$1T Omnibus Spending Plan Maintains ACA Implementation Funding

House and Senate budget negotiators on Monday unveiled an omnibus spending bill that would keep the government funded through September, ease some of the sequester's across-the-board spending cuts and maintain spending levels to implement the Affordable Care Act, the  New York Times reports (Weisman, New York Times, 1/13).

On Tuesday, the House is expected to pass a short-term spending bill (HJ Res 106) that will give lawmakers an additional three days to consider the omnibus package. Negotiators on both sides of the aisle appear optimistic that the bill will get enough bipartisan support to pass (Wasson, "On The Money," The Hill, 1/13).

Overall, the spending package would provide $1.012 trillion for discretionary spending for fiscal year 2014, including $491.7 billion for domestic programs (Hook, Wall Street Journal, 1/13). Senate Appropriations Chair Barbara Mikulski (D-Md.) noted that the bill provides funding for all 12 subcommittees and expressed optimism that "[t]here will be no shutdown" ("On The Money," The Hill, 1/13).

Specifically, the spending bill would reduce Labor-HHS-Education funding by about $100 million from the fiscal year 2013 enacted level, with labor and education programs taking most of the reductions to offset increases in health care spending (Young, CQ Roll Call, 1/13). For example, CDC would be funded at $6.9 billion, a $567 million increase from FY 2013, and FDA would receive nearly $2.6 billion, up $91 million from FY 2013, according to House appropriators.

NIH would receive the biggest increase from FY 2013 spending levels, boosting funding by $1 billion, to $29.9 billion, for FY 2014. The spending package also would provide $115 million for mental health programs through the "Now is the Time" violence-prevention initiative. The spending package also contains a provision that would allow HHS to transfer up to $305 million out of trust funds to program management for Medicare (Young/Attias, CQ Roll Call, 1/13).

In addition, the spending package maintains several abortion riders from previous spending bills, including the so-called Hyde amendment that prohibits Medicaid plans from offering abortion coverage and a ban on federal funding from being used to pay for most abortion procedures, including those in the District of Columbia and federal prisons (Bettelheim, CQ Roll Call, 1/14). However, Mikulski noted that the bill contains no new abortion restrictions ("On The Money," The Hill, 1/13).

Despite GOP opposition, funding for the implementation of the ACA remains mostly intact under the spending bill, the Times reports (New York Times, 1/13).

The bill would keep spending levels for CMS -- the agency largely tasked with implementing the ACA -- at $3.7 billion, which is its funding level under sequestration (Young, CQ Roll Call, 1/13). However, it would cut the ACA's Prevention and Public Health Fund by $1 billion and the Independent Payment Advisory Board's funding by $10 million.

House Appropriations Committee Chair Hal Rogers (R-Ky.) said the $1 billion cut would "prevent the Secretary of Health and Human Services from raiding these funds for ObamaCare exchanges" (Easley, "Healthwatch," The Hill, 1/13).

White House Budget Director Silvia Burwell on Monday praised the compromise package. Burwell said, "Appropriations Chairmen Mikulski and Rogers deserve credit for working together to craft this legislation in a bipartisan and constructive manner. The Administration urges Congress to move quickly to pass it." ("On The Money," The Hill, 1/13).

Sascha Haverfield, vice president for scientific and regulatory affairs at the Pharmaceutical Research and Manufacturers of America, also touted the proposal, noting that the user fee provision "will benefit patients, public health and regulatory science" (Young/Attias, CQ Roll Call, 1/13).

Meanwhile, Carrie Wolinetz, president of United for Medical Research, said the package did not do enough to restore NIH funding, saying that the proposal "won't adequately reverse the damage done by last year's budget sequester and ensure the nation's biomedical research enterprise makes continued progress in lifesaving research and development" (Montgomery/O'Keefe, Washington Post, 1/13).