most importantly, vote in their districts and states. You have their attention and can explain to them the impact policy proposals would have for their constituents and your ability to provide care. Please take advantage of your legislators being home and highlight for them the need to protect Medicaid and access to the 24/7 services that hospitals and health systems provide.</p><p>In addition, if you haven’t done so yet, there’s still time to make plans to join nearly 1,000 hospital and health system leaders for the <a href="/education-events/2025-aha-annual-membership-meeting" target="_blank" title="AHA Annual Membership Meeting">AHA’s Annual Membership Meeting</a> May 4-6 in Washington, D.C. You’ll hear directly from legislators, policymakers and thought leaders, as well as have the opportunity to go to Capitol Hill to deliver our field’s message about protecting access to care and services, providing relief from burdensome regulations and policies, and strengthening and supporting the health care workforce.</p><p>We’ve seen time and time again when our field speaks with a strong and united voice, lawmakers hear us. And we get results. That unity will be more important than ever over the next few weeks and months as we stand up for patients to protect access to the care that hospitals and health systems provide in every community across America.</p> Fri, 11 Apr 2025 08:25:31 -0500 Budgeting /news/headline/2025-04-10-house-passes-revised-budget-resolution <p>The House, by a vote of 216-214, passed the revised <a href="https://www.budget.senate.gov/imo/media/doc/senate_amendment_h_con_res_14.pdf" title="House res">budget resolution</a> for fiscal year 2025. This follows the Senate’s passage of the bill <a href="/news/headline/2025-04-04-senate-expected-vote-revised-budget-resolution-over-weekend" title="Senate bill pass">last week</a>. Reps. Victoria Spartz, R-Ind., and Thomas Massie, R-Ky., joined all Democrats today in voting “no.”  </p><p> </p><p>Notably, the resolution instructs the House Energy and Commerce Committee, which has primary jurisdiction over Medicaid and other health care programs, to cut a minimum of $880 billion in spending. AHA members April 3 received a <a href="/2025-04-03-senate-unveils-amendment-house-budget-resolution-vote-expected-week" title="bulletin">Special Bulletin</a> with additional highlights of what’s included in the revised budget resolution and AHA resources.   </p><p> </p><p>With the House and Senate's passage of the resolution, Congress can move forward with the <a href="/issue-landing-page/2025-02-07-budget-reconciliation-process-resource-page" title="recon process">reconciliation process</a>. The next step calls for specific committees to begin drafting legislation consistent with their instructions in the budget resolution. This is where the hard work begins, as House and Senate committees must decide on the specific policies to be included within the reconciliation bill.  </p><p> </p><p>The budget resolution gives Senate and House committees until May 9 to report legislation, but this is not a binding deadline. </p> Thu, 10 Apr 2025 15:45:39 -0500 Budgeting <div class="container"><div classs="row"><div class="col-md-8"><p>Early this morning, the Senate by a vote of 51 to 48 passed its <a href="https://www.budget.senate.gov/imo/media/doc/senate_amendment_h_con_res_14.pdf" target="_blank" title="Senate.gov: H.Con.Res.14">revised budget resolution</a> for fiscal year 2025 with Sens. Rand Paul, R-Ky., and Susan Collins, R-Maine, voting with Democrats in opposition.</p><p>During the six-hour “vote-a-rama session,” Sen. Ron Wyden, R-Ore., offered an amendment to strike the instructions for the House Energy & Commerce Committee to cut spending by $880 billion, citing his concerns around potential cuts to the Medicaid program. The amendment was not agreed to by a vote of 49-50. Three Republicans, Sens. Collins, Josh Hawley, R-Mo., and Lisa Murkowski, R-Alaska, voted in favor of the amendment along with Senate Democrats.</p><p>The House is expected to consider the revised resolution next week. This marks the next step toward reaching a common budget resolution that will allow Congress to move forward with the <a href="/issue-landing-page/2025-02-07-budget-reconciliation-process-resource-page">reconciliation process</a>.</p><p>The resolution is drafted to provide flexibility to Senate and House Committees when they begin drafting their individual bills. As is customary, the budget resolution does not provide details on potential cuts to Medicaid or Medicare, as well as the extension of the Enhanced Premium Tax Credits (EPTCs).</p><h2>Key Highlights of the Budget Resolution</h2><h3>Debt Ceiling</h3><p>The resolution includes instructions to allow Congress to increase the debt limit. The House Ways & Means Committee instruction is $4 trillion, and the Senate Finance Committee’s is $5 trillion.</p><h3>Tax Policy</h3><p>The resolution assumes a budget mechanism called “current policy baseline” to set up a pathway toward making the tax cuts within the Tax Cuts & Jobs Act (TCJA) permanent.</p><h3>Preserves House Instructions</h3><ul><li>The House Ways & Means Committee is instructed to increase deficits by not more than $4.5 trillion (TCJA extension).</li><li>The House Energy and Commerce Committee is instructed to reduce deficits by not less than $880 billion. The Energy and Commerce Committee has primary jurisdiction over Medicaid and other health care programs.</li><li>The resolution reflects the desire of the House-passed budget resolution to reach $2 trillion in spending cuts.</li></ul><h3>Adds Senate Health Committee Instructions</h3><ul><li>The Senate Finance Committee is instructed to increase deficits by not more than $1.5 trillion (TCJA extension and other tax policy).</li><li>The Senate Health, Education, Labor and Pensions (HELP) Committee is instructed to reduce deficits by not less than $1 billion. This is a change from the Senate’s original previous budget resolution. The HELP Committee has jurisdiction over measures relating to education, labor, health and public welfare.</li></ul><h3>Deadline for Committees</h3><p>The budget resolution gives Senate and House committees a May 9 deadline to report legislation, but this is not a binding deadline.</p><h2>Next Steps</h2><p>The resolution now moves to the House for consideration next week. Congressional leaders hope to complete work on the budget resolution before leaving for their two-week April recess (April 14-25).</p><p>Once both chambers have passed the budget resolution, committees that have received instructions in the budget resolution will begin drafting the reconciliation bill.</p><h2>AHA Take</h2><p>As the Senate and House forge ahead on the fiscal year 2025 budget resolution and reconciliation process, the AHA continues to urge Congress to take seriously the impact of reductions in health care programs, particularly Medicaid. We ask Congress to construct a path forward that protects Medicaid and patients from harmful cuts that would impact access to care for millions of Americans. The AHA will continue to keep the field updated on the latest developments and action needed.</p><h2>Resources on Protecting Medicaid, Other Health Programs</h2><p>The AHA continues to develop and share resources with hospitals and health systems on the importance of protecting Medicaid and other health programs. Please visit our <a href="/advocacy/action-center">Action Center</a> for a host of resources on key advocacy issues. In addition, the Coalition to Strengthen America’s Healthcare, of which the AHA is a founding member, continues to run advertising, share digital resources and engage in grassroots activity on the importance of protecting Medicaid. See the <a href="https://strengthenhealthcare.org/" target="_blank" title="Coalition to Strengthen America's Healthcare homepage">Coalition website</a> for the latest advertising and resources.</p><h2>Further Questions</h2><p>If you have further questions, please contact Rachel Jenkins, AHA senior associate director of federal relations, at <a href="mailto:rjenkins@aha.org?subject=RE: Special Bulletin: Senate Passes Revised Budget Resolution">rjenkins@aha.org</a>.</p></div><div class="col-md-4"><p><a href="/system/files/media/file/2025/04/Special-Bulletin-Senate-Passes-Revised-Budget-Resolution-20250405.pdf" target="_blank" title="Click here to download the Special Bulletin: Senate Passes Revised Budget Resolution PDF"><img src="/sites/default/files/inline-images/Page-1-Special-Bulletin-Senate-Passes-Revised-Budget-Resolution-20250405.png" data-entity-uuid="457fa1ef-79fd-44b7-9ca9-266f7310196e" data-entity-type="file" alt="Special Bulletin: Senate Passes Revised Budget Resolution page 1." width="690" height="900"></a></p></div></div></div> Sat, 05 Apr 2025 10:50:00 -0500 Budgeting <div class="container"><div class="row"><div class="col-md-8"><p>Senate Budget Committee Chair Lindsey Graham, R-S.C., April 2 released the <a href="https://www.budget.senate.gov/imo/media/doc/senate_amendment_h_con_res_14.pdf?mkt_tok=NzEwLVpMTC02NTEAAAGZl8RTAeR77E_lSejQRLXuYl1AOsKjOdJI0nU2PMfXA8wXmmXVYF7CcZk5tv11NHb3ujccKHrsSVucOEOWX58ycMOSAOS21R7ZAFkGPAKzprtG7Q" target="_blank">Senate's amendment</a> to the House budget resolution for fiscal year 2025. This marks the next step toward reaching a common budget resolution that will allow Congress to move forward with the <a href="/issue-landing-page/2025-02-07-budget-reconciliation-process-resource-page" target="_blank">reconciliation process</a>.  </p><p>The amendment is drafted to provide flexibility to Senate and House Committees when they begin drafting their individual bills. As is customary, the budget resolution does not provide details on potential cuts to Medicaid or Medicare, as well as the extension of the Enhanced Premium Tax Credits (EPTCs).</p><h2>Key Highlights of the Budget Resolution</h2><p><strong>Debt Ceiling:</strong> The resolution includes instructions to allow Congress to increase the debt limit. The House Ways & Means Committee instruction is $4 trillion, and the Senate Finance Committee’s is $5 trillion.</p><p><strong>Tax Policy: </strong>The resolution assumes a budget mechanism called “current policy baseline” to set up a pathway toward making the tax cuts within the Tax Cuts & Jobs Act (TCJA) permanent.</p><p><strong>Preserves House Instructions:</strong></p><ul><li>The House Ways & Means Committee is instructed to increase deficits by not more than $4.5 trillion (TCJA extension).</li><li>The House Energy and Commerce Committee is instructed to reduce deficits by not less than $880 billion. The Energy and Commerce Committee has primary jurisdiction over Medicaid and other health care programs.</li><li>The resolution reflects the desire of the House-passed budget resolution to reach $2 trillion in spending cuts.</li></ul><p><strong>Adds Senate Health Committee Instructions:</strong></p><ul><li>The Senate Finance Committee is instructed to increase deficits by not more than $1.5 trillion (TCJA extension and other tax policy).</li><li>The Senate Health, Education, Labor and Pensions (HELP) Committee is instructed to reduce deficits by not less than $1 billion. This is a change from the  Senate’s original previous budget resolution. The HELP Committee has jurisdiction over measures relating to education, labor, health and public welfare.</li></ul><p><strong>Deadline for Committees:</strong> The budget resolution gives Senate and House committees a May 9 deadline to report legislation, but this is not a binding deadline.</p><h2>Next Steps</h2><p>The Senate is expected to begin consideration of the budget resolution as soon as tonight. We anticipate the Senate to potentially work into the weekend processing amendments prior to a final vote. Health-related amendments are expected, particularly around Medicaid and EPTCs. We will be monitoring these developments.</p><p>If the revised resolution passes the Senate, it will move to the House for consideration next week. Congressional leaders hope to complete work on the budget resolution before leaving for their two-week April recess (April 14-25).</p><p>Once both chambers have passed the budget resolution, committees that have received instructions in the budget resolution will begin drafting the reconciliation bill.</p><h2>AHA Take</h2><p>As the Senate and House forge ahead on the fiscal year 2025 budget resolution and reconciliation process, the AHA continues to urge Congress to take seriously the impact of reductions in health care programs, particularly Medicaid. We ask Congress to construct a path forward that protects Medicaid and patients from harmful cuts that would impact access to care for millions of Americans. The AHA will continue to keep the field updated on the latest developments and action needed.</p><h2>Resources on Protecting Medicaid, Other Health Programs</h2><p>The AHA continues to develop and share resources with hospitals and health systems on the importance of protecting Medicaid and other health programs. Please visit our <a href="/advocacy/action-center" target="_blank">Action Center</a> for a host of resources on key advocacy issues. In addition, the Coalition to Strengthen America’s Healthcare, of which the AHA is a founding member, continues to run advertising, share digital resources and engage in grassroots activity on the importance of protecting Medicaid. See the Coalition <a href="https://strengthenhealthcare.org/" target="_blank">website</a> for the latest advertising and resources.</p><h2>Further Questions</h2><p>If you have further questions, please contact Rachel Jenkins, AHA senior associate director of federal relations, at <a href="mailto:rjenkins@aha.org">rjenkins@aha.org</a>. </p></div><div class="col-md-4"><a href="/system/files/media/file/2025/04/senate-unveils-amendment-to-house-budget-resolution-with-vote-expected-this-week-bulletin-4-3-2025.pdf"><img src="/sites/default/files/2025-04/cover-senate-unveils-amendment-to-house-budget-resolution-with-vote-expected-this-week-bulletin-4-3-2025.png" data-entity-uuid data-entity-type="file" alt="Special Bulletin Cover Image" width="640" height="833"></a></div></div></div> Thu, 03 Apr 2025 16:02:35 -0500 Budgeting <div class="container"><div class="row"><div class="col-md-8"><p>Today, the Senate voted 54-46 to pass a continuing resolution (CR) to fund the government through Sept. 30 and avoid a government shutdown. The House of Representatives March 11 passed the Full-year Continuing Appropriations and Extensions Act of 2025 (<a href="https://www.congress.gov/bill/119th-congress/house-bill/1968" target="_blank" title="H.R. 1968">H.R. 1968</a>) by a vote of 217-213.</p><p>Some of the health care provisions in the bill include:</p><p><strong>Medicaid disproportionate share hospital relief</strong>. The bill eliminates the Medicaid DSH cuts through Sept. 20, 2025, but also adds another year of cuts for fiscal year 2028.</p><p><strong>Medicare rural extenders</strong>. The bill extends the enhanced low-volume adjustment through Sept. 30, 2025, and the Medicare-dependent hospital program through Oct. 1, 2025.</p><p><strong>Medicare telehealth and hospital-at-home extensions</strong>. The bill extends key telehealth waivers and the hospital-at-home program through Sept. 30, 2025.</p><p><strong>Extension of the work geographic index floor under the Medicare program</strong>. The bill extends a 1.0 floor on the work geographic practice cost index through Oct. 1, 2025.</p><p><strong>Medicare rural ambulance</strong>. The bill extends add-on payments for ambulance services through Oct. 1, 2025. These add-on payments support rural, “super-rural” and urban ambulance services.</p><p><strong>Workforce extenders</strong>. The bill includes an extension for Community Health Centers, the National Health Service Corps, and Teaching Health Centers Graduate Medical Education Program through Sept. 30, 2025.</p><h2>OTHER ITEMS OF INTEREST</h2><p><strong>Physician payment</strong>. The bill does not provide relief for Medicare physician reimbursement rates, which under current law and regulatory policy includes a 2.8% reduction for 2025.</p><p><strong>Medicaid and Site-neutral</strong>. The CR does not include any cuts to Medicaid or siteneutral payment cuts to hospitals.</p><h2>Further Questions</h2><p>If you have further questions, please contact the AHA at 800-424-4301.</p></div><div class="col-md-4"><a href="/system/files/media/file/2025/03/house-senate-pass-continuing-resolution-funding-government-averting-shutdown-bulletin-3-14-2025.pdf"><img src="/sites/default/files/inline-images/cover-house-senate-pass-continuing-resolution-funding-government-averting-shutdown-bulletin-3-14-2025.png" data-entity-uuid="949ebe90-eefe-40c3-804b-f38d9b846d3b" data-entity-type="file" alt="Special Bulletin Cover Image" width="640" height="834"></a></div></div></div> Fri, 14 Mar 2025 16:38:03 -0500 Budgeting /news/headline/2025-03-10-house-expected-consider-cr-fund-government-through-sept-30-extend-key-health-care-provisions <p>House Republican leaders March 8 unveiled a <a href="https://rules.house.gov/sites/evo-subsites/rules.house.gov/files/documents/crfull_xml.pdf" title="House extender bill">bill</a> that would fund the federal government through Sept. 30 of this year, as well as extend certain key health care provisions that are set to expire at the end of March. The bill, known as a continuing resolution, would largely keep government funding at current levels through the end of this fiscal year, with some adjustments. Current government funding is set to expire March 14. </p><p>The House Rules Committee is expected to consider the bill today, and it could be on the House floor for a vote on March 11. If it passes the House, it is expected to be on the Senate floor later this week.</p><p>Some key highlights of health care provisions include: </p><ul><li><strong>Medicaid Disproportionate Share Hospital Relief. </strong>The bill would eliminate the Medicaid DSH cuts through Sept. 30, 2025.   </li><li><strong>Medicare Rural Extenders. </strong>The bill would extend the enhanced low-volume adjustment program through Sept. 30, 2025, and the Medicare-dependent hospital program through Oct. 1, 2025.</li><li><strong>Medicare Telehealth and Hospital-at-home Extensions. </strong>The bill would extend key telehealth waivers and the hospital-at-home program through Sept. 30, 2025.</li><li><strong>Extension of the Work Geographic Index Floor under the Medicare Program. </strong>The bill will extend a 1.0 floor on the work geographic practice cost index through Oct. 1, 2025.</li><li><strong>Medicare Rural Ambulance.</strong> The bill will extend add-on payments for ambulance services through Oct. 1, 2025. These add-on payments support rural, “super-rural” and urban ambulance services. </li></ul> Mon, 10 Mar 2025 14:43:08 -0500 Budgeting /press-releases/2025-02-25-aha-statement-house-budget-resolution <p class="text-align-center"><strong>Rick Pollack</strong><br><strong>President and CEO</strong><br><strong>���������� Association</strong></p><p class="text-align-center"><strong>February 25, 2025</strong></p><p>On behalf of the hospitals, nurses, doctors and those who care for and serve the needs of the 72 million patients that rely on Medicaid, we urge you to consider the implications of hinging the budget reconciliation bill’s fate on removing health care access for millions of our nation's patients. These are hardworking families, children, seniors, veterans, and disabled individuals who rely on essential health care services.<br><br>We ask the House to construct a path forward that protects Medicaid from harmful cuts that would impact access to care for millions of Americans.</p><p class="text-align-center"> </p><p class="text-align-center">###</p> Tue, 25 Feb 2025 10:42:56 -0600 Budgeting /press-releases/2025-02-12-aha-statement-congressional-budget-resolution-deliberations <p class="text-align-center"><strong>Rick Pollack</strong><br><strong>President and CEO</strong><br><strong>���������� Association</strong></p><p class="text-align-center"><strong>February 12, 2025</strong></p><p>As the Senate and House Budget Committees begin deliberations on their Fiscal Year 2025 budget resolutions, the ���������� Association urges Congress to take seriously the impact of reductions in health care programs, particularly Medicaid.</p><p>While some have suggested dramatic reductions in the Medicaid program as part of a reconciliation vehicle, we would urge Congress to reject that approach. Medicaid provides health care to many of our most vulnerable populations, including pregnant women, children, the elderly, disabled and many of our working class.</p><p class="text-align-center"> </p><p class="text-align-center">###</p> Wed, 12 Feb 2025 13:20:37 -0600 Budgeting /news/headline/2024-09-25-house-passes-cr-funding-government-through-dec-20 <p>The House Sept. 25 voted 341-82 to pass a continuing resolution (<a href="https://www.govinfo.gov/content/pkg/BILLS-118hr9747ih/pdf/BILLS-118hr9747ih.pdf">H.R.9747</a>) funding the government through Dec. 20 and avoiding a government shutdown. The Senate was also expected to pass the legislation Wednesday evening. Among other provisions, the CR will allow the Federal Emergency Management Agency to access its full-year appropriation beginning Oct. 1. The bill also extends certain public health authorizations and delays for one-year clinical lab fee schedule cuts and reporting. </p> Wed, 25 Sep 2024 16:06:28 -0500 Budgeting /news/headline/2024-08-02-op-ed-former-pennsylvania-governor-argues-against-cutting-hospital-care-patients <p>In an <a href="https://www.post-gazette.com/opinion/guest-columns/2024/08/02/rural-hospital-funding-site-fair-act-tom-corbett/stories/202408030004">op-ed</a> published Aug. 2 in the Pittsburgh Post-Gazette, former Pennsylvania Governor Tom Corbett highlights how hospitals, especially those in rural areas, are facing significant financial challenges and how some proposals being considered by Congress would cut patient care by slashing billions of dollars in funding to hospitals. “If these bad ideas make it out of the Belt­way and be­come law, even more hos­pi­tals would have to shrink their ser­vices or shut their doors … We can do bet­ter. I urge law­mak­ers to re­ject pol­i­cies that would cut pa­tient care and fo­cus on real solu­tions that sup­port our hos­pi­tals, our health­care work­ers, and our res­i­dents’ ac­cess to care.”</p> Fri, 02 Aug 2024 14:45:31 -0500 Budgeting