Congress returned to Capitol Hill this week facing uncertainty over who the next Speaker of the House will be and a looming deadline for action on its statutory debt ceiling.

The Treasury Department warned Congress on Oct. 15 that the nation will hit its debt ceiling on Nov. 3 – two days earlier than projected – and would be unable to pay its pending bills if Congress does not take action.

"At that point, we expect Treasury would be left with less than $30 billion to meet all of the nation's commitments – an amount far short of net expenditures on certain days, which can be as high as $60 billion," Treasury Secretary Jack Lew wrote House Speaker John Boehner, R-Ohio.

The Treasury Department had set a deadline of Nov. 5, but Lew said that needed to be moved up two days because “the trend in our projected net resources has continued to be negative, and our projections for the relevant period have declined an additional $4-6 billion.”

He said Congress must lift the debt ceiling by Nov. 3 or face the prospect of a government default. That could bring another fiscal showdown between the White House and congressional Republicans. In October 2013, a debt-extension agreement was reached just before the Treasury had expected to run out of borrowing authority.

For more on Lew’s letter to Boehner, click on: http://tinyurl.com/o7gh64v.

Boehner had planned to leave Congress at the end of this month. But the sudden decision by House Republican Majority Leader Kevin McCarthy, R-Calif., to not seek the speakership has left Republicans struggling to find someone else. House Republicans plan to vote internally to nominate the next speaker Oct. 28, with a floor vote slated for Oct. 29. House Ways and Means Committee Chairman Paul Ryan, R-Wis., is viewed as Boehner’s most likely successor.

When the speaker announced last month that he would step down at the end of October, he promised to finish as much work as he could before his resignation. In addition to the nation hitting its debt ceiling early next month, federal highway funding runs out Oct. 29 and the latest stopgap funding bill expires Dec. 11.

While congressional leaders have not publicly settled on a strategy or timeline for raising the debt ceiling, the House on Oct. 21 voted 235 to 194 to pass related legislation, H.R. 692, the Default Prevention Act. In the event that the debt limit is reached, the legislation would allow the federal government to keep borrowing above the statutory debt limit in order to pay principal and interest on debt held by the public or the Social Security Trust Fund. The bill would prohibit Treasury from paying Members of Congress. The House Ways and Means Committee last month passed the legislation.

The House also is expected to take up a reconciliation measure, which would repeal five provisions of the Affordable Care Act: the individual and employer mandates; the “Cadillac” tax (a tax on the most expensive employer-sponsored health-care coverage plans); the medical-device tax; and Medicare’s Independent Payment Advisory Board.  

In a recent message to hospital and health system leaders, AHA President Rick Pollack said these developments on Capitol Hill set up a “season of potential showdowns that could be risky” for the field. He urged hospital and health system leaders to “continue to tell your hospital's story to your federal legislators so they are continuously aware of what is at stake whenever they consider matters that would affect funding for hospital care.”