A $1.1 trillion spending package that will keep government open through September 2016 passed in the House Friday morning without drama, according to The Hill. The decision marks the first major alteration to the Affordable Care Act approved by Congress.
Here are five things to know about the bill and how it will affect healthcare.
1. The bill passed in the House 316-113. The package passed with strong support from both parties. Democrats voted 166-18 for the bill and Republicans voted 150-95, according to The Hill. In the bill, Republicans lost out on stricter policies for Syrian refugees coming to the U.S., as well as blocking Planned Parenthood funds.
2. The Senate will vote on the package later Friday. The Senate is expected to pass the bill, which will likely be paired with the tax package approved by the House Thursday, according to the report. The White House indicated President Barack Obama will sign both measures, according to the report.
3. The bill renews the James Zadroga Act to secure health benefits for 9/11 first responders and puts a hold on three revenue-generating taxes in the ACA. These taxes include the health insurance tax, the medical device tax and the "Cadillac tax." Democrats in particular wanted to delay the Cadillac tax to help garner union support ahead of the election year, according to the report. Unions oppose the excise tax, which caps open-ended tax breaks on expensive employee health plans.
4. Despite President Obama's support for the Cadillac tax, he will not veto the bill. The White House indicated this is not a deal breaker for the president, according to the report. According to estimates from the Congressional Budget Office, a two-year delay of the Cadillac tax will cost Washington $9 billion by the end of 2019. If the tax is permanently repealed the CBO estimates it would amount to $87 billion in lost revenue by 2025.
5. The bill notably does not provide any help for Puerto Rico, which is currently facing a major debt crisis. The commonwealth faces a $72 billion public debt, but cannot file chapter 9 bankruptcy to restructure it. Meanwhile, about 45 percent of its population is on Medicaid, but its Medicaid block grant is expected to run out by 2017, and physicians are leaving for the mainland U.S. at a rate of about 400 per year.
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