Congress is embarking on its annual holiday tradition of scrambling to pass all outstanding legislation that piled up over the course of the year and needs to be enacted before the new year. This year they have amassed an especially long list of complicated and critical items that need attention before they attempt to leave town on December 22:
- Avert government shutdown with Continuing Resolution (CR)
- Extend Community Health Center funding
- Extend Children’s Health Insurance Program (CHIP) funding
- Other “health extenders” policy items (Medicare, NHSC, THCGME, DSH, etc.)
- Tax reform
- Renegotiate/raise budget caps for FY18
- Hurricane/disaster relief emergency spending package
- Reauthorize National Flood Insurance Program
- Omnibus appropriations or long-term CR for FY18
- Renew National Security Agency’s Internet Surveillance Program
- Murray-Alexander/market stabilization?
- DACA/immigration deal?
Where to Start?
Congressional Republicans and the President have made clear their strong preference is to finalize the tax reform bill first, and that everything else will need to come after that. At the same time, Republicans and Democrats are working to find agreement on how to pay for upwards of $100 billion in additional funding under a deal to raise the budget caps and avoid the triggering of automatic cuts to both defense and non-defense domestic programs in early January. And they must also take action to keep the government open by passing another Continuing Resolution (CR) before December 22, which is the date the current two-week CR passed by Congress on December 8 is set to expire.
Waiting on all of that to be resolved is a long list of health policy items, including health center funding. This package of “health extenders” has been largely ironed out and agreed to, but is caught in the middle of sticky negotiations over the rest of the complicated, controversial, and interconnected “must-pass” items.
Luckily, we do have some progress to report. On December 13, the House Appropriations Committee released their draft of another short-term Continuing Resolution, which would keep the government open until January 19, once again giving them additional time to try to work out a longer term CR or omnibus appropriations bill to cover the rest of FY18.
The particularly good news for health centers is that the new House CR bill includes a two-year extension of our mandatory Community Health Centers Fund, as well as two additional years of funding for both National Health Service Corps (NHSC) and Teaching Health Centers Graduate Medical Education (THCGME), and five years for the Children’s Health Insurance Program (CHIP). The funding levels are identical to what was included in the CHAMPIONING HEALTHY KIDS Act, which the House passed in early November. The bill continues to use the same controversial offsets to pay for these funding extensions – cuts to the Public Health and Prevention Fund, changes to the grace period for enrolling in Qualified Health Plans, etc. – that Democrats oppose.
These offsets, combined with the fact that the bill includes a full year of Defense Department funding but only one month of funding for non-defense domestic programs, means the bill as currently written won’t be able to pass the Senate, where they need the support of at least 8 Democrats. We expect the House to pass their version early next week, while the Senate will write and pass their own alternative version of a Continuing Resolution soon after.
So what does that mean for Health Center Funding?
It is a really good sign that the first version of this bill includes funding for health centers. That means your hard work and advocacy has resulted in Members of Congress letting congressional leadership know that they don’t want to pass another short term CR without also enacting a long-term solution to the health center funding cliff. Now we have to work harder than ever to make sure this funding is included in the Senate’s version, and ultimately, in whatever final bill is passed by Congress and signed by the President. Health centers should stay engaged with their congressional offices, letting them know of the specific negative effects that the uncertainty is causing — and to push for the swiftest resolution possible in the coming days.
If you are looking for more ways to get involved in pushing cliff fix legislation over the finish line, please visit our Health Center Advocacy Network page to take action now!