�Թϲ�����

Democratic voters eager to see “Medicare for all” or some other major health overhaul pass the next time they control the White House may want to take a close look at what happened this week in Congress. Leaders from both parties had unveiled legislation to stop surprise medical bills, the often exorbitant bills faced by patients when they go to a hospital that takes their insurance but are treated by a doctor who does not. The White House and major consumer groups had also endorsed the plan, which was to be included in the year-end spending bill. But to the negotiators’ consternation, the spending package that emerged on Monday — and was passed on Tuesday by the House — had nothing about surprise bills. (Sanger-Katz, 12/17)

The House on Tuesday approved a $1.4 trillion spending package that would stave off a looming shutdown and fund the federal government through September, acting in a burst of bipartisanship just a day before Democrats plan to impeach President Trump. The legislation would also remove three controversial taxes from the Affordable Care Act, the 2010 law that was a top legislative achievement of President Barack Obama. (Werner and DeBonis, 12/17)

The sweeping legislation, introduced as two packages for political and tactical purposes, is part of a major final burst of legislation that’s passing Congress this week despite bitter partisan divisions and Wednesday’s likely impeachment of Trump. Thursday promises a vote on a major rewrite of the North American Free Trade Agreement, while the Senate is about to send the president the annual defense policy bill for the 59th year in a row. (12/17)

The repeal of three ObamaCare taxes in the bipartisan government funding deal poised to pass Congress this week will deprive the government of $373.3 billion over 10 years, according to a nonpartisan analysis. The analysis released Tuesday by Congress’s Joint Committee on Taxation, the companion of the Congressional Budget Office, analyzed the cost of repealing three taxes that were passed in ObamaCare as a way to help fund the law’s coverage expansion. (Sullivan, 12/17)

Just in time for the holidays, Congress appears ready to give health insurers several gifts in its year-end spending deal, unveiled Monday and passed by the U.S. House of Representatives Tuesday. One of those includes a permanent repeal of a loathed industry tax that insurers have been lobbying to kill for years. Commercial health insurers serving employers and individuals generally passed that tax, known as the HIT, along to their members in the form of higher premiums. Medicaid managed-care insurers are reimbursed for the tax by the states they contract with. (Livingston, 12/17)

Congress is moving to pass the biggest new sales restrictions on tobacco products in more than a decade, with support from two unlikely backers: Marlboro-cigarette maker Altria and vaping giant Juul Labs. The legislation would raise the minimum age to purchase all tobacco products, including electronic cigarettes, from 18 to 21 nationwide, a step long-sought by health advocates. (Perrone and Lardner, 12/17)

Doctors and advocates are hopeful that new funding for federal agencies to study gun violence will prove to be the first step in preventing mass shootings, suicides and other firearm deaths. For the first time in 23 years, a government spending bill will set aside funds — in this case, $25 million — for the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) to collect data on what the American Medical Association has called a public health crisis. (Hellmann, 12/18)

Among the many provisions included is one that California and other Western states still recovering from destructive wildfires have sought for years. It ends a long-standing practice known as “fire-borrowing,” which required the U.S. Forest Service to raid its other funds whenever it ran out of money to pay for fighting wildfires. Faced with increasingly long and costly fire seasons, the Forest Service often wound up strapped for cash as a result of a firefighting budget that amounted to a fraction of what it actually cost to fight fires. (Phillips, 12/17)

President Donald Trump intervened to cut the federal government's Medicaid funding for Puerto Rico as part of a larger government spending deal, according to four sources with knowledge of the discussions. The budget deal unveiled by lawmakers this week allocates up to $5.7 billion in Medicaid funds for the island over two years — instead of $12 billion over four years that Republican and Democratic leaders on two key congressional committees had endorsed after months of negotiating a long-term financial path for Puerto Rico. (Pradhan, 12/17)

Lawmakers quietly tucked a boost for the pharmaceutical industry in the massive, end-of-year spending package they unveiled late Monday — a surprising turn for a Congress that has, at least rhetorically, pushed to rein in pharma’s high prices. The provision, just three lines and 17 words in a 1173-page bill, would effectively expand the definition of biologic drugs, a category that includes presumably more complicated medicines made from living cells. (Florko, 12/17)

Special Olympics spared from cuts: The Trump administration tried to kill the popular program in its budget. Education Secretary Betsy DeVos defended the cut before Congress. But after the administration faced backlash on social media and from lawmakers, President Donald Trump said he had “overridden” his people to restore funding for the games. Now, Special Olympics funding will rise to $20.1 million, a more than 14 percent boost. (12/17)

The U.S. Congress on Tuesday approved the largest overhaul to the American military’s housing program in more than two decades, vowing to end slum-like living conditions and hold private landlords and defense officials accountable for them. The reforms, included in the yearly National Defense Authorization Act, aim to protect some 200,000 military families living on U.S. bases from health hazards including mold, lead, asbestos and pest infestations. (12/17)

The U.S. House on Tuesday approved a $1.4 trillion spending package that would significantly boost defense spending in Connecticut and increase funding for a slew of social programs as well, including Head Start and child care programs. The spending bill would provide a total of $738 billion in fiscal 2020 funding for the military and $632 billion for non-defense departments such as Education, Housing and Urban Development, and Health and Human Services, increasing spending for both “guns and butter” and adding to the federal deficit. (Radelat, 12/17)