Congress Clinches Bipartisan Health Deal

Congressional leaders reached a bipartisan, bicameral health care deal early Tuesday morning they hope lawmakers will pass later this week as part of a four-bill government spending package.

Alongside funding for the departments of Defense, Transportation, Labor, Health and Human Services and Homeland Security through Sept. 30, senior appropriators are proposing a crackdown on drug intermediates known as pharmacy benefit managers, or PBMs.

Lawmakers in both parties and chambers have been working toward reaching a compromise in this policy area for months after a PBM overhaul fell out of the December 2024 government funding bill amid criticism from then-President-elect Donald Trump and billionaire ally Elon Musk.

The health care agreement would extend several public health programs, including major telehealth flexibilities, through the end of 2027. It also would fund, through the end of the fiscal year in 2030, a program run through the Centers for Medicare and Medicaid Services that reimburses facilities for offering hospital-level care in the home.

In a major win for Democrats, the deal would boost funding for community health centers to $4.6 billion for fiscal year 2026. Another provision in the package would allow Medicare coverage for multi-cancer early detection screening tests.

It’s not clear whether conservatives in the House will allow the health care deal to go through. Fiscal hawks are due to balk at the spending increases for various programs, and the framework is silent on many of the policies called for last week by President Donald Trump’s “Great Healthcare Plan” — including expansions to tax-advantaged health savings accounts and certain policies mandating lower drug prices.

In a continued blow for members on both sides of the aisle, the agreement also would not revive enhanced Affordable Care Act subsidies that lapsed at the end of last year and are causing premiums to spike for individuals on Obamacare insurance plans.

 

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