Insurers win and lose in omnibus spending bill

President Donald Trump on Friday grudgingly signed a $1.3 trillion, two-year omnibus spending bill that came after days of wrangling behind closed doors over contentious policies that included an embattled stabilization package for the individual market that would fund cost-sharing reduction payments and a $30 billion reinsurance pool. So who won and who lost?

Winners:

Insurers that fought to keep a new policy that cuts their share of the cost of prescription drugs not covered by Medicare while raising it for drugmakers.

The National Institutes of Health, which received a $3 billion boost in funding.

Opioid addiction abatement efforts, which received $735 million to develop alternative pain medications, support treatment programs in rural areas and expand access to naloxone. In total, HHS received $3.6 billion to fight drug abuse.

Rural communities, with HHS’ spending on rural areas totaling $290.8 million.

Providers, getting $182 million to reduce a backlog of more than 500,000 Medicare appeals.

Pediatricians, who will benefit from a $2.4 billion increase in the Child Care and Development Block Grant.

Losers:

Insurers, following failed efforts to include CSR payments and reinsurance. The Affordable Care

Act, which now faces several attempts to limit data or grant opportunities related to the legislation.

Drugmakers, who wanted to offload some of their newfound financial liability for the Medicare Part D donut hole back to insurers.