Update: Senate Passes LHHS Appropriations Bill

Update 9/4/18: The House will go to conference with Senate lawmakers on the DoD / Labor-HHS spending package instead of voting on their own. First, the conference agreement for the Energy-Water/MilCon-VA/Legislative Branch Minibus will be taken up, possibly as early as this week. After passage of the first Minibus, Senate Majority Leader Mitch McConnell says he'd like to move to conference on the two other minibuses already passed: Ag-FDA/T-HUD/Financial Services/Interior-Environment AND Defense/Labor-HHS.

When a date for the conference on the Labor-HHS Bill is announced, we will update Members.


Original post: Last night the Senate passed a bill with hundreds of millions of increases in rural funding.  NRHA has long fought for these significant increases in the rural health safety net. The Senate’s package included legislation funding the Department of Defense, the Department of Labor, and the Department of Health and Human Services (HHS).

As we discussed on the blog earlier this week, the base bill funding HHS included key provisions for critical rural programs including more money to fund treatment and programs addressing the opioid crisis, increases to funding at the National Institutes of Health (NIH) for important research, and additions to many programs to help better target money to rural communities that are in desperate need of funding.

Even further, many of our rural health advocates offered additional amendments to support health care in rural communities. The final bill included a number of additional rural amendments:

  • Senators Lisa Murkowski (R-AK) and Heidi Heitkamp (D-BD) included an amendment to improve obstetric care for women living in rural areas by awarding up to $1,000,000 for grants for the purchase and implementation of telehealth services or other necessary technology and equipment to improve care coordination and delivery for pregnant women in rural America.  
  • Senators Joe Manchin (D-WV), Shelley Moore Capito (R-WV), Sherrod Brown (D-OH), and Bob Casey (D-PA) added an amendment that would require a report to Congress on potential barriers to participation in the Coal Worker's Health Surveillance program. Many coal workers live in rural Appalachia and face significant barriers to accessing care. We look forward to seeing this report and to the information it will provide on improving the health of coal workers across our rural communities.
  • Two additional promising amendments regarding substance abuse and Neonatal Abstinence Syndrome are being analyzed by NRHA’s Government Affairs Team. We will keep members updated when we have further information.

With the passage of the Defense and Labor-HHS measures, the two largest of the 12 spending bills Congress is typically required to pass annually, the Senate has now debated the largest number of annual appropriations bills on the floor since 2009. This is the quickest an appropriations package has moved since 1994. We hope, as the power now turns to the House of Representatives, that they will also work across the aisle to ensure that rural patients and health care providers have the security and funding they need.

The House has already passed its own Defense bill but has not taken up the Labor-HHS bill. The House has two choices: they can either go to conference with the Senate on the Defense/Labor-HHS minibus because the House has passed its Defense measure, or it could take up the Senate minibus package, though many in Washington feel this is unlikely.

We appreciate the massive funding increase the Senate is sending to our rural communities, and we thank the many members who helped contribute key stories and facts to help make this possible. As the funding process continues, NRHA will continue to monitor all legislation relevant to rural heath and update members.

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