August 24, 2018

Senate passes $90B HHS spending bill

Daily Briefing

    The Senate on Thursday voted 85-7 to approve a fiscal year (FY) 2019 spending bill to fund HHS and other federal departments that would give NIH a $2 billion funding bump over FY 2018 levels.

    Sens. Mike Crapo (R-Idaho), Jeff Flake (R-Ariz.), Mike Lee (R-Utah), Rand Paul (R-Ky.), Jim Risch (R-Idaho), Bernie Sanders (I-Vt.), and Pat Toomey (R-Pa.) voted against the bill.

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    The bill's passage marks the first time in 11 years that the Senate approved a standalone spending bill for the Department of Education (DOE), Department of Labor (DOL), and HHS instead of approving the departments' funding as part of a larger spending package. The measure is one of 12 spending bills the Senate needs to pass to fund the federal government beyond Sept. 30, The Hill reports. The Senate is seeking to avoid an omnibus bill, which would combine the 12 spending bills into one piece of legislation, after President Trump in March said he would not sign an omnibus spending measure. To date, the Senate has passed nine of the 12 spending bills.

    The Senate and House will have to reconcile their spending bills before they can be sent to Trump.

    Bill details

    The bill the Senate passed Thursday would allocate a total of $854 billion to fund DOL, DOE, HHS and the Department of Defense.

    Health care provisions

    The bill includes a total of $90 billion to fund HHS, up by about $1 billion from FY 2018 levels.

    As part of that total, the bill would allocate:

    • $39.1 billion to NIH, an increase of about 5% from FY 2018 levels, which includes $2.3 billion for Alzheimer's disease and dementia research;
    • $3.7 billion for programs to combat the opioid epidemic—including $500 million for NIH research to develop non-addictive pain treatments and $1.5 billion for State Opioid Response Grants authorized under the 21st Century Cures Act;
    • $562 million to the Biomedical Advanced Research and Development Authority; and
    • $1 million for HHS to implement Trevor's Law, which requires federal, state, and local agencies to coordinate their efforts to investigate potential cancer clusters.

    The Senate also approved several amendments to the spending bill, including one introduced by Sens. Dick Durbin (D-Ill.) and Chuck Grassley (R-Iowa) that would authorize funding to help HHS develop regulations to require drugmakers to include drugs' list prices in direct-to-consumer advertisements. The list price proposal originally was included in Trump's policy "blueprint" on prescription drug prices, though it is unclear if the federal government can enforce such a requirement, as some industry experts have said it could be unconstitutional.

    In addition, the Senate approved an amendment introduced by Sens. Bill Nelson (D-Fla.) and Marco Rubio (R-Fla.) that would create a $10 million demonstration program to expand school-based mental health services in low-income schools.

    The Senate rejected:

    • An amendment introduced by Sen. Joe Manchin (D-W.Va.) that would have allowed the Senate's counsel to intervene in a law brought by 20 Republican-led states that challenges the Affordable Care Act's constitutionality; and
    • An amendment introduced by Sen. Rand Paul (R-Ky.) that would have cut federal funding for Planned Parenthood (Luthi, Modern Healthcare, 8/23; Baker, "Vitals," Axios, 8/24; Bowers, McKnight's Senior Living, 8/24; Bull, FOX59, 8/23; Carney, The Hill, 8/23; Thielking, "Morning Rounds," STAT News, 8/24).

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