WASHINGTON -- Congress passed a stopgap early Friday that included 10 years of funding for the Children's Health Insurance Program and $7.8 billion for community health centers (CHCs), and permanently removed a cap on Medicare outpatient therapy payments.
The measure passed by a vote of 71-28 in the Senate and 240-186 in the House; President Trump has signed it.
The bill, which will keep the government open through March 23, also includes funding for assisting victims of national disaster in Puerto Rico and the U.S. Virgin Islands, and it repeals the Independent Payment Advisory Board (IPAB), an unpopular feature of the Affordable Care Act. It also extends the Children's Health Insurance Program (CHIP) for 10 years, up from the 6-year extension the program received in the previous short-term spending bill.
The CHIP extension is "just remarkable providing unprecedented security and certainty for the families that depend on CHIP, and the state governments that need more predictability to map out their own expenditures," said Sen. Orrin Hatch (R-Utah).
Other health-related provisions in the bill include:
- The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, "which, once enacted, will improve health outcomes for Medicare beneficiaries living with chronic conditions," said Hatch. "It will also help bring down Medicare costs and streamline care coordination services."
- $7.6 million for repairing facilities and replacing equipment at FDA facilities in Puerto Rico
- $300 million for a 2-year extension of the Special Diabetes Program for type 1 diabetes patients, and a similar amount for a 2-year extension of the Special Diabetes Program for Native Americans
- Expanded access to intensive cardiac rehabilitation programs under Medicare
The measure also gives Congress the authority to come up with a 2-year omnibus spending bill, which would presumably be voted on and passed before the new March 23 deadline.
Money to Fight the Opioid Crisis
Senate Majority Leader Mitch McConnell (R-Ky.) praised the bill's $6 billion funding for combatting the opioid crisis. "This agreement provides for new grants, prevention programs and law enforcement initiatives to bolster existing national and state efforts," he said.
Rep. Evan Jenkins (R-W.Va.), whose state has an overdose rate 33% higher than the national average, said that until now, money for the crisis has been somewhat maldistributed. "We must use a formula based on per-capita statistics to ensure funds go to hardest-hit states ... where the crisis and the need is the greatest," he said.
Sen. Rand Paul (R-Ky.), who kept delaying Senate votes on the measure in an effort to focus on how much the bill would increase the deficit, pushed to debate an amendment that would maintain the current budget caps, but Senate leadership rejected the request. He stressed that the new bill would add $500 billion in spending over the next 2 years.
"The reason I'm here tonight is to put people on the spot. I want people to feel uncomfortable. I want them to have to answer people at home who said, 'How come you were against President Obama's deficits and then how come you're for Republican deficits?' Isn't that the very definition of intellectual dishonesty?" he said.
Senate Minority Leader Chuck Schumer (D-N.Y.) noted that the bill includes billions of dollars in funding for improving veterans' hospitals and clinics, "so that when our brave soldiers come home bearing the scars of war, their country serves them just as well as they served us."
Help for Puerto Rico
The bill also includes $4.8 billion in Medicaid funding for residents of Puerto Rico. "We were facing a medical cliff in April," said Resident Commissioner Jenniffer González-Colón (R-P.R.) "[It was] a medical cliff that would put an end to insurance for 680,000 patients on the island. That's the reason this bill is so important for Puerto Rico."
Sen. Dick Durbin (D-Ill.) also applauded another provision in the bill: an increase in the budget for the National Institutes of Health (NIH). "[NIH Director] Dr. [Francis] Collins had told me that the problem with medical research is that if it's not certain next year that you'll receive a grant to continue your research, you get discouraged and start looking for another job," Durbin said. "We can't let that happen."
This is the third straight year Congress has increased NIH's funding by at least 5%, and "the good news is this budget will go beyond 5%; we'll have a 7-8% increase in real growth," he said.
Durbin said he supports the bill even though it doesn't include a legislative fix for those affected by the pending expiration on March 5th of the Deferred Action for Childhood Arrivals (DACA) program. "At that point, 1,000 young people each day on average will lose their protection from deportation and their legal right to work in America," he said.
House Minority Leader Nancy Pelosi (D-Calif.) opposed the bill because of its failure to address the DACA issue, giving an 8-hour floor speech on Wednesday to declare her opposition. Durbin noted that Senate leaders have agreed to allow a bill that addresses these issues to come to the floor next week, and House Speaker Paul Ryan (R-Wis.) also promised to address the issue.
ACA Stabilization Not Included
The bill that passed Friday morning does not appear to include legislation championed by Sen. Susan Collins (R-Maine) aimed at stabilizing the Affordable Care Act' s (ACA) individual insurance market.
McConnell had promised Collins votes on two bills, the Bipartisan Health Care Stabilization Act, authored by senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), which would fund the cost-sharing reduction payments -- which President Trump ended last year -- received by low-income enrollees in the ACA exchanges to help pay their out-of-pocket costs in 2019 and 2020.
The other bill Collins has been pushing is one she introduced with Sen. Bill Nelson (D-Fla.) that would allocate $5 billion a year for 2 years to re-insure insurance companies for their high-cost patients on the ACA exchanges.