On Tuesday, December 20, 2022, Congress released a massive federal spending bill to fund the government through the 2023 fiscal year and avert a shutdown – most recently, the Continuing Resolution was extended through December 23, 2022.This 4,155-page spending package of nearly $1.7 trillion is expected to be signed into law by President Joe Biden at the end of the week.

Below you’ll find some of the important health policy provisions included and excluded from the Omnibus bill that are most pertinent to health centers and our broader community. Please keep in mind that provisions are subject to change until the final bill is passed.

Included Provisions in the Omnibus Bill

Medicaid Coverage:

  1. Beginning April 1, 2023, states will be required to re-start Medicaid eligibility redeterminations. However, states must attempt to contact beneficiaries before they disenroll them from the program.
  2. Gradually phases out the 6.2 percent funding bump states received for not touching their Medicaid rolls amid the pandemic.
  3. Allows states to permanently extend Medicaid coverage for new mothers for 12 months and prohibits children from getting kicked off Medicaid or the Children’s Health Insurance Program for a continuous 12 months, even if their family’s income changes.
  4. Ensures that Puerto Rico’s Medicaid program is funded for the next five years, which prevents more than one million Puerto Ricans from losing their benefits. Additionally, the package increases the federal government’s share of Medicaid costs paid to Puerto Rico to 76 cents.

Medicare Payment Cuts: The Medicare sequester cuts that were scheduled to go into effect on January 1, 2023, will be delayed until at least 2025. The package will prevent 2.5 percentage points of a scheduled 4.5% cut to the Medicare physician fee schedule in 2023, and 1.25 percentage points of cuts in 2024.

Medicare Coverage: Allows oral antiviral drugs, including the COVID-19 pill Paxlovid, to be covered under the Medicare Part D prescription drug benefit.

National Health Service Corps (NHSC) Funding: Increases NHSC funding by $4 million, a 3% increase from the previous year.

Telehealth: Extends Medicare telehealth flexibilities for two years, through December 31, 2024.

IHS Funding: Last month, ACU supported a letter to address chronic clinical staff shortages, especially across Indian Health Service (IHS) through recruiting, retaining, and training health care workers. The agency received an advance appropriation, meaning that the omnibus bill also includes funding for Fiscal Year 2024 (FY24). Therefore, IHS won’t be impacted by any temporary funding measures if Congress fails to pass the FY24 budget before September 30, 2023.

988 Suicide & Crisis Lifeline Funding: The $502 million directed towards 988, the nationwide 3-digit number for mental health crisis and suicide prevention services, represents nearly $400 million more from the previous year.

Opioid Treatment: Providers will no longer be required to get a special waiver from the Drug Enforcement Administration before being able to prescribe buprenorphine, a treatment for opioid addiction. The legislation also improves access to FDA-approved non-opioid therapies for outpatient surgical procedures.

Pandemic Preparedness: Various provisions will aim to change the nation’s pandemic strategy, such as improved disease data collection, greater oversight of health agencies, and requiring the Senate to confirm the director of the Centers for Disease Control and Prevention. The last mandate would start on January 20, 2025.

Nutrition Programs: $13.4 billion increase for Supplemental Nutrition Assistance Program (SNAP); $28.5 billion increase for child nutrition programs and $6 billion increase for Women, Infants, and Children (WIC).

Excluded Provisions in the Omnibus Bill

Expanded Child Tax Credit: The bill doesn’t reinstate the expanded child tax credit.

COVID-19 Relief: This legislation doesn’t provide additional funding for COVID-19 relief. 

Title X Funds: Title X received flat funding of roughly $286 million this year. The federal family planning program provides affordable reproductive health care services.

Next Steps

While the Omnibus Bill is expected to pass and avert a shutdown, health centers still have a vital role to play as we move forward in uplifting the voices of our communities and ensuring that future bills protect and expand key health extender programs, including the NHSC. Keep up-to-date with the latest developments and calls to action by joining our network as an advocate and stay tuned for an upcoming white paper on the National Health Service Corps and more in the near future.

Do you have further questions or need help getting started with advocacy at your health center? Please contact Jordan Marshall, ACU’s Deputy Director of Policy & Advocacy.