Bipartisan Budget Acts (Raising the Caps)


LINK TO UPDATED 2018 SENATE-HOUSE CALENDAR  


BIPARTISAN BUDGET ACTS

BACKGROUND ON BBA-18:

Increasing the Discretionary Spending Caps:

  • The Bipartisan Budget Act of 2018 raised the statutory caps on discretionary spending by a total of $296 billion over FY’18 and FY’19.
  • Defense caps:
    • FY’18 increased from $549 billion to $629 billion (+$80 billion, 15%)
    • FY”19 increased from $562 billion to $647 billion (+$85 billion, 15%)
  • Non-Defense caps: 
    • FY’18 increased from $516 billion to $579 billion (+$63 billion, 12%)
    • FY’19 increased from $529 billion to $597 billion (+$68 billion, 13%)
  • Background on the discretionary spending caps:
    • “Discretionary spending” is the portion of the Federal budget (about 30 percent) that is appropriated each year by Congress and is allocated roughly half to defense and half to non-defense programs.  (The remaining 70% of the budget is entitlement programs and interest payments).
    • Defense and non-defense discretionary spending caps were originally put in place in 2011 as part of debt ceiling negotiations and were lowered further in 2013 (by automatic reductions called “sequestration”) when a special congressional committee failed to achieve deficit reduction from entitlement reforms and new revenues.
    • However, Congress quickly backed away from the sequester-level caps on discretionary spending and raised the caps in bipartisan budget agreements in late 2013 (for FY’14 and ’15), in 2015 (for FY’16 and ’17), and now in 2018 (for FY’18 and FY’19).
    • The same issue will arise in 2019 with regard to raising the statutory caps for FY’20 and FY’21.
    • See the Chart showing current spending caps for FY’20 and ’21.

Continuing Resolution Through 3/23/18:

  • Provides time for negotiating FY’18 appropriations consistent with the new caps.
  • CR also includes provisions relating to the 2020 Decennial Census; the Strategic Petroleum Reserve; the Southeastern Power Administration; juror fees; the Federal Family Education Loan program; the F-35A program; the Department of Transportation credit programs; authorization of the HOPE VI program; Indian Health Service facilities; and requirements for public institutions of higher education operating in severely economically distressed communities.
  • Read the Appropriations Committee CR summary

Debt Ceiling Suspension Through 3/1/19:

  • The Act suspends the Debt Ceiling through March 1, 2019 in order to avert a Treasury default next month.

Disaster Funds:

Health Provisions:

  • Community Health Centers, CHIP, and Public Health:
    • Extends and increases mandatory funding for community health centers to $3.8 billion for FY18 and $4 billion for FY19
    • Children’s Health: extends CHIP an additional 4 years for a total authorization of 10 years.
    • Extends mandatory funding for the National Health Service Corps at the current level of $310 million per year in FY18 and FY19.
    • Extends and increases funding for the Teaching Health Center Graduate Medical Education (GME) Program to $126.5 million per year in FY18 and FY19;
    • Extends mandatory funding for both the Special Diabetes Program for Type 1 Diabetes and the Special Diabetes Program for Indians at $150 million per year in FY18 and FY19;
    • Reauthorizes the Maternal, Infant, and Early Childhood Home Visiting Program; and
    • Significantly reduces funding for the Prevention and Public Health Fund set up by the ACA to improve disease prevention at the clinical and community level [see background article, “How will CDC cuts affect health programs abroad and at home.”
  • Medicaid
    • Delays for two years cuts to Medicaid Disproportionate Share Hospital (DSH) payments, which assist hospitals and health systems that care for vulnerable populations—children, the poor, the disabled and the elderly–while maintaining the $4 billion in reductions for FY20 and setting the amount of reductions for FY21 through FY25 at $8 billion per year.
  • Medicare:
    • The bill repeals the Independent Payment Advisory Board (IPAB) established by the Affordable Care Act to develop cost-containment measures for Medicare.  Opponents of IPAB have complained about the authority of IPAB to put cost containment measures into effect unless replaced or overturned by Congress (Background on IPAB);
    • Repeals the Medicare payment caps for outpatient therapy services;
    • Increases the availability of telehealth services;
    • Reauthorizes and amends Medicare Advantage (MA) Plans;
    • Extends through 2022 the Medicare Dependent Hospital (MDH) Program and the Medicare Low-Volume Hospital Program as well as other “Medicare extenders”;
    • Includes the CHRONIC Care Act relating to dialysis, special needs plans, telehealth, Accountable Care Organizations (ACOs) and other provisions;
    • Includes the Medicare Part B Improvement Act; and includes numerous additional changes to Medicare policies dealing with physician payments, the Medicare Advantage (MA) program, Accountable Care Organizations (ACOs), the Geographic Practice Cost Index, radiation therapy services, home health services,  eligibility for the Intensive Cardiac Rehabilitation Benefit, outpatient therapy supervision, long-term care hospital payments, ambulance services, and other programs and procedures.

Foster Care

  • provisions aimed at keeping children out of foster care and with their families including:
  • funds for mental health and substance use treatment programs or parenting skills programs to assist parents at risk of losing their children; and
  • extending funding for services provided for family reunification if a child returns home from foster care

Aid to Farmers

Tax Extenders:

Agreement to Fund Opioids, Infrastructure, Child Care, Vets, NIH, College:

  • The Bipartisan Agreement that lead to the Budget Act assumes that the forthcoming omnibus appropriations bill, will include the following funds:
    • Opioids and Mental Health: $3 billion for FY18 (and $3 billion for FY19) to combat the substance abuse epidemic, including enhanced state grants (with additional assistance for those states with the highest mortality rates and tribes), public prevention programs, and law enforcement activities related to substance abuse and mental health programs;
    • Infrastructure:  $10 billion for FY18 (and $10 billion for FY19) to invest in infrastructure, including programs related to rural water and wastewater, clean and safe drinking water, rural broadband, energy, innovative capital projects, and surface transportation;
    • Child Care: $2.9 billion for FY 18 (and $2.9 billion for FY 19) for child care, including the Child Care and Development Block Grants (CCDBG);
    • Veterans: $2 billion for FY18 (and $2 billion for FY19) to reduce the VA healthcare maintenance backlog;
    • National Institutes of Health: $1 billion for FY18 (and $1 billion for FY19) to support additional scientific research; and
    • College Affordability: $2 billion for FY18 (and $2 billion FY19) for student-centered programs that aid college completion and affordability, including those that help police officers, teachers, and firefighters.

Select Committees on Pensions, Budget Process:  

  • Joint Select Committee on Solvency of Multiemployer Pension Plans to be established to develop legislation to address underfunded multiemployer pension plans (background on Multiemployer Defined Benefit Pension Plans and Multiemployer Composite Plans).
  • Joint Select Committee on Budget and Appropriations Process Reform to consider budget process and appropriations reform legislationMembers named thus far:
    • House Speaker Paul Ryan (R-WI) named House Budget Chairman Steve Womack, R-Ark., House Rules Chairman Pete Sessions, R-TX, and GOP Reps. Rob Woodall of Georgia and Jodey Arrington of Texas.
    • House Minority Leader Nancy Pelosi selected House Appropriations ranking member Nita M. Lowey, D-N.Y., Budget ranking member John Yarmuth, D-Ky., Lucille Roybal-Allard, D-Calif., and Derek Kilmer, D-Wash.

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