Health Highlights In Congress’ $1.4 Trillion Spending Bill: Tobacco Age, ‘Cadillac Tax,’ Medical Research And More

The New York Times: Spending Deal To Avert Shutdown Carries Key Priorities For Both Parties
Lawmakers on Monday unveiled a dozen bills that would allocate $1.4 trillion in federal spending for the remainder of the fiscal year to prevent the government from shutting down at midnight on Friday. The legislation, divided into two packages, provides funding for all federal agencies and departments and for extending a number of community and health programs. The measures drew bipartisan support after months of gridlock, and gave members of each party something to brag about. (Cochrane, 12/16)

Reuters: U.S. Spending Deal Would Raise Tobacco Age, Deny Some Trump Border Wall Money
Congress would raise the U.S. tobacco purchasing age to 21 and permanently repeal several of the Affordable Care Act's taxes under a massive government spending bill unveiled on Monday. ... The crackdown on youth smoking, by changing the minimum age for cigarette and other tobacco purchases to 21 from the current 18, would give the U.S. Food and Drug Administration six months to develop regulations. The agency would then have three years to work with states on implementing the change. (Cowan and Cornwell, 12/16)

CNN: Measure To Raise Legal Age For Tobacco Sales To 21 Is Among Provisions Attached To Spending Bills
The restriction on tobacco sales has long been a push by a somewhat odd compilation of members, ranging from Senate Majority Leader Mitch McConnell a Kentucky Republican, and Republican Sens. Mitt Romney of Utah and Todd Young of Indiana, and some of the chamber's top Democrats, including Sens. Richard Durbin of Illinois, Tim Kaine of Virginia and Brian Schatz of Hawaii. Those lawmakers have been looking for a means to get the prohibition across the finish line, and now they've found one by attaching it to a must-pass series of bills to avoid a government shutdown. (Mattingly and Kelly, 12/16)

The Washington Post: Congress Set To Prohibit Sales Of Tobacco To Anyone Under 21
Public health advocates praised the move, saying it would help reduce kids’ access to vaping products. But they stressed much more action is needed to reverse the youth vaping surge. And several expressed concern that the White House will use the “Tobacco 21” measure, as it is called, to avoid imposing the ban on flavored e-cigarettes that Trump announced in September but subsequently backed away from. (McGinley and Abutaleb, 12/16)

ABC News: Congress Could Raise Federal Age To Buy Tobacco To 21 As Part Of Spending Bill
The change would lead to a "substantial reduction" in smoking among young people, according to the report from the National Academy of Medicine, and that by the time today's teenagers were adults it could decrease the prevalence of tobacco use by 12%, as well as decreasing health problems attributed to tobacco use. "It's both a positive step and we have to make it a very important caution," Matthew Myers, president of the Campaign for Tobacco-Free Kids, told ABC News Live. (Ebbs and Turner, 12/16)

The Associated Press: Budget Deal Puts Access To Health Care Above Curbing Costs
The deal would repeal a cost-control measure in “Obamacare” known as the Cadillac Tax, an unpopular levy on benefit-rich health insurance plans scheduled to take effect in 2022. That means Congress is upsetting the balance between expanding access and controlling costs that former President Barack Obama tried to strike in his signature law, said Kathleen Sebelius, who served as his health secretary. “President Obama thought it was very important to have additional access paid for,” said Sebelius. “This just takes a big step backwards.” (Alonso-Zaldivar, 12/16)

The Wall Street Journal: Federal Spending Agreement Adds Up To Nearly $1.4 Trillion
The repeal of the health-care taxes would be a windfall for the industry. Absent from the agreement is an effort to protect consumers from surprise, out-of-network medical bills despite a monthslong congressional effort to craft a workable, bipartisan proposal. (Duehren and Rubin, 12/16)

Politico: Congress To Repeal 3 Major Health Taxes, Fund Gun Violence Research In Year-End Spending Deal
It is also expected to extend expiring health care programs through May 22, and notably, it doesn’t include a last-ditch effort from key committee leaders to pass legislation protecting consumers from getting slapped with “surprise” medical bills. The short-term extension could give surprise billing a vehicle to ride on next year, according to a senior House Democratic aide. And Congress is also aiming to ban the sale of tobacco products to people under 21. (Luthi and Emma, 12/16)

Politico: Congress Debuts $1.37T Spending Deal That Sidesteps Border Fight
The legislation would also provide $41.7 billion for medical research at the NIH, a nearly 7 percent increase over current funding. Republican leaders are touting the fact that the deal does not include new funding or directives for international efforts to aid family planning and reproductive health. They are proud that the legislation would deliver a $22 billion increase in defense spending, as well as a 3.1 percent military pay increase — the largest bump in a decade. (Scholtes and Emma, 12/16)

Politico Pro: Year-End Spending Deal Punts On Thorniest Health Policy Fights
Congress spent most of the year debating what to do about drug prices and “surprise” medical bills, but lawmakers largely punted on both issues in their year-end spending package. The minibus spending bill (H.R. 1865) — likely the last piece of legislation on which health provisions could hitch a ride this year — instead delivers a major gift to health care interests by killing three Obamacare taxes. (Roubein, 12/17)

Modern Healthcare: Budget Deal Repeals Affordable Care Act Taxes, Delays DSH Cuts
Compromise legislation to address surprise medical bills and a major drug-pricing package, however, were left out of the year-end deal. And lawmakers delayed long-term action on funding expiration for several healthcare priorities until May 22, which provides another potential vehicle for those larger packages. Senate health committee Chair Lamar Alexander (R-Tenn.), House Energy and Commerce Chair Frank Pallone (D-N.J.) and Energy and Commerce ranking Republican Greg Walden of Oregon on Dec. 8 released surprise billing legislation that the leaders wanted included in a year-end spending deal, but the effort petered out after leaders of the Ways and Means Committee released vague outlines of a rival proposal and called for the issue to be considered in the new year. (Cohrs, 12/16)

The Hill: Funding Deal Blocks Trump ObamaCare Moves, Repeals Health Taxes 
The deal does include one relatively small bill to lower drug prices, called the Creates Act, which cracks down on drug companies gaming the system to delay the introduction of cheaper generic competitors. (Sullivan, 12/16)

Reuters: 'Havana Syndrome' U.S. Diplomats Get Benefits In Spending Bill
U.S. diplomats who mysteriously fell ill in Cuba and China would get long-term emergency health and other benefits under a $1.4 trillion spending bill lawmakers unveiled on Monday. Over 40 U.S. government employees were affected by the incidents, which started in 2017 and have not been explained. They helped lead President Donald Trump to reduce staffing at the country's mission in Havana. (12/16)

Bloomberg: Congress Jams Tax Repeals In $1.4 Trillion Spending Bills
The deal would also extend the National Flood Insurance Program’s authorization to Sept. 30 and the Terrorism Risk Insurance program for seven years. The spending agreement includes the Bipartisan American Miners Act of 2019 to prevent insolvency of the 1974 UMWA Pension Plan. Further, this provision extends health retirement benefits to miners impacted by coal company bankruptcies that took place in 2018 and 2019. Without this provision, 92,000 coal miners’ pensions and the health care benefits for 13,000 miners would have been at risk. West Virginia Senator Joe Manchin said last week he would delay all Senate business until the miner’s provision was inserted into the funding package. (Wasson and Davison, 12/16)

NPR: From Border Security To Tobacco Age, Both Parties Tout Key Wins In Spending Deal
On Monday, Pelosi touted wins in the agreement. "All Democrats can take great pride in this strong appropriations package, which achieves critical victories for the health, financial security and well-being of the American people," Pelosi said in a statement Monday evening. "With this agreement, Democrats are protecting the quality, affordable health care of millions by permanently repealing health care taxes and preventing the President from waging further health care sabotage." (Grisales, 12/16)