Tucked into the Senate budget bill are a host of provisions that help a broad array of industries and sectors, including energy, health care and education, through increased spending and tax credits.
The Senate deal would raise strict spending caps on domestic and military spending in this fiscal year and the next by about $300 billion. It would also lift the federal debt limit until March 2019 and provide nearly $90 billion in disaster relief to deal with last year’s fires and hurricanes.
It also includes a series of unexpected spending increases, including restoring some provisions that were jettisoned from last year’s $1.5 trillion tax package. And the bill includes an extension of 48 different tax credits that expired at the end of 2016, including several incentives meant to help particular sectors like mining and horse racing.
Here are some of the provisions included in the 600-plus-page bill, which heads for a vote later today:
The bill would kill an unpopular provision of the Affordable Care Act, its Independent Payment Advisory Board, which was devised to help keep Medicare spending growth from rising above a set level. No one has ever been appointed to the board, and its services have not yet been needed — Medicare spending has experienced unusually slow growth rates in recent years — but the board was long denounced by Republicans as a rationing board, and disliked by some Democrats for taking payment policy authority away from Congress.
The bill extends a number of special payment bonuses for different Medicare providers, many of which were once intended to be temporary, but get regularly continued. Those include extra payments for rural hospitals, a higher payment rate for ambulances, and increased payment rates to certain Medicare doctors. It preserves loan repayment programs for health providers who choose to work in underserved areas, and preserves funding for hospitals that train residents.
The bill expands pilot programs meant to test the value of in-home care for some Medicare patients. And it expands the ability of private Medicare Advantage plans to offer so-called “telehealth,” where doctors treat patients over the phone or internet. It would allow Medicare providers who are part of an accountable care association to offer patients cash bonuses as incentives for healthy behaviors.
The bill increases discounts that pharmaceutical companies must give seniors enrolled in the Medicare Part D drug plans, by making the so-called “doughnut hole” smaller. This was a policy that was part of the Affordable Care Act, but the new legislation would speed up implementation by one year.
The spending plan would cut $1.35 billion in funding to an Affordable Care Act program meant to improve public health and prevention funding for states and municipalities.
It would extend funding for the Children’s Health Insurance Program for an additional four years. Last month’s spending bill had already extended the program for six years, so now CHIP will be funded for an entire decade. Another popular program that delivers health care to low income children and adults, the government-funded clinics known as Community Health Centers, will also get a two-year funding extension.
The bill would extend funding to abstinence-only sex education programs.
The spending bill restores a provision that was stripped out of last year’s $1.5 trillion tax bill after the Senate parliamentarian objected to its inclusion.
The bill would exempt Berea College, a small private college in Kentucky that provides free tuition, from being subject to a new tax on large higher education endowments that was included in last year’s tax law.
The bill adds language that makes the new excise tax on investment income applicable only to schools with “tuition-paying” students, shielding Berea College, which does not charge tuition. The school is in the home state of Senator Mitch McConnell, the majority leader.
Owners of race horses and motor sports entertainment complexes would get an extension of special tax treatment. Horse owners are allowed to depreciate their horses over the course of three years. For racetracks, the depreciation is over the course of seven years. Those breaks would remain in place for 2017.
The Senate bill features a multitude of tax breaks for renewable energy sources that had been neglected in a 2015 deal to bolster wind and solar power. These so-called “orphaned” technologies include geothermal, small wind farms and fuel cells. Much like existing credits for wind and solar power, these incentives would phase out starting in 2020.
The bill also extends an existing production tax credit for nuclear power past 2020, which would benefit a pair of long-delayed reactors being built in Georgia that aren’t expected to come online before 2021. Southern Company has said it may not be able to complete the reactors, the only two still under construction in the United States, without the credit.
A separate measure would greatly expand a tax credit for companies that capture carbon dioxide from power plants or other polluting facilities and pump it underground. Oil firms such as Occidental Petroleum have been pumping captured CO2 into old wells in order to extract additional oil. Some environmental groups also lobbied for the measure, arguing that carbon capture technology, still in its infancy, could one day prove a crucial tool for tackling climate change.
The bill retroactively extends tax credits for biodiesel, advanced biofuels and fuel-cell vehicles through the end of 2017. Industry lobbyists had unsuccessfully fought to get many of these measures included in the tax overhaul bill passed by Congress in December. They could still face resistance in the House.
The bill extends a tax credit for 20 percent of an employers’ spending on mine rescue team training costs, up to $10,000. A separate provision allows the immediate deduction of a company’s investment in mine safety equipment.
The bill continues a special tax rate of 23.8 percent for 2017 for gains from timber sales, a break from the top rate of 35 percent that would have otherwise applied.