At the end of last week, Congress approved, and the President signed into law, a $1.3 trillion spending package, the Consolidated Appropriations Act of 2018 or H.R. 1625, finalizing discretionary spending for the 12 annual spending bills for Fiscal Year (FY) 2018.  Pursuant to the increased defense and non-defense spending caps set by the February Bipartisan Budget Act, H.R. 1625 provided $138 billion more than FY 2017 funding.  No Affordable Care Act stabilization measures were included in this appropriations package  (see related Bipartisan Health Care Stabilization article).

The Department of Health and Human Services (HHS) was appropriated $88 billion, a $10 billion increase over FY 2017 funding.  Within the HHS budget, the National Institutes of Health received $37.1 billion, a $10 billion increase over FY 2017 funding and including $100 million toward the development of a universal flu vaccine.  The omnibus includes $315 million for Children’s Hospitals Graduate Medical Education, $15 million more than FY 2017, and $290.8 million for rural health programs, $135 million more than FY 2017.

To address the opioid crisis, the bill provides over $4 billion across a number of federal agencies, including HHS, the Department of Homeland Security, the Department of Justice, and the Department of Veterans Affairs.  Of this amount, $1 billion is allocated to fund state opioid response grants.

The Consolidated Appropriations Act contained relatively few health policy provisions.  The bill did extend pass-through payment status for a limited number of new drugs biologics, for which pass-through status expired at the end of 2017 and for which payment was bundled.  The bill did not include changes to the Medicare Part D coverage gap, which was amended by the February Bipartisan Budget Act to close the so-called “donut hole” one year sooner by requiring pharmaceutical manufacturers to pay 70%, as opposed to 50% of coverage gap beginning next year.