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

Donald Trump speaking
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. (Image: C-SPAN)

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.

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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 coverage
  • Repeals the controversial Independent Payment Advisory Board (IPAB)
  • 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.