Congress strikes two-year budget deal: takeaways for healthcare leaders and benefits brokers

Congress unveiled a two-year budget agreement Friday that would boost federal spending for several health programs.

Here are a few to know about in the budget agreement.

CHIP to be funded for a decade

The budget deal includes an additional four-year extension of the Children’s Health Insurance Program. That extension is on top of the six years of CHIP funding Congress approved in late January.

Funding for community health centers

The plan includes more than $7 billion in funding over two years for the nation’s community health centers. Federal funding for community health centers, which serve more than 27 million people, expired Sept. 30.

Relief for Disproportionate Share Hospitals

The spending deal would delay payment cuts to Disproportionate Share Hospitals mandated by the ACA, which have been pushed back since 2010. Disproportionate Share Hospitals serve a significantly disproportionate number of low-income patients and receive payments from the Centers for Medicaid and Medicare Services to cover the costs of providing care to uninsured patients.

Additional Funding for NIH and NHSC

The budget deal includes $2 billion in additional funding for the National Institutes of Health and $495 million for the National Health Service Corps.

Repeal of the IPAB

The budget deal would repeal the ACA’s Independent Payment Advisory Board, which was intended to hold down Medicare payments if the program’s spending exceeded a certain threshold. Members have never been appointed to the IPAB.

Cut prescription drug costs for seniors

The bill accelerates changes made in the Affordable Care Act to reduce the amount of out-of-pocket costs a senior has to pay for drug coverage. The so-called “doughnut hole” in Medicare’s drug benefit will be eliminated one year earlier than it would have been under the ACA.

Higher Medicare premiums for wealthy

Seniors with incomes of more than $500,000 a year (or $750,000 for a couple) will have to pay a greater share of their Medicare bills. Those highest income earners will owe 85% of program costs, instead of 80% under current law. Most Medicare beneficiaries pay 25%.

Cash for mental health and opioid crisis

Many health initiatives will get a boost, including $6 billion targeted to fight the opioid epidemic and fund mental health initiatives. The legislation extends the government’s major health insurance program for lower-income children an additional four years beyond a six-year renewal Congress recently approved. The bill also increases funding for community health centers, which serve lower-income patients. It delays Medicaid cuts to hospitals that serve large shares of poor people, adds funds to repair and rebuild veterans’ health clinics, and boosts funding for medical research.