Congress Passes Key Addiction-Related Policy and Funding Provisions in the Consolidated Appropriations Act, 2026

As of today, both the US House and US Senate have passed HR 7148 - the Consolidated Appropriations Act, 2026, a package of Fiscal Year (FY) 2026 appropriations bills for several agencies, including the Department of Health and Human Services (HHS). Congress also passed a continuing resolution to fund the Department of Homeland Security for two weeks while lawmakers continue to negotiate guardrails around the operation of US Immigration and Customs Enforcement.

The Labor-HHS joint explanatory statement can be found here.

Key addiction-related policy and funding provisions in the package are described below.

Substance Abuse and Mental Health Services Administration (SAMHSA) Funding

• $7.4 billion total for SAMHSA
  • Of the total, $4.2 billion for substance use prevention and treatment programs, including under the Public Health Service Act, 21^st Century Cures Act, and SUPPORT Act.
    • Of this, $1.595 billion for State Opioid Response Grants 
      • At least 4.25% to Indian Tribes/Tribal organizations.
    • Of this, approximately $2 billion for the Substance Use Prevention, Treatment, and Recovery Services Block Grant
    • Of this, $564 million for Substance Abuse Treatment Programs of Regional and National Significance
      • Of this, approximately $26.8 million for SBIRT.
      • Of this, $114 million for Targeted Capacity Expansion -  “Medication Assisted Treatment.” 
  • Of the total, $240.9 million for Substance Abuse Prevention Programs of Regional and National Significance.
  • Of the total, $145 million for the Rural Communities Opioid Response program.
  • Of the total, $19,516,000 for the Minority Fellowship Program (includes Addiction Medicine per the SUPPORT Reauthorization Act of 2025) as follows:  
    • $7,136,000 (from Substance Abuse Treatment Programs of Regional and National Significance)
    • $1,321,000 (from Substance Abuse Prevention Programs of Regional and National Significance)
    • $11,059,000 (from Mental Health Programs of Regional and National Significance)
  • Of the total, $203 million for crosscutting support, including national surveys on drug use and mental health, data collection, and evaluation.

Public Health and Other Extenders

• Extension of Mandatory Funding for Community Health Centers (CHCs) 
  • $4.6 billion for fiscal year 2026
  • $1.159 billion for October 1, 2026 - December 31, 2026
• Extension of Mandatory Funding for National Health Services Corps (NHSC)
  • $350 million for fiscal year 2026
  • $88.2 million for October 1, 2026 - December 31, 2026
• Extension of Mandatory Funding for Teaching Health Centers Operating Graduate Medical Education Programs (THCGME)
  • $225 million for fiscal year 2026
  • $250 million for fiscal year 2027
  • $275 million for fiscal year 2028
  • $300 million for fiscal year 2029

Medicare: Extension of Telehealth Flexibilities

• Extends critical Medicare coverage for telehealth flexibilities (e.g., audio-only services) through Dec. 31, 2027.

Medicare Advantage Provider Directories

• Mandates Medicare Advantage plans to maintain accurate and public provider directories to assist enrollees in their decision-making when selecting plans.

National Institute on Drug Abuse (NIDA) Funding

• $1,662,695,000 for Fiscal Year 2026 

National Institute on Alcohol Abuse and Alcoholism (NIAAA) Funding

• $595.318 million for Fiscal Year 2026

Centers for Disease Control and Prevention (CDC)

• National Center for Chronic Disease Prevention and Health Promotion
  • $246,500,000 for Tobacco Prevention and Control

Health Resources and Services Administration (HRSA)

• $8.95 billion total for HRSA
  • Of the total, $130 million for National Health Services Corps (NHSC), which is available to support substance use treatment services.
  • Of the total, $518 million for Health Professions Education and Training (Title VII).
    • Of this, $40 million for Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program.
    • Of this, $253 million for Interdisciplinary Community-Based Linkages.
      • Of this, $114 million for Behavioral Health Workforce Education and Training.
        • Of this, per a House Report and Senate Report, $25 million for the Addiction Medicine Fellowship Program.

Harm Reduction Policy

• Bans using appropriated funds to purchase sterile needles or syringes for hypodermic injection of illegal drugs; however, the ban is inapplicable where a state/local health department (in consultation with CDC) determines a significant risk of hepatitis or HIV outbreak due to injection drug use and the program operates in accordance with state/local law.
• On harm reduction, the agreement acknowledges the administration's efforts to prioritize prevention, treatment, and long-term recovery in relation to substance use disorder, including the availability of opioid overdose reversal medications.

Controlled Substances Limitations

• Bans using funds to promote legalization of any Schedule I drug unless part of federally sponsored clinical research.