behind the scenes — like a big package designed to improve the nation’s readiness for the next big pandemic. It also included items that Republicans had been championing during the election season — like an extension of telemedicine coverage in Medicare. And it included small policy measures that some legislators have wanted to pass for years, like requiring Medicare to cover compression garments for patients with lymphedema.
Though the bill was primarily designed to fund existing government programs, a lot of health policy hitched a ride.
Big, “must-pass” bills like the $1.7 trillion omnibus often attract unrelated policy measures that would be hard to pass alone. But the scope of the health care legislation in last month’s bill is unusual. At the end of 2022, congressional leaders decided to do something that staffers call “clearing the decks,” adding all the potentially bipartisan health policy legislation that was ready and written. There turned out to be a lot to clear.
What’s In (and Not In) the $1.7 Trillion Spending Bill
What’s In the $1.7 Trillion Spending Bill
A sprawling package. Congress passed a $1.7 trillion spending package that will keep the U.S. government open through September. Here is a look at some key provisions in the 4,155-page bill:
Military spending is the big winner. The Defense Department would see an extraordinary surge in spending when adding its regular 2023 fiscal year budget together with additional aid for Ukraine. All together, half of the funding included in the bill goes to defense, or a total of $858 billion.
Making it easier (for some) to save for retirement. The package includes new provisions that would alter how millions of Americans save for retirement, including older people who want to stash away extra money before they stop working and those struggling under the weight of student debt.
Overhauling the Electoral Count Act. The legislation includes an overhaul of the 135-year-old law. Supporters of former President Donald J. Trump sought to exploit ambiguities in the law to disrupt the traditionally ceremonial counting of the presidential electoral ballots on Jan. 6, 2021.
A ban on TikTok on government devices. TikTok will be banned from all federal government devices under the bill. The move is intended to assuage heightened privacy and national security concerns about the app, which is owned by the Chinese company ByteDance.
International climate finance loses out. The bill includes just $1 billion to help poor countries cope with climate change. The figure falls far short of President Biden’s promise that the United States would spend $11.4 billion annually by 2024 to help developing nations adapt to a warming planet.
Other provisions. The bill also contains increased funding for the police, billions in aid for communities ravaged by natural disasters and a win for the lobster industry over whales. Read more about what’s in the bill, including more than $15 billion in earmarks.
The midterm election also played a role. Many lawmakers saw that the incoming Republican House majority would be far less likely to pass another big spending bill, and so the omnibus was widely viewed as a last legislative hurrah.