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Congressional leaders have finalized a sweeping $1.3 trillion budget bill that substantially boosts military and domestic spending but leaves behind young immigrant "Dreamers," deprives President Donald Trump some of his border wall money and takes only incremental steps to address gun violence. (Taylor and Mascaro, 3/22)

Left out of the bill was a health-care measure sought by GOP Sens. Susan Collins (Maine) and Lamar Alexander (Tenn.) that would have allowed states to establish high-risk pools to help cover costly insurance claims while restoring certain payments to insurers under the Affordable Care Act. Trump, who ended the “cost-sharing reduction” payments in the fall, supported the Collins-Alexander language. But Democrats opposed it because they claimed it included language expanding the existing prohibition on federal funding for abortions. (DeBonis, O'Keefe and Werner, 3/21)

Of the $88 billion HHS appropriation announced Wednesday night, not a penny is going toward Obamacare. Instead, Congress is slapping oversight requirements on HHS regarding its administration of the health exchanges. Congressional leaders released the long-awaited $1.3 trillion, two-year spending omnibus after days of wrangling behind closed doors over contentious policies that included an embattled stabilization package for the individual market that would fund cost-sharing reduction payments and a $30 billion reinsurance pool. (Luthi, 3/21)

Sen. Susan Collins (R-Maine) said Wednesday it is "extremely disappointing" that a bill she backed to stabilize ObamaCare markets was left out of a must-pass government funding bill. Collins voted for the tax reform legislation in December after securing a commitment from Senate Majority Leader Mitch McConnell (R-Ky.) to support the ObamaCare fix. Collins had worried about the repeal of ObamaCare's individual mandate in the tax bill, and the resulting premium increases. She wanted the stability measures to try to make up for that. (Sullivan, 3/21) 

The push to get the cost-sharing payment bill passed took on greater importance after the tax bill signed into law by Trump late last year eliminated the individual mandate in Obamacare, putting more pressure on insurers working in state health exchanges. The impact of the the loss of the mandate and the cost-sharing payments won’t fully be known until insurance companies submit their rates to state insurance commissioners later this spring. (Blethen, 3/21)

Republicans denounced Democrats on Wednesday for opposing a bill aimed at lowering ObamaCare premiums, saying Democrats walked away from a deal so they could blame the GOP for premium increases ahead of the midterm elections. Sen. Lamar Alexander (R-Tenn.), a leader of the push for the bill to stabilize ObamaCare markets, said Democrats were blocking the measure from must-pass government funding legislation this week solely because of abortion-related objections, despite support for the measure from President Trump, Speaker Paul Ryan (R-Wis.) and Senate Majority Leader Mitch McConnell (R-Ky.). (Sullivan, 3/21)

The release of the 2,000-plus-page bill Wednesday evening, after a two-day delay, touched off a legislative sprint as lawmakers try to pass it before Friday night, the deadline to avoid a government shutdown. And with a key senator unwilling to say whether he would agree to accelerate the deal’s consideration, it remained uncertain whether they would be able to meet the challenge. (DeBonis and Werner, 3/21)

“No bill of this size is perfect,” House Speaker Paul Ryan (R., Wis.) said in a statement Wednesday night. “But this legislation addresses important priorities and makes us stronger at home and abroad.” (Peterson and Meckler, 3/22)

Congressional leaders are hoping to avoid the need for a short-term spending bill to keep the government open for a few days beyond Friday. But if the spending bill is released Wednesday as planned, the House will likely vote on the measure Thursday, giving the Senate just one day to clear the deal before funding expires. (Caygle, Everett, Bade and Ferris, 3/21)