President Donald Trump signed a $1.2 trillion spending package on February 3, funding the Department of Health and Human Services (HHS) and enacting reforms to pharmacy benefit managers (PBMs). The package also includes measures for telehealth and hospital-at-home services.
The spending package was negotiated between Senate Democrats and the White House, and it provides full-year funding for the federal government through the end of the year. It was signed after the House voted 217-214 to pass the package, which includes five appropriations bills and a temporary funding bill for the Department of Homeland Security (DHS).
The HHS funding includes $116.6 billion in discretionary funding and reduces spending on federal bureaucracy by $100 million. It also includes several healthcare extenders, such as the Medicare telehealth program and the Acute Hospital Care at Home waiver. The bill extends the Acute Hospital Care at Home program for five years and the Medicare telehealth flexibilities for two years.
The PBM reforms in the bill aim to prevent PBMs from tying compensation in Part D to the list price of drugs and increase price transparency for employers in their PBM contracts. The bill also requires Medicare Advantage plans to provide accurate provider lists and establishes unique identification numbers for health systems' outpatient services.
The National Community Pharmacists Association and the National Association of Chain Drug Stores welcomed the PBM reforms, while the Pharmaceutical Care Management Association, the leading lobbying organization for the PBM industry, criticized the measures as potentially increasing prescription drug costs.
Telehealth advocates celebrated the Medicare telehealth and hospital-at-home provisions, emphasizing the importance of long-term certainty for these services. The American Telemedicine Association (ATA) urged Congress to act quickly to prevent the telehealth waivers from expiring, warning of major disruptions for patients and healthcare providers.
The spending package also addresses concerns over the deployment of immigration officers, with Senate Democrats demanding new oversight policies for immigrant agents after recent fatal shootings. The package includes temporary funding for DHS to allow negotiations on new restrictions and oversight measures.
