May 1, 2017

How the shutdown-averting budget deal would affect health care

Daily Briefing

Congressional negotiators on Sunday reached a deal on a roughly $1 trillion omnibus spending bill that would fund the federal government through the end of the current fiscal year (FY) and includes a $2 billion funding increase for NIH.

The deal, which Congress still needs to approve, comes after the House and Senate last week passed a one-week spending bill (H.J. Res. 99) that funds the federal government through May 5. The latest deal would fund the government through Sept. 30, when FY 2017 ends.

Details of the new spending bill

Under the latest spending agreement, NIH would get a $2 billion funding increase over the next five months, including an additional:

  • $476 million for the National Cancer Institute;
  • $400 million for Alzheimer's disease research;
  • $120 million for former President Barack Obama's All of Us Research Program, formally known as the Precision Medicine Initiative, as it seeks to recruit volunteers for genetic testing and health tracking;
  • $110 million for Obama's Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative to support efforts to map the human brain.

The spending agreement also hikes funding to fight the United States' opioid misuse epidemic, from $150 million to about $800 million. That funding, according to STAT News, would be divided among opioid misuse programs at CDC, the Substance Abuse and Mental Health Services Administration, and the Health Resources and Services Administration.

Trump proposes cutting $1.2B from NIH to fund border wall, military spending

In addition, the spending agreement would:

  • Permanently extend retired coal miners' health care benefits, which had been at risk of shutting down;
  • Preserve federal funding for Planned Parenthood through the remainder of FY 2017; and
  • Provide $295 million for Puerto Rico's Medicaid program.

The spending agreement also would increase funding for the military and for border security, but it does not include funding for the wall that President Trump has vowed to build along the United States' border with Mexico.

Lawmakers comment on the deal

Senate Minority Leader Chuck Schumer (D-N.Y.) praised the deal, saying, "This agreement is a good agreement for the American people, and takes the threat of a government shutdown off the table." He added, "The bill ensures taxpayer dollars aren't used to fund an ineffective border wall, excludes poison pill riders, and increases investments in programs that the middle-class relies on, like medical research, education, and infrastructure."

House Minority Leader Nancy Pelosi (D-Calif.) also lauded the agreement. Pelosi in a statement said, "The omnibus is in sharp contrast to [Trump's] dangerous plans to steal billions from lifesaving medical research, instead increasing funding for the NIH by $2 billion."

However, Rep. Jim Jordan (R-Ohio) said he was "disappointed" with the measure. "We'll see how it plays out this week but I think you're going to see conservatives have some real concerns with this legislation."

According to the New York Times, neither Senate Majority Leader Mitch McConnell (R-Ky.) nor House Speaker Paul Ryan (R-Wis.) had issued statements on the agreement as of late Sunday night.

Jennifer Hing, a spokesperson for the House Appropriations Committee, said, "The agreement will move the needle forward on conservative priorities and will ensure that the essential functions of the federal government are maintained" (Facher, STAT News, 5/1; Kaplan/Flegenheimer, New York Times, 4/30; Miller, Washington Times, 4/30; Cowan, Reuters, 5/1; Hughes, Wall Street Journal, 4/30; Snell, "PowerPost," Washington Post, 4/30).

What does health care reform beyond the ACA look like? Join us on May 2nd

Stuart Clark, Managing Director

The first part of the Health Care Advisory Board’s latest “State of the Union” explores what the Trump administration and GOP-controlled Congress will mean for the future of coverage expansion, payment reform, and federal entitlement programs.

The presentation provides an objective analysis of the next era of health care reform, unpacking the potential futures of Medicare, Medicaid, and the private insurance market—and what those changes would mean for provider strategy. The presentation also includes a detailed assessment of the accomplishments, shortcomings, and unintended consequences of the Obama-era reforms.

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