Archive: Federal Budget

Samantha Sears

Behavioral Health Policy and Practice Intern

A little-known provision in the recent budget deal included new federal funding for social impact bonds (or pay-for-success contracts) that are meant to spur innovation and lower government spending. Social impact bonds are financing program contracts where privately funded initiatives receive government spending only if the program achieves its targeted outcomes. Social impact bonds are used in behavioral health care to improve clinical outcomes, yield savings and share risk in financing new approaches to treatment.

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Samantha Sears

Behavioral Health Policy and Practice Intern

The Congressional Budget Office (CBO) projects the country’s annual budget deficit will reach $1 trillion by 2020 in a new report released this week. The annual report was delayed this year to incorporate analysis on the impact of the Tax Cuts and Jobs Act passed in late 2017. The report highlights not only growing deficits but also growing health care spending for programs like Medicare, Medicaid and social safety net programs.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Wednesday evening, Congressional leaders unveiled a massive $1.3 trillion omnibus spending bill that would set government funding through Sep. 30, 2018. As currently written, the 2018 omnibus boosts federal health spending by $10.1 billion, providing increases for the Substance Abuse and Mental Health Services Administration (SAMHSA), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and more. Importantly, about $4 billion of the additional funding is specifically dedicated to addressing the opioid crisis. The omnibus must pass the House and Senate, then be signed by President Trump by midnight on Friday — when the government’s current funding lapses — to avoid a government shutdown.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

As the March 23rd government funding deadline inches closer, members of the House and Senate continue their slow move toward a bipartisan agreement on spending levels for the remainder of Fiscal Year 2018. At the time of this writing, text of the spending bill is not expected until next week and lawmakers are likely to leave town for the weekend. Congress has until March 23rd to approve a budget deal to avert another government shutdown.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The National Council for Behavioral Health hosted a congressional staff briefing on Wednesday highlighting government programs and initiatives that promote the integration of primary and behavioral health care. The panel featured four grantees from the Promoting Integration of Primary and Behavioral Health Care grant program, two of whom are also participants in the Medicaid Certified Community Behavioral Health Clinic demonstration program.

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Shelley Starkey

Alongside the most recent budget deal, Congress allocated $6 billion over the next two years to address the nation’s opioid epidemic. In response, 27 mental health and addiction groups, including the National Council, called on Congress to direct the money into nationally-recognized, evidence-based programs and practices. These programs and practices include: mental health and substance use block grants, the Certified Community Behavioral Health Clinic program, the Opioid State Target Response grants and SAMHSA.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Monday, President Trump unveiled his Fiscal Year (FY) 2019 budget request — detailing his Administration’s legislative and regulatory priorities for next year. The document revives last year’s failed attempts to block grant Medicaid, boosts spending to combat opioid addiction, and outlines other major health care priorities. As with most presidential budgets, this proposal stands little chance of being enacted into law as written. Instead, the President’s budget proposal will act more as a messaging tool to Congress, which just passed a major budget deal boosting defense and non-defense discretionary spending limits last week.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

Last week, Congress passed the Family First Prevention Services Act, a sweeping reform of the child welfare system as part of a larger spending package. The measure allows states to use federal foster care matching funds for prevention services addressing mental health, substance use and parenting skills to keep at-risk children from entering the foster care system. The Act also limits federal reimbursements for foster youth who are placed in congregate care settings. After coming close to passage in 2016, the Family First Act was tucked into last week’s massive budget deal, fast-tracking its enactment.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

This week, Senate leaders released a major bipartisan budget deal to lift the caps on defense and non-defense discretionary spending. The deal is accompanied by a short-term spending package for the purposes of preventing a government shutdown and giving lawmakers time to draft specific appropriations bills. The deal sets federal spending for the next two years, boosting both defense and non-defense spending by a combined $300 billion. Importantly, the deal also provides $6 billion in funding to battle opioid addiction, a four-year extension of the Children’s Health Insurance Program (CHIP), and renewal of community health center funding and Medicare extenders.

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Shelley Starkey

The federal government has been funded by short-term deals since September 30 last year. Congress must reach another deal by Thursday, February 8, to keep the government’s doors open. With a handful of policy issues on which both Republicans and Democrats seem reluctant to budge, the next steps for a long-term fiscal year (FY) 2018 funding solution remain unclear.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

After a three-day government shutdown, the House and Senate passed a stopgap spending bill Monday to keep the government running through Feb. 8. The deal also provided a six-year extension of the Children’s Health Insurance Program (CHIP) and delayed certain Affordable Care Act (ACA) taxes. With a new Feb. 8 funding deadline, lawmakers will once again start negotiating on a long-term FY 2018 budget deal and a potential immigration package, among some remaining health care measures that have been logjammed in the government funding process.

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Shelley Starkey

The White House’s Office of National Drug Control Policy (ONDCP) faces a second threat of losing 95 percent of its budget under President Trump’s Fiscal Year 2019 proposal, according to Politico. Defunding ONDCP would directly contradict the Administration’s declaration of the opioid crisis as a public health emergency, as the office is responsible for coordinating the federal response to the crisis. The National Council opposes this proposal, and will continue to work to ensure proper funding for this important office.

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Stephanie Pellitt

Policy and Advocacy Associate

For the fourth time in as many months, Congress is faced with another government funding deadline. With a potential shutdown looming, Congress is expected to pass another short-term spending bill today that would keep the government open until mid-February. On the health care front, the spending deal would renew funding for the Children’s Health Insurance Program (CHIP) for six years and delay some Affordable Care Act (ACA) taxes. The stopgap spending bill has passed the House, but faces an uncertain future in the Senate.

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Stephanie Pellitt

Policy and Advocacy Associate

Members of Congress returned to Capitol Hill this week following a holiday break. Neither chamber starts the new year with a clean slate, however, as Congress faces deadlines on government funding and a host of individual programs after voting to delay those decisions at the end of last month. Congress has less than three weeks to avert another government shutdown as well as sort through several competing health care priorities. Here is a preview of what to watch for in early 2018.

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Shelley Starkey

The Children’s Health Insurance Program (CHIP), which currently provides comprehensive health coverage to roughly 9 million children and pregnant women across the United States, is still in danger following Congress’ inability to pass a long-term funding solution. On Dec. 22nd, Congress passed a continuing resolution (CR) that extended funding for the program through the end of March 2018. The National Council is deeply concerned for the future of this critical program, and urges Congress to act swiftly to extend CHIP for the millions of children and families who rely on it.

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Stephanie Pellitt

Policy and Advocacy Associate

This week both the House and Senate passed a revised version of the Tax Cuts and Jobs Act (TCJA), sending tax reform to President Trump’s desk to become law. The TCJA will have major implications for the nation’s health care system through its repeal of the individual mandate and by adding $1.5 trillion to the federal deficit, which will likely limit what Congress will be able to spend on both discretionary and mandatory health programs, such as Medicaid, in the future. The National Council is deeply disturbed by the negative impact that will result from the passage of the Tax Cuts and Jobs Act.

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Stephanie Pellitt

Policy and Advocacy Associate

Late Thursday evening, Members of Congress passed a stopgap spending bill to avoid a government shutdown before the federal funding deadline on Friday (Dec. 22nd). The new continuing resolution (CR) funds the government through January 19th and provides short-term funding extensions for the Children’s Health Insurance Program (CHIP) and community health centers. A number of questions regarding the long-term future of key health care issues will likely not be decided until January.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

On Wednesday, Republican leaders in Congress announced that they had brokered a deal amongst themselves on their sweeping tax reform plan, the Tax Cuts and Jobs Act. Republican leaders plan to bring the bill to the floor of the House and Senate next week and hope to have it signed into law by the New Year. House appropriators also introduced a spending bill to keep the government open until January 19th. The bill includes several health care measures, but is expected to undergo substantial revision to pass in the Senate.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The hustle and bustle of the holiday season is not lost on leaders here in Washington, D.C. As of this writing: Congressional leaders are negotiating a deal to avert a government shutdown; a conference committee has formed to hammer out differences between the House and Senate’s tax reform bills; and appropriators are quietly working on an end-of-year health care spending package that could include reauthorization of Children’s Health Insurance Program, Medicare extenders and more.

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Shelley Starkey

On Tuesday, the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing to discuss the opioid epidemic and how Congress should address prevention, treatment, and recovery for opioid use disorders. The hearing convened national leaders on the issue, including the representatives of the Substance Abuse and Mental Health Services Administration (SAMHSA), National Institutes of Health (NIH), and Centers for Disease Control and Prevention (CDC). Discussion highlighted the expansion of the Certified Community Health Center (CCBHC) demonstration as a way to dramatically expand opioid addiction treatment capacity in more states.

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