What’s in the omnibus for health care

WHAT’S IN THE OMNIBUS — The $1.3 trillion spending bill was posted last night, with Congress now rushing to pass it by Friday midnight. If they don’t, prepare for a possible third government shutdown of the year.

The health care highlights for Pros | The entire 2,232-page bill | POLITICO’s overview

Among the big takeaways for health care readers:

— $10 billion more for HHS. The agency overall would receive $88.1 billion in fiscal 2018, according to Senate appropriators, representing a $10.1 billion increase compared with fiscal 2017 levels.

— More funding for research too. NIH would receive a nearly 9 percent bump to $37.1 billion — including $100 million toward developing a universal flu vaccine. More for Pros.

CDC would receive $8.3 billion under the legislation, a $1.1 billion boost and a sharp departure from the nearly $900 million in cuts that the White House proposed last month. More for Pros.

Drilling down:

— $4 billion to fight opioid crisis. The funding — for prevention, treatment and law enforcement — is spread across agencies including HHS, Homeland Security, Justice and Veterans Affairs. It represents a $3 billion increase over what lawmakers committed last year to addressing the addiction epidemic. More for Pros.

— Bioterrorism, public health response efforts see major funding boosts. Efforts to stockpile drugs, vaccines and other efforts to shield the nation from possible bioterrorism or another public health emergency are all set to receive boosts in funding under the bill, H.R. 1625 (115), to fund the government through September. More for Pros.

More payment for a handful of new drugs. Less than two dozen products are estimated to benefit from the change in the omnibus that allows for five years of pass-through status actually limited to two years because the bill specifies that it only applies to drugs that lost pass-through status on Dec. 31, 2017 and for which payment was bundled into a group of services under Medicare policies beginning Jan. 1. More for Pros.

— $335 million for CDC’s workplace safety office. Congress rejected the Trump administration’s proposed 41 percent cut to the National Institute for Occupational Safety and Health and also rebuffed the White House’s attempt to move NIOSH out of the CDC. More for Pros.

More money for abstinence education. Lawmakers agreed to boost funding for abstinence education by two-thirds, to $25 million.

— More info on ACA workers. The budget requires the Trump administration to publish information on the number of employees and contractors involved in “implementing, administering, enforcing, or otherwise carrying out” the Affordable Care Act.


— Congress nixed a series of anti-abortion riders, including a bill expanding conscience protections.

— Congress rejected the White House’s plan to gut drug policy office. The Trump administration had proposed a 95 percent cut to the White House Office of National Drug Control Policy. It was the second straight year that lawmakers have rebuffed the attempt to gut the office, which sets drug-fighting strategy across the government and is popular on the Hill.

— Congress reiterated: No money for Obamacare’s risk corridors. Once again, lawmakers prohibited money from being spent to make risk corridor payments to insurers. The program, which expired after 2016, was supposed to cushion the financial blow for insurers that attracted disproportionately expensive customers. Because Republicans required the program to be budget neutral, however, payments came up $12 billion short. Dozens of insurers have filed lawsuits to recover the funds.

** A message from PhRMA: There is currently no requirement that hospitals pass 340B program savings along to patients, and economists suggest 340B may actually contribute to higher out-of-pocket costs for patients. Let’s fix the 340B program. http://politi.co/2IqKpF3 **

WHAT’S NEXT AFTER HOUSE PASSES RIGHT-TO-TRY — The chamber in a party-line vote approved a bill designed to let very sick patients request access to experimental medicines without government oversight.

It’s a victory for the Goldwater Institute and the White House. The small libertarian think tank crafted the proposal and the administration vigorously campaigned for the law. Meanwhile, it’s a blow for the many policy wonks who opposed the idea, saying it would weaken patient protections. Many pharma companies also opposed the bill, whose benefits are not as straightforward as they may seem.


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