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. Both chambers of Congress voted to pass the bill early Friday morning, sending the bill to President Trump’s desk for signature.
OPIOIDS AND MENTAL HEALTH FUNDING
The budget deal provides $6 billion over two years ($3 billion in FY18 and $3 billion in FY19) to support substance use and mental health programs. Specifically, the package funds grants to states to fight drug abuse and expand substance use and mental health treatment. Additional assistance would be focused on states with the highest opioid mortality rates. The provisions also fund public prevention programs and law enforcement activities related to mental health and substance use.
“This agreement will also bolster our ongoing national struggle against opioid addiction and substance abuse,” Senate Majority Leader Mitch McConnell (R-KY) said of the agreement on the Senate floor. “It will fund new grants, prevention programs, and law enforcement efforts in vulnerable communities across the country.”
FUNDING OTHER HEALTH CARE PRIORITIES
Children’s Health Insurance Program (CHIP): The deal extends funding for CHIP by an additional four years — a ten-year extension when combined with the six-year reauthorization secured as part of the most recent spending deal. This measure brings much-needed stability to a program that 9 million children and families depend upon for health insurance.
National Institutes of Health (NIH): NIH receives an additional $2 billion over two years to support scientific research. The study of non-opioid pain therapies is currently a top priority for NIH.
Community Health Centers and Medicare Extenders: The bill ends a five-month lapse in federal funding for community health centers with a two-year funding extension. Multiple Medicare payment policies, known as Medicare “extenders”, received significant renewals. Most notably, the Medicare payment cap on physical and speech therapy was lifted permanently.
Public Health Prevention Fund: The deal drastically cuts the Affordable Care Act Public Health Prevention Fund by $12.7 billion, a much more significant cut than an earlier House spending bill proposed.
Medicare “Donut Hole”: The agreement closes the prescription drug “donut hole” for seniors in 2019 by requiring drug manufacturers to pay for a portion of the costs in the coverage gap.
Medicare Telehealth: The bill advances landmark policies of the CHRONIC Care Act to expand telehealth services for Medicare beneficiaries. The bill also allows Medicare Advantage plans to offer a wider array of supplemental benefits starting in 2020, not limited to primarily health-related services.
Disaster Funding: The budget deal adds $90 billion in disaster funding, which includes $5 billion for Puerto Rico’s Medicaid program.
WHAT HAPPENS NEXT?
Both chambers of Congress passed the budget deal early Friday morning after a brief government shutdown that lasted only a few hours. The bill cleared the Senate easily, but faced more opposition in the House from members on both sides of the aisle. Minority Leader Nancy Pelosi (D-CA) had urged Democrats not to vote for any package that did not include a Deferred Action for Childhood Arrivals (DACA) resolution and some House Freedom Caucus members opposed the bill due to its increases in domestic spending. The bill now heads to President Trump’s desk for signature.
Stay tuned to Capitol Connector in the coming weeks for more detail on the budget’s provisions.
National Council for Mental Wellbeing