Trump signs $400B budget deal that funds healthcare programs, reopens government after overnight shutdown at at
Tue Feb 27 10:53:03 PST 2018



February 9, 2018


Trump signs $400B budget deal that funds healthcare programs, reopens
government after overnight shutdown 



3WlR6ZnQzcjVrazVTYzFaTnpxdURtS0pZa3JcL05RIn0%3D&mrkid=905528> Fierce



By Ilene MacDonald

A brief, overnight government shutdown came to an end Friday morning when
President Donald Trump signed a $400 billion, two-year bipartisan, budget
deal that includes funding for several major healthcare programs, including
the Children's Health Insurance Program (CHIP), community health centers and
initiatives to combat the opioid crisis.

The spending deal lifts budget caps to increase defense and domestic
spending over the next two years, but will increase the national deficit by
roughly $320 billion. The addition to the deficit led Sen. Rand Paul, R-Ky.,
to protest the bill, delaying a Senate vote past the midnight deadline and
forcing a government shutdown.

But Senate leaders won a motion to take up the bill at 1:00 a.m. and then
voted 71 to 28 in favor of the budget deal, which includes a six-week
temporary funding bill that will keep the government operating until March
23 to provide time to implement the full budget pact. The House voted
240-186 to approve the bill a few hours later, and Trump signed the bill
just as federal workers were about to begin their work day.

The deal provides funding for several healthcare programs, but doesn't
include language to protect so-called dreamers, young immigrants who were
brought to the country by their parents without proper documentation.

That issue led to a three-day government shutdown three weeks ago that only
ended when majority leader Sen. Mitch McConnell, R-Ky., promised to take up
debate on immigration issues if the Senate hadn't reached agreement on
Deferred Action for Childhood Arrivals (DACA) by early February.  That
debate is set to begin next week, CNN reports. However, House Minority
leader Nancy Pelosi, D-Calif., voted against the bill after speaking for
eight hours, where she criticized House Speaker Paul Ryan for failing to
commit to schedule a vote to protect dreamers. Trump announced that program,
which protects immigrants from deportation, will end on March 5.

The budget pact does secure funding for two years for several health
programs that have been in limbo. It reauthorizes community health centers
for two years and authorizes CHIP for another four years, in addition to a
recent six-year extension. It also provides:

*	    $6 billion to combat the opioid crisis and treatment of mental
health issues
*	    $2 billion for National Institutes of Health research
*	    $90 billion in disaster relief

The deal also will:

*	    Accelerate the closing of the "doughnut hole" in Medicare drug
*	    Repeals the controversial Independent Payment Advisory Board
*	    Funds the National Quality Forum, National Health Service Corps
and the Teaching Health Center Graduate Medical Education program
*	    Delays spending cuts to disproportionate share hospitals
*	    Makes reforms to the VA Choice program, which allows veterans to
receive care from providers in the private sector


Healthcare stakeholders praised the passage of the bill. The American
Medical Association sent FierceHealthcare a copy of the letter it sent to
Congress on Thursday. The AMA said it supports the bipartisan legislation,
which will provide funding and stability for important healthcare programs,
and also make improvements that will allow physicians, Congress and the
administration to work together to implement payment systems focused on
quality and value.


The Healthcare Leadership Council said in a statement that it was especially
pleased with the repeal of IPAB, which eliminates the threat of reduced
access to care as a result of that board making arbitrary budget cuts to
Medicare. And the Association of American Medical Colleges said that the
deal will help safety-net hospitals continue to serve vulnerable patients.




Jeff Wells
Deputy Editor, CAL/AAEM News Service


Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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