There were a number of other important items included in the CR/budget agreement that may have been missed due to the size of the deal. $100 million is added to SSBG with a new separate section to fund social impact bonds or “pay for success” projects. The projects will provide competitive grants to states and localities that seek to leverage results through the public and private financial incentives to address a range of social challenges such as education, child welfare and criminal justice issues. It is also heartening in that it expands on SSBG likely at the same time the new Administration budget will once again call for its elimination. Other items include:
• The debt ceiling is “suspended” until after the election to March 1, 2019, eliminating a vote on raising it in March 2018.
• Disaster relief is included at $90 billion for the hurricane states, Puerto Rico and the fire-ravaged states. Importantly Puerto Rico gets two years of full funding for its Medicaid program. Puerto Rico has a separate funding formula on Medicaid that is capped—and stressed due to the hurricane.
• An extension of Community Health Centers at $7 billion.
• More tax cuts! The bill would provide tax breaks that are scored as costing $17.4 billion to the deficit over the next ten years. That is on top of the December package. The tax breaks include provisions for some small private colleges (Kentucky), new depreciation benefits for NASCAR race tracks and racehorses, film and television production costs, wind energy credits, and some mortgagee insurance premiums.
• Elimination of an ACA created panel to make recommendations to address cost savings in Medicare if costs go up.
• Increased premiums for high income Medicare recipients and a quicker closing of the Medicare prescription drug coverage “donut hole.” A provision in the original Medicare prescription program that required patients to pay drug costs above a certain cost.