Archive: Federal Budget

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

The 116th Congress began on Thursday amid a government funding lapse that has shut down roughly 25 percent of the federal government. Democrats are set to lead the House chamber for the first time since 2010, while Republicans remain in control in the Senate. While legislation may be move less quickly in the new divided Congress, lawmakers will still face a number of “must-pass” bills that include health care priorities. Additionally, the Trump Administration will continue to shape the health care landscape with Medicaid waivers and potential payment reforms. Here is a preview of what’s ahead in health policy in 2019.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Wednesday, the House overwhelmingly passed a bipartisan “minibus” package for fiscal year 2019 Defense-Labor, Health and Human Services, Education (Labor-HHS) appropriations bills, which include funding for federal mental health and addiction programs. Notably, the bill (H.R. 6157) would increase funding for some mental health and addiction programs as well as provide around $3.8 billion to specifically to address the opioid addiction crisis. The “minibus” also included a stopgap spending measure to fund the rest of the government into early December. With the Senate having passed the bill last week, the bill now heads to President Trump, who has said that he will sign the measure by September 30th to avert a government shutdown.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

This week, the Senate overwhelmingly passed a bipartisan “minibus” package for fiscal year 2019 Defense-Labor, Health and Human Services, Education (Labor-HHS) appropriations bills, which include funding for federal mental health and addiction programs. Notably, the bill (H.R. 6157) would increase funding for some mental health and addiction programs as well as provide around $3.8 billion to specifically to address the opioid addiction crisis. With the House expected to vote on the package next week, Congress hopes to finalize the federal health care budget and avoid a government shutdown before the September 30th spending deadline.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

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.

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Shelley Starkey

Policy & Advocacy Coordinator

Just before the July 4th recess, the Senate Appropriations Committee advanced 12 bills as a first step to setting funding levels across the federal government for Fiscal Year 2019, including a package for key health, education, and labor programs. A key focus in the proposal is combating opioid addiction, which marks a 1,275% increase in funding over the past 4 years for prevention, treatment, recovery, and research programs. As currently written, the National Institutes of Health and the Substance Abuse and Mental Health Services Administration would see significant increases in their topline budgets.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

The House Appropriations Committee approved its Labor-HHS budget for fiscal year 2019, funding key federal health, education and labor programs for the year ahead. The Substance Abuse and Mental Health Services Administration (SAMHSA) saw increases of more than $400 million to its programming, though several key programs maintained level funding to prior years, and a fund to support the expansion of Certified Behavioral Community Health Clinics (CCBHCs) faces elimination.

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Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

Last Friday, the appropriations subcommittee that covers health care programs approved funding levels for federal health spending for FY 2019. Earlier this year, Congress set federal spending levels for FY 2019, boosting both defense and non-defense spending by a combined $300 billion. As currently written, the Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) appropriations bill would prioritize efforts to address the opioid crisis and increase medical research.

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Shelley Starkey

Policy & Advocacy Coordinator

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a funding opportunity for nonprofit organizations, including community mental health and addiction treatment providers, in certain states and tribal communities to improve access to medication-assisted treatment (MAT), a highly effective, evidence-based treatment for opioid use disorder (OUD). Eligible organizations wishing to compete for up to almost $525,000 per year must submit their applications by July 9th.

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Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

On Thursday, the Mental Health Liaison Group (MHLG) hosted a briefing for congressional staff on the need for more and clearer information regarding health information privacy laws, including the Health Information Portability and Accountability Act (HIPAA). The briefing brought together providers, consumers and family members to share stories about their interactions with health privacy laws, and in particular, to advocate for funding of the Compassionate Communication of HIPAA provisions authorized in the 21st Century Cures Act of 2016. The National Council is a leading and founding member of the MHLG and was pleased to have two members participate on the panel.

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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

Policy & Advocacy Coordinator

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

Policy & Advocacy Coordinator

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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