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The House gave final approval early Friday to a far-reaching budget deal that will reopen the federal government and boost spending by hundreds of billions of dollars, hours after a one-man blockade by Senator Rand Paul of Kentucky delayed the votes and forced the government to close. With the House’s approval, before dawn and Friday’s workday, the government will reopen before most Americans knew it closed, with a deal to provide $300 billion in additional funds for this fiscal year and next to military and non-military programs, disaster relief for the victims of last year’s hurricanes and wildfires, and a higher statutory debt ceiling. (Kaplan, 2/8)

The 240-to-186 House vote came just after 5 a.m., about three hours after the Senate cleared the legislation on a vote of 71 to 28, with wide bipartisan support. (DeBonis and Werner, 2/9)

The budget deal in Congress is billed as a measure to grant stability to a government funding process that has lurched from crisis to crisis — but it is also stuffed with provisions that will broadly affect the nation’s health care system, like repealing an advisory board to curb Medicare spending and funding community health centers. Many of the provisions have been in gestation for months, even years in some cases. Some will save money. Many will cost money — potentially a lot of money. ... The bill [also] increases discounts that pharmaceutical companies must give seniors enrolled in the Medicare Part D drug plans, by making the so-called “doughnut hole” smaller. This was a policy that was part of the Affordable Care Act, but the new legislation would speed up implementation by one year. (Pear, 2/8)

The bill would kill an unpopular provision of the Affordable Care Act, its Independent Payment Advisory Board, which was devised to help keep Medicare spending growth from rising above a set level. No one has ever been appointed to the board, and its services have not yet been needed — Medicare spending has experienced unusually slow growth rates in recent years — but the board was long denounced by Republicans as a rationing board, and disliked by some Democrats for taking payment policy authority away from Congress. (Sanger-Katz, Plumer, Green and Tankersley, 2/8)

Some Democrats are calling this deal a win because it gives a “historic” boost to nondefense spending. Overall, domestic spending would rise by $60 billion this fiscal year and $78 billion the following year. (Long and Stein, 2/8)

“What makes Democrats proudest of this bill is that after a decade of cuts to programs that help the middle class, we have a dramatic reversal," added Senate Minority Leader Chuck Schumer (D-N.Y.), who helped craft the deal along with Senate Majority Leader Mitch McConnell (R-Ky) and House leaders. "Funding for education, infrastructure, fighting drug abuse, and medical research will all, for the first time in years, get very significant increases, and we have placed Washington on a path to deliver more help to the middle class in the future.” (Bresnahan, Scholtes and Caygle, 2/8)

Drug pricing advocates are decrying the budget deal announced Wednesday for leaving out a bipartisan drug pricing measure that they had pushed for. The measure would prevent branded drug companies from using delay tactics to prevent cheaper generic competitors from coming onto the market. (Sullivan, 2/8)

The Senate's two-year spending caps deal paves the way for lawmakers to include a big insurer ask in their spending omnibus: reinsurance and short-term funding of cost-sharing reduction payments. Reinsurance is the "most important" policy Congress could pass to lower premiums because of the funding backstop and certainty for high-cost coverage of sick enrollees, said Justine Handelman, senior vice president of policy at the Blue Cross and Blue Shield Association. The proposal gaining momentum is a bipartisan House bill by Rep. Ryan Costello (R-Pa.) that would funnel $10 billion annually for three years into a federal funding pool. (Luthi, 2/8)

According to a preliminary analysis of the deal, federal deficits would surpass $1 trillion by 2019, a level not seen since the recession and its aftermath. (Parlapiano, 2/8)