Senate Passes $1.3 Trillion Spending Bill by 65-32 Vote, Avoiding Government Shutdown

In the early hours of Friday morning, the Senate passed a $1.3 trillion federal spending bill funding the government until September. Early Friday afternoon, President Donald Trump signed the bill after threatening in morning tweets that he would veto it.

The House approved the bill on Thursday.

While some expected Senator Rand Paul, R-Kentucky, to create a repeat of last month's brief shutdown, as he decried the spending in the bill, as well as the process, The Washington Post reported he eventually gave in to the pleadings of Senate Majority Leader Mitch McConnell, R-Kentucky. On Thursday, Paul tweeted about the bill throughout the day, posting a picture of himself holding all 2232 pages of the bill after he printed it out in his office.

The bill would boost investment in the National Institutes of Health (NIH) by $3 billion and includes $3.6 billion in opioid funding, according to Senator Lamar Alexander, R-Tennessee, who chairs the Senate Health Committee. His office said that is an increase of $2.55 billion, or 244%, although drug policy experts have said spending on the magnitude of much more is needed to fight the crisis.

The opioid funding includes:

• $500 million for the NIH, including for research to develop a non-addictive pain killer
• $500 million for state opioid grants under the 21st Century Cures Act
• $330 million for law enforcement grant programs, including those that were authorized by the Comprehensive Addiction and Recovery Act (CARA).
• $476 million for HHS grants including funding for state Prescription Drug Monitoring Programs (PDMPs), which are databases that track controlled substance prescriptions, allowing doctors and pharmacists to check a patient’s history.

The funding bill also reopens the path for public health research into gun violence. Such research by the CDC had been banned under the 1996 legislation known as the “Dickey Amendment,” but the new provision partially alters that ban. The Dickey Amendment was supposed to prevent the CDC from advocating for gun control, but it had been interpreted as a blanket prohibition on gun violence research. The new provision will allow CDC to conduct research on the public health impact of gun use, but still prohibits the agency from advocating for gun control.

However, there were also some health measures left out of the bill:

• A provision that would reduce drug companies’ share of costs when beneficiaries reach the Medicare donut hole, as well as the CREATES Act, which would crack down on delay tactics pharmaceutical companies use to prevent competition of cheaper generic drugs.
• A fix to stabilize the Affordable Care Act markets—which had been sought by Senator Susan Collins, R-Maine—including cost-sharing reductions and reinsurance.