Advocacy efforts pay off: Spending bill funds REACH and Prevention & Public Health Fund 

On Friday, Congress passed and President Trump signed an omnibus spending bill to fund the government through the end of September. Compared to earlier drafts of the House and Senate spending bills and the Trump administration’s proposed budget, prevention and public health fared better than expected, and spending on domestic programs is at its highest level since 2010: 

• Advocates helped secure funding for REACH, which had been zeroed out in in previous spending bills. The spending bill also allocates $800.9 million to the Prevention and Public Health Fund. 
• The Centers for Disease Control and Prevention will receive an $1.1 billion boost in funding. 
• Congress clarifies that the CDC is allowed to conduct gun violence research, ending what was effectively a 22-year moratorium on such research. 

We want to share an initial overview of a 2,323-page, $1.3 trillion spending package, recognizing that more in-depth analysis will emerge in coming days. 

Public health and equity: After a strong push from advocates, REACH -- which had been zeroed out in the House and Senate spending proposals, and in the Trump administration’s proposed budget -- has been funded at $50.95 million. Funding for the Centers for Disease Control and Prevention -- which had faced steep cuts -- will receive a $1.1 billion boost. The Prevention and Public Health Fund is included at $800.9 million. The CDC Office on Smoking and Health will receive a $5 million increase over last year’s funding levels, to $210 million (the original House spending proposal had cut the Office of Smoking and Health by $50 million).

Gun violence prevention: Lawmakers agreed that the CDC “has the authority to conduct research on the causes of gun violence,” clarifying language in the Dickey Amendment that states that “none of the funds… may be used, in whole or in part, to advocate or promote gun control,” a provision that has effectively barred the CDC from researching gun violence since 1996. The Fix NICS Act would strengthen federal background checks for gun purchases by incentivizing states to update the National Instant Criminal Background Check System. The STOP School Violence Act of 2018 focuses on school security. 

Opioids: The spending bill allocates over $4.65 billion to address the opioid epidemic, with funding going to Mental Health Block Grants and State Opioid Response Grants; opioid addiction research at the National Institutes of Health; overdose prevention, surveillance, and prescription drug monitoring at the Centers for Disease Control and Prevention; access to treatment in rural and underserved communities; mental health support services at the Department of Veterans Affairs; and other programs. 

Housing: The Department of Housing and Urban Development will receive a one-year increase in funding for housing vouchers; the Low Income Housing Tax Credit; supportive housing for veterans, people with disabilities, and the elderly; lead abatement; homeless assistance programs; and other affordable housing measures. The Community Development Block Grant -- which funds local affordable housing and anti-poverty programs, and was zeroed out in the administration’s proposed budget -- is being nearly doubled to $5.2 billion. The spending bill prohibits the Department of Housing and Urban Development from directing local governments to change zoning laws that have discriminatory effects, echoing the Trump administration’s move earlier this year to delay the Affirmatively Furthering Fair Housing rule. 

Education: The spending bill more than doubles funding for Student Support and Academic Enrichment grants, which had been eliminated in the administration’s proposed budget. These grants fund trauma-informed classroom management, mental health support services, and school violence prevention.  

Immigration: The spending bill does not address the status of hundreds of thousands of Dreamers, participants in the Deferred Action for Childhood Arrivals program. The Congressional Hispanic Caucus urged lawmakers to oppose the spending bill: "It is indefensible for Congress to pass a spending bill that not only leaves DREAMers without permanent protections but also funds their deportations and those of immigrants with deep ties to their communities.” The spending bill does not defund sanctuary cities, despite urging from the Trump administration to do so. 

Environmental protection: The spending bill maintains overall funding levels for the Environmental Protection Agency and adds $753 million to fund water infrastructure improvements and accelerate clean-up activities at Superfund sites, among other activities.

Healthcare: The final spending bill does not include funding to stabilize the Affordable Care Act marketplaces. The bipartisan stabilization plan was dropped from the spending bill due to the inclusion of policy riders to restrict coverage of abortion.