Congress is working to pass a $1.7 trillion omnibus spending package before a Friday deadline, which would lead to a federal government shutdown.
The omnibus bill, which was unveiled on Tuesday, contains significant appropriations for defense funding, emergency assistance to Ukraine and aid for nationwide environmental crises like flooding or wildfires.
As it relates to healthcare, the bill also includes $9.2 billion for the Centers for Disease Control and Prevention, as well as funds for the Indian Health Service and provisions addressing the ongoing opioid and mental health crises.
Notably, however, COVID-19 funding was left out of this bill.
“The omnibus is aggressive, generous and far-reaching in health care, making it more affordable, more extensive,” Senate Majority Leader Chuck Schumer, D-N.Y., said this week. “The sooner we pass the omnibus, the better.”
A significant chunk of money is being set aside to fund healthcare research, including $47.5 billion toward the National Institutes of Health, marking a 5.6% increase from previous funding levels.
The bill also dictates that the Advanced Research Projects Agency, or ARPA-H – President Biden’s newly launched agency that aims to boost breakthroughs in medicine – would receive $1.5 billion and be considered a part of the NIH. This follows the debate over where the new agency would be held.
The package also includes a $760 million increase to the CDC, accounting for “fundamental public health activities” across public health infrastructure and infectious disease, according to an overview of the bill. The funding comes after CDC Director Rochelle Walensky launched an internal review of the agency earlier this year and called for an agency revamp to better respond to future health crises.
Some of the most significant health focuses in the bill, however, can be found in the opioid epidemic provisions, which aim to battle the continuous high rates of overdose deaths.
Nearly $5 billion will go toward tackling opioid misuse, marking a $345 million increase. That includes $1.6 billion that will go toward states through the State Opioid Resource Grant, as well as funds for medication-assisted treatment, opioid overdose surveillance at the CDC and rural communities especially hard-hit by the crisis.
The omnibus would also make it easier for healthcare providers to prescribe buprenorphine, which treats substance abuse disorder and opioid addiction.
Additionally, the bill also hones in on mental health. More than $1 billion in the package would go toward the Community Mental Health Services Block Grant to bolster mental health services throughout the U.S. It would also infuse $500 million – nearly doubling previous funding – into the 988 mental health hotline launched in July.
The package would also give the IHS more stable funding through an advance appropriation, or money through the 2024 fiscal year, so that the agency won’t have to worry about temporary funding next year.
Meanwhile, the Food and Drug Administration would see some changes in regards to the accelerated approval pathway, if this version of the omnibus is passed. Another provision would officially give the FDA the ability to require pharma companies to provide post-approval studies if their drugs are sent through the process.
One provision would establish an intra-agency council that would be tasked with making sure the accelerated approval pathway is being held to proper standards. Those measures come after the pathway has received increased scrutiny in the past several years, partially due to the controversial approval of Biogen’s Alzheimer’s drug, Aduhelm.
But pandemic aid was entirely left out of the package, despite a $10 billion request from the Biden administration last month for more COVID-19 aid.That’s in line with the federal government’s preparations to eventually end the public health emergency for COVID-19 and wind down its programs to buy up vaccines, treatments and tests for the public. A lack of COVID-19 aid in the omnibus also means the government won’t be investing in the development of new vaccines that would target future variants, at least for now.