Last week was a busy week in the House and Senate with regard to the Fiscal Year (FY) 2016 appropriations process. Both the House and Senate Appropriations Committee approved their Labor, Health, and Human Services (LHHS) FY2016 bills.
For FY2016, health centers have requested that the House and Senate LHHS Subcommittees maintain the FY2015 total funding level of $5.1 billion. HR 2 became law in April and extended the mandatory Health Centers Fund for two years at $3.6 billion a year. Therefore, the request for FY16 is for the LHHS bills to continue forward the $1.5 billion in discretionary funding which, when added to the $3.6 billion in mandatory funding contained in HR 2, provides for a total funding level of $5.1 billion. This funding request is the same as the total amount Health Centers received in FY2015 and requires no increase in funding from Congress.
The House FY16 LHHS bill as passed by the Appropriations Committee contains the full health center request for FY2016: a discretionary funding level of $1.5 billion, combined with the $3.6 billion made available in H.R. 2, for a total of $5.1 billion. A copy of the Subcommittee summary can be viewed here and the NACHC press release on the legislation can be viewed here.
The Senate FY16 LHHS bill is a bit more complicated, in that it utilizes a portion of the current unspent FY15 funding to instead fund increases to the program in subsequent years. The Senate bill provides a total of $5.2 billion for health centers in FY 16, including $1.5 billion in discretionary funding and $3.7 billion in mandatory funding, a $100 million increase. To do so, the bill uses existing funding available to health centers today to provide increases in future years.
As you may recall, the FY15 omnibus provided a $1.4 billion increase to health centers over the previous year, but left $541 million of that amount unobligated, just in case Congress failed to extend the Health Centers Fund by September 30th. However, when Congress passed HR 2 in April, ensuring stability in funding for FYs 16 and 17, health centers began advocating for HHS to utilize ALL available funding for health centers in FY15 so that health centers in their states could meet the demands for increased access to primary care in their communities.
Neither of these proposals are final and the appropriations process still has a long way to go before a final bill becomes law. In addition, Congress may still try to address the total budgetary spending caps which required the FY2016 LHHS bills to reduce their overall spending levels by about $3.7 billion in both the House and Senate to avoid sequestration. If the past is any indication, Congress may not finalize the FY2016 bills individually, but instead pass a series continuing resolutions as they get closer to or past the September 30th deadline. We could potentially expect a long term continuing resolution or omnibus later in the year or into 2016. In the meantime, NACHC will continue to work with the House and Senate Appropriators as the FY16 appropriations process continues to support the best possible outcome with regard to health center funding. [NOTE: our goal is the long range stability in funding – not just fy16]
Even as the FY2016 appropriations process progresses, we are continuing to work with all parties to get as much of the FY2015 funding as possible out the door to health centers. Thus far, HRSA has awarded $150 million in outreach and enrollment, $51 million in behavioral health integration, $36 million in quality improvement, and $101 million in New Access Points. Last Friday, the Department of Health and Human Services (HHS) issued a funding opportunity for $350 million in expanded services. Between what has been allocated under the FY2015 omnibus and what has already been spend by HHS, there is approximately, $440 million remaining in FY2015 funding. We know that there are still more than 300 approved/unfunded applications pending for New Access Points. With this level of demand, we have encouraged HHS to fully utilize all of the funding available for things such as additional expanded services and medical capacity, base grant adjustments, workforce related issues, and non-duplicative New Access Points.
Please stay tuned to Health Centers on the Hill for updates on the LHHS bills as information becomes available.