April 30, 2019

House panel releases FY 2020 HHS spending bill. Here's what's inside.

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    The House Appropriations Committee on Monday released a draft HHS spending bill for fiscal year (FY) 2020 that calls for a total of $99 billion in funding for HHS, including $50 million in funding for research on gun violence.

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    Draft bill details

    The draft bill would allocate a total of $189.8 billion to fund the Departments of Education and Labor, as well as HHS. That total would be an $11.7 billion increase over FY 2019's enacted level and $47.8 billion more than President Trump had requested in his FY 2020 budget proposal, according to a release.

    Health care provisions

    The draft bill would allocate a total of $99 billion to HHS, up $8.5 billion from FY 2019 levels and $20.9 billion more than Trump included in his budget request. As part of that total, the draft bill would allocate:

    • $41.1 billion to NIH—up $2 billion from the FY 2019 level and $6.9 billion more than Trump's budget request;
    • $8.3 billion to CDC—up $921 million from the FY 2019 level and $1.7 billion more than Trump's budget request;
    • $7.6 billion to the Health Resources and Services Administration—up $475 million from the FY 2019 level and $1.5 billion more than Trump's budget request;
    • $5.9 billion to the Substance Abuse and Mental Health Services Administration (SAMHSA)—up $115 million from the FY 2019 level and $179 million more than Trump's budget request;
    • $358 million for the Agency for Healthcare Research and Quality—up $20 million from the FY 2019 level; and
    • $4 billion to CMS for "administrative expenses"—up $315 million from the FY 2019 level and $405 million more than Trump's budget request.

    The draft bill also includes:

    • $150 million through September 2022 to award grants to communities and organizations for Certified Community Behavioral Health Clinics, which are expected to run out of funds at the end of June;
    • $3.8 billion for substance use disorder prevention and treatment—up $14 million from the FY 2019 level;
    • $1.5 billion for state grants for substance use disorder prevention and recovery efforts, including $50 million for tribes and tribal organizations severely affected by substance misuse;
    • $17 million for SAMSHA's Suicide Lifeline; and
    • $14 million for SAMSHA's Zero Suicide initiative.

    Under the proposed funding amounts, CDC and NIH each would receive $25 million to conduct research on how to prevent firearm-related deaths and injuries. Federal lawmakers have not appropriated funds for gun violence research since 1996, when Congress first passed the so-called Dickey Amendment, which bars CDC from using federal funds to promote gun control. Congress in a budget deal signed into law last year clarified that the amendment does not prohibit the federal agencies from using funds from studying firearms, as long as the research does not promote gun control. According to The Hill, it is unclear whether the Republican-controlled Senate would approve funding for gun-violence research.

    The draft bill also would:

    • Allow federal lawmakers to visit HHS-funded facilities where migrant children are housed and establish new standards for how HHS should care for children housed in facilities funded by the department;
    • Block the Trump administration's final rule barring abortion providers and clinics that refer patients for abortion care from receiving Title X family planning grants; and
    • Prohibit the use of federal funds to promote the legalization of Schedule I drugs, unless there is evidence that the drugs provide therapeutic value or there is federally funded research seeking to determine their therapeutic value.

    The House Appropriations Committee's Subcommittee on Labor, HHS, Education, and Related Agencies on Tuesday will mark up the draft bill (Roubein, Politico, 4/29; Hellmann [1], The Hill, 4/29; Hellmann [2], The Hill, 4/29; Werner, Washington Post, 4/29; Diamond, "Pulse," Politico, 4/30).

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