Budget, Federal | December 20, 2019

Congress Passes $1.4 Trillion Spending Plan, Averts Government Shutdown

This week, Congress approved final federal appropriations packages for Fiscal Year 2020, which officially began on October 1, 2019. Totaling $1.4 trillion, all of the various appropriations bills were bundled into two separate “minibus” packages – one is for most domestic programs and priorities (plus international assistance) and the other is for national security and commerce and treasury programs and priorities.

Both Congressional Republicans and Democrats made several significant concessions in reaching a final agreement, notably with Republicans securing more funding for national security-related issues and Democrats securing increased funding for domestic programs. Under the new spending plan, federal spending increased by $50 billion in new investments compared to FY 2019. President Donald Trump indicated he will sign the measures by the end of the day today, preventing a federal government shutdown when current funding expires at midnight tonight.

High-level health related issues that were addressed in the agreement include increasing the smoking age to 21 nationwide, the repeal of three Affordable Care Act (ACA) related tax provisions (medical device, Cadillac health plan, and fees on health insurers), and funding for gun-related violence research.

Of particular note to local health departments, the spending package includes:

  • $50 million to support modernizing public health data surveillance and analytics at the U.S. Centers for Disease Control and Prevention (CDC), as well as state and local health departments. Funding is to be used to update antiquated data reporting to a common data platform that will enable the nation’s public health workforce to use real-time data to predict and prevent public health threats in the future.
  • $140 million to the CDC for Ending the HIV Epidemic activities.
  • $70 million to bolster the Ryan White HIV/AIDS program with funds distributed to high-need jurisdictions. The overall Ryan White program will be funded at $2.4 billion, representing an increase of $70 million from FY 2019. An additional $50 million will be directed to health centers in high-need jurisdictions to increase the use of PrEP among high-risk groups.
  • $476 million in continued funding for opioid abuse and overdose prevention with the CDC directed to continue funding to states for their prevention and surveillance activities.
  • $616 million for the 317 Immunization Grants Program, an increase of $5 million from FY 2019, to help assist efforts in combating increased infections of vaccine-preventable diseases such as measles.
  • $230 million to address tobacco and electronic cigarettes, an increase of $20 million from FY 2019. Funding is to be targeted to state and local health departments so they will be able to direct adequate resources to stem the tide of youth use of electronic cigarettes.
  • $675 million for the Public Health Emergency Preparedness program (same as FY 2019).
  • $276 million for the Hospital Preparedness program, an increase of $11 million from FY 2019.
  • $12.5 million directed to the National Institutes of Health to conduct research on firearm injury and mortality prevention.  

A statement regarding the appropriations measures from the National Association of County and City Health Officials (NACCHO) is available here.