A $1 trillion spending bill that funds the government through Sept. 30 restores money for some health programs but delivers a blow to the Affordable Care Act.
Even so, President Obama is expected to sign it.
The House approved the Consolidated Appropriations Act for FY 2014 (H.R. 3547) on Jan. 15 by a vote of 359-67, and the Senate approved it a day later 72-26.
Republican members of the House Appropriations Committee added language to the bill that puts a hold on any new funding for the ACA in fiscal 2014 and takes $1 billion out of the law’s Prevention and Public Health Fund. The fund is hotly contested and has been labeled a "slush fund," by opponents.
The House Appropriations panel also succeeded in cutting $10 million in funding for the Independent Payment Advisory Board (IPAB). The IPAB was due to make its first recommendations by mid-January; however, the Obama administration has yet to appoint any members.
The spending bill continues to ban the use federal funds for needle exchanges; for research that creates or uses embryos; and for abortion, except in the case of rape, incest, or endangerment of the life of the mother.
The bill includes a $3.7 billion budget for the Centers for Medicare and Medicaid Services – almost $200 million less than it received in fiscal year 2013 but equal to what it would receive under sequestration. Some $305 million is earmarked for the timely processing and payment of benefits.
The bill increases funding for other federal health-related agencies. The National Institutes of Health budget was increased $1 billion, which should allow it to begin 385 clinical trials, according to the Senate Appropriations Committee.
There is new funding for the Brain Research through Advancing of Innovative Neurotechnologies (BRAIN) Initiative, and funding for an initiative to study prevention and treatments for Alzheimer’s disease.
Mental health programs at various labor, health, and education agencies will receive $1.13 billion, an increase of $213 million, according to the Senate panel. Those programs include violence prevention and grants to schools to help train teachers and to help build a mental health workforce. The Senate Committee estimates that new training will help add 4,375 social workers, psychologists, therapists and other mental health professionals to the behavioral health workforce. The Substance Abuse and Mental Health Services Administration received a $144 million increase in its budget, bringing it to $3.6 billion.
Funding for the Centers for Disease Control and Prevention was increased $567 million to $6.9 billion. That budget includes $30 million to support the Advanced Molecular Detection initiative, which helps the agency detect and stop infectious disease outbreaks and $160 million for the Preventive Health & Health Services Block Grant.
The legislation also includes $3.6 billion to improve the quantity and quality of health care services in medically underserved areas and populations. As part of that, $350 million is appropriated to create more than 450 new community health centers and expand services at existing ones.
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