The end of the year bipartisan spending deal will allocate $1.4 trillion in federal funding for the remainder of the fiscal year (through Sept. 30) and avoid a shutdown. The House has already passed the deal and the Senate is poised to do the same by tomorrow.
So what health priorities made the cut for this deal?
- Repeal of three ACA taxes intended to help pay for the law – the Cadillac tax, the health insurance tax, and the medical device tax. The Cadillac tax has never gone into effect; it would have taxed high-cost, generous health insurance plans. It was intended to be a major source of revenue for the costs of the ACA. The health insurance tax (applied to insurers) and the medical device tax have been implemented sporadically until now.
- Funding to the tune of $25 million will go to the CDC and NIH for gun violence research the FIRST TIME in over 20 years.
- Raising the minimum age to buy tobacco and e-cigarette products from 18 to 21.
- Funding to address the HIV epidemic and for the Suicide Prevention Lifeline.
- Extension of funding for some expiring health care programs to May 22 – this short-term extension could give lawmakers a legislative vehicle for a surprise billing deal in the spring.
- 2 years of Medicaid funding for Puerto Rico and other territories. This is shorter than what leaders originally opposed (4 years) but is a reprieve from past temporary extensions.
- To help pay for the package, language will be included to make it easier for generic drug companies to obtain samples of brand name drugs needed to develop lower cost products. It is projected to save nearly $4 billion over a decade.
- Provision to prevent HHS from ending auto-enrollment in the ACA exchanges.
- Ten years of funding for the Patient-Centered Outcomes Research Institute (PCORI) to continue evaluating risks and benefits of health treatments.
By the numbers: This deal would add almost $50 billion in new spending and more than $500 billion to the deficit over the next decade.
Image from Samuel Corum for The New York Times.