This week, the fiscal year (FY) 2019 health and defense spending bill passed its final hurdles when it was approved by the House of Representatives by a vote of 361 – 61 and President Trump signed the measure into law. The Health spending measure, known as the Labor-Health and Human Services bill (Labor-HHS), includes a $2 billion funding increase for the NIH, which sets FY2019 NIH funding at $39.1 billion. After expressing some earlier disapproval of the health-defense spending package because it does not include border wall funding, President Trump signed the bill into law before the end of the fiscal year on Sept. 30, averting a government shutdown. The bill also includes a short-term spending measure to fund agencies in the seven remaining annual spending bills that have not been agreed to (FDA, State, EPA, Homeland Security, etc.) until Dec. 7.  The package does not include any policy riders on clean air, tobacco or the Affordable Care Act (ACA).