Senate Passes FY 19 Health Appropriations
Last week, the Senate overwhelmingly passed a joint Defense and Labor-HHS appropriations bill that would increase federal health spending in the upcoming fiscal year. Notably, the bill would increase funding for some mental health and addiction programs as well as provide around $3.7 billion to specifically to address the opioid addiction crisis. House and Senate members now face a time crunch to reconcile their appropriations bills before a September 30th funding deadline and potential government shutdown.
The Senate funding bill provides the Department of Health and Human Services (HHS) with a $2.3 billion increase in discretionary spending (compared to FY 2018), bringing HHS’s total discretionary health spending to approximately $90.1 billion. Compared to last year, the Substance Abuse and Mental Health Services Administration (SAMHSA) would receive an additional $580 million and the National Institutes of Health (NIH) would receive an additional $2 billion. The Mental Health Block Grant’s funding would increase by $25 million to $747 million, while the Substance Abuse Prevention and Treatment Block Grant would remain at $1.9 billion for FY 2019.
The Senate approved around $3.7 billion, an increase of $145 million, for activities intended to curb opioid use and addiction. As one of Congress’ highest priorities, funding to address the opioid crisis was split across several agencies and programs. The bill included the following opioid-specific investments:
- CCBHCs: $150 million, an increase of $50 million, for the continued expansion of new Certified Community Behavioral Health Centers (CCBHCs). CCBHCs are a new type of Medicaid provider that are rapidly expanding access to opioid and other addiction care in their communities.
- State Opioid Response Grants: $1.5 billion for SAMHSA’s State Opioid Response (SOR) Grant, which continues a 15 percent set-aside for states with the highest mortality rate related to opioid use disorders and a $50 million set-aside for Indian tribes and tribal organizations. Part of the funding replaces the $500 million expiring from the Opioid State Targeted Response (STR) fund, created under the 21st Century Cures Act.
- Research: $500 million to NIH for research related to opioid addiction, development of opioid alternatives, pain management and addiction treatment.
- Treatment in Rural Areas: $120 million focused on responding to the opioid epidemic in rural communities, which includes $20 million for the establishment of three Rural Centers of Excellence on Substance Use Disorders that will support the dissemination of best practices related to the treatment for and prevention of substance use disorders within rural communities.
- Health Centers/FQHCs: $200 million for Community Health Centers to support and enhance mental health or substance use disorder services.
- Public Health: Maintains $476 million at CDC for opioid overdose prevention and surveillance as well as a public awareness campaign. The bill includes $5 million for a new CDC initiative to combat infectious diseases directly related to opioid use.
- Children and Families: $40 million, the same as the FY 2018 level, for mental health and substance use prevention and treatment for children and families in, or at-risk of entering, the foster care system.
- Telehealth: $2 million to support an evidence-based tele-behavioral health system to focus on opioids.
Attention now turns to the House, which has yet to hold a floor vote on its health appropriations bill. Once the House passes its bill, the House and Senate will have very few working days to reconcile the differences between the two chambers’ packages before funding for the current fiscal year expires on Sept. 30th. Should the deadline pass, Congress will be forced to enact a continuing resolution (CR) to keep current funding levels in effect or face a government shutdown.