This week, Congress passed a $1.5 trillion omnibus spending package for fiscal year 2022 with broad bipartisan support. Included in the domestic appropriations are several key healthcare provisions of interest to ACCC and the cancer care community.
This week, Congress passed a $1.5 trillion omnibus spending package for fiscal year 2022 with broad bipartisan support in both the House of Representatives and the Senate. Included in the domestic appropriations are several key healthcare provisions of interest to ACCC and the cancer care community.
Most important, the package would extend Medicare telehealth flexibilities for 151 days beyond the end of the COVID-19 public health emergency (PHE). Currently, geographic and originating site restrictions are only waived for Medicare telehealth services while the COVID-19 PHE remains in effect. Many stakeholders believe the Biden administration will allow the PHE to lapse in July, so the passage of this legislation would allow these flexibilities to continue for an additional five months through December 2022. This would give Congress more time to consider permanently expanding access to telehealth and avert an abrupt end to current policy, which would significantly reduce telehealth access for Medicare beneficiaries when the PHE terminates.
Notably, the package appropriates $1 billion for the creation of the Advanced Research Projects Agency for Health (ARPA-H) through September 2024. ARPA-H is seen by many as a cornerstone in President Biden’s healthcare agenda and a prominent piece of his Cancer Moonshot relaunch. This new agency would serve to accelerate the pace of breakthroughs in biomedical research to improve prevention, detection, and treatment for a range of diseases, including cancer. This funding falls far short of Biden’s requested $6.5 billion to establish and run the agency, which would be housed within the Department of Health and Human Services but outside the National Institutes of Health (NIH). Moreover, for the agency to be formally established, Congress must still pass authorizing legislation, which could face partisan hurdles.
Finally, the package provides $45 billion in continued funding for NIH, representing an increase of $2.25 billion over the funding level enacted for fiscal year 2021. This funding includes $6.9 billion for the National Cancer Institute (inclusive of $194 million specifically for the Cancer Moonshot), an increase of $50 million for health disparities research, $59 million for the Office of Research on Women’s Health, and increased investments to enhance diversity in the biomedical research workforce.
Notably absent from the massive spending package is additional funding for COVID-19 relief, which was removed by House Speaker Nancy Pelosi at the last minute. The Administration had requested $22.5 billion to fund treatment, vaccination, and global support efforts, but opposition by Senate Republicans and disagreement within the Democratic caucus over the specifics of this funding resulted in its complete removal from the spending package. House Democrats subsequently introduced a standalone version of a $15.6 billion COVID relief bill, but it is expected to face challenges in both the House and Senate.
The 2,741-page omnibus package now heads to President Biden’s desk, where it must be signed into law by March 15 to avert a partial government shutdown. Additional details on the healthcare provisions of the package can be found in the Division-by-Division Summary of Appropriations as well as a shorter subcommittee summary for Labor, Health and Human Services, Education, and Related Agencies.
Matt Devino, MPH, is the Director of Cancer Care Delivery and Health Policy at ACCC.
