Appropriations nears finish line, major health changes left out

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The Big Story 

Congress is poised to finally finish the 2024 appropriations package, which would fund the Department of Health and Human Services among other agencies. 

© Greg Nash

The agreement, which passed the House earlier Friday, gives a slight boost to HHS but previously agreed-upon budget caps meant the increase was essentially flat. It would fund HHS at $116.8 billion for fiscal 2024 — a small bump over the $115.4 billion enacted level 

But by coming to an agreement, lawmakers avoided an across-the-board 1 percent sequester cut. 

Most of the contentious health changes were stripped out. Changes to the pharmacy benefit manager (PBM) industry and hospital payment reforms were excluded from the $1.2 trillion government funding bill, after members failed to come to a last-minute agreement. 

Those major legislative changes will now likely have to wait until a year-end “lame duck” session.  

“The path [forward] is every single opportunity until we get it done. This ought to have been done yesterday,” Senate Finance Committee Chair Ron Wyden (D-Ore.) told reporters, adding that the number of people involved made it difficult to make everyone happy. 

“It wasn’t even really four corners. You know, the traditional Capitol Hill lingo…I think it was more like five or six corners, and threading the needle is a challenge. We got some work to do in the House,” Wyden said. 

At the same time, the controversial anti-abortion riders House Republicans tucked into nearly every major spending bill were also excluded.  

Lawmakers touted “meaningful investments” for Alzheimer’s research. The National Institutes of Health will get a $300 million boost in base funding from current levels, with $100 million going to Alzheimer’s disease and related dementias research.  

PEPFAR, the flagship U.S. program to combat HIV and AIDS abroad, got a one-year extension, the first time since its inception the program wasn’t reauthorized for five years. The extension keeps funding flat through March 2025, but it won’t impose any anti-abortion restrictions sought by conservatives.  

Congress faces a midnight deadline before funding lapses. 

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Around the Nation 

Local and state headlines on health care:

• Air quality health alert issued as wildfires continue to burn across Virginia (WFXR)

• What HCA has told feds it’s doing to fix staffing issues at Mission Hospital. Why nurses say it’s not happening. (North Carolina Health News)

• Texas Medical Board proposes new guidance for abortion medical exceptions (Texas Tribune)

What We’re Reading 

Health news we’ve flagged from other outlets:

• What’s next for the Coronavirus? (The New York Times)

• Social Security chief testifies in Senate about plans to stop ‘clawback cruelty’ (KFF Health News)

• Pharmaceutical companies worry the Supreme Court’s abortion pill ruling could have a wider effect on drugs and research (The 19th News)

What Others are Reading 

Most read stories on The Hill right now:

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What People Think 

Opinions related to health submitted to The Hill:

• Patients deserve to know whether private equity owns their health care

• Congress should urgently reauthorize America’s key to pandemic preparedness

You’re all caught up. See you Monday!