Health Center Federal Policy

Officially Shutdown-A Recap of How We Got To This Point and What It Means For Health Centers

As of Monday at midnight, the deadline to agree upon a Continuing Resolution (CR) passed and the federal government officially shutdown. Let’s review how Congress arrived at the first government shutdown in 17 years and what the impact will be for health centers.

As predicted, on Friday, the Senate voted to amend the House-passed version of the Continuing Resolution (CR), changing the end date of the CR from December 15th to November 15th and striking the language defunding the Affordable Care Act (ACA). This defunding would have resulted in a massive loss of funding for health centers, leading to the closure of health centers, lost health care capacity, and a loss of jobs in local communities.

The Senate-amended CR was then sent back to the House for consideration. On Sunday, the House amended the Senate-passed CR to include language delaying implementation of the Affordable Care Act for one year, repealing the tax on medical devices under the ACA, and changing back the expiration date of the CR to December 15th.  This text related to the delay of the ACA would have frozen the Health Center Fund at the Fiscal Year (FY) 2013 level of $3.1 billion and not allowed any additional funding to be distributed from the Health Center Fund in future years. This bill was then sent back the Senate.

On Monday afternoon, the Senate voted to remove all of House amendments to the CR including the expiration date reverting it back to November 15th. This bill, or “clean CR,” which is the same as the original bill the Senate sent over to the House on Friday, was sent back to the House again.

While House Leadership contemplated their next move, Minority Leader Nancy Pelosi offered a “healthy number of Democratic votes” to Majority Leader John Boehner for a “clean multi-month CR”, but her offer was not taken up. Instead, the House amended the CR again on Monday afternoon to include a one-year delay of the ACA’s individual mandate and a provision eliminating employer-sponsored health subsidies for Members of Congress and their staff. This version of the CR was sent back over to the Senate and once again, the Senate amended it to remove the House’s ACA-related provisions and sent it back as a “clean” extension of federal funding until December 15th.

As Congress inched toward the midnight deadline, House leadership floated the idea to Majority Leader Harry Reid to appoint a Conference Committee to work out the differences between the two chambers. Senator Reid stated he would only agree to a Conference Committee if the House would pass a “multi-week” funding bill with no provisions related to the Affordable Care Act- a “clean” CR which they have repeatedly sent back to the House. House leadership would not agree to fund the government, even temporarily, without any limitations on the ACA. At 1am, after the government had already shutdown, the House proceeded to vote on a motion to go to conference with the Senate. This was swiftly rejected by the Senate this morning and at this time the government will remain shut down until an agreement is made on the CR.

How would a shutdown impact health centers? The information as we have it:  

  • With a shutdown of limited duration, most CHCs should be able to access their grant funds through the Payment Management System and funds should be available.
  • It is our understanding, however, that not all health centers may be able to access funding through the Payment Management System, exceptions include:

– those with drawdown requests/restrictive terms and conditions that trigger one of the Payment Management System edit checks and/or the drawdown limit controls may not be able to access funds.

  • The Bureau of Primary Health Care’s Outreach and Enrollment (O/E) Team will be available to support outreach and enrollment supplemental funding activities. Contact the O/E Team at bphc-pca-oe@hrsa.gov.
  • Some HRSA employees will be furloughed resulting in a slow response to inquiries from the field.

NACHC asks health centers that experience a grave threat to their immediate operations as a result of payment delays and PCAs who become aware of these situations to contact Julie Schmidt at jschmidt@NACHC.COM.

For more information on HHS’ contingency plan for agency operations during a government shutdown, click here.

How does Congress resolve this showdown over the CR? Senate Majority Leader Harry Reid and President Obama have continually said they will reject all efforts to delay, defund, or rescind the ACA and House Majority Leader Boehner is still insisting on concessions regarding the ACA. With both sides in their respective corners at the moment, a path forward remains unclear. We will continue to post updates on Congressional action regarding the CR or from HRSA as soon as we receive them.

10 Comments on “Officially Shutdown-A Recap of How We Got To This Point and What It Means For Health Centers

  1. Serving in Congress/Senate is suppose to be a privilege, not a retirement/pension plan! They need to be subject to all of the rules and regulations and laws they pass including “health care” .

  2. Senator McCain points out that even if they got enough votes, the Republicans would not have enough (67) to overide a presidential veto.

  3. The AFA is law. The House has a moral obligation to quit trying to undo it that a small group of legislatures don’t want to acknowledge. Keep this in mind when asked to help with voter registration prior to the upcoming elections. It is important that we encourage the underserved to use the voting power they don’t always realize they have.

  4. Congress members who caused the shutdown should not have health insurance available, no paychecks since it is a Government shutdown, So people should respond to their actions BY voting them out

  5. If we as FQHC’s managed our affairs like Congress we would have been out of business a long time ago. It is time they stop giving themselves privileges not afforded to the rest of the population and became as answerable as we are for our finances. Yes we do need to educate our patients but we also need to teach accountability to everyone. Not everything should just be an easy handout, especially for members of Congress.

  6. I sooo agree with all of these statements. These pathetic, pompous horses behinds, should be booted out of anything involving government for their lifetimes. There are so many Americans that are sick and tired of all the political Shenanigans in Washington. Most of these people who are supposed to be serving the citizens of this country are only there to line their own pockets and will live “High off the Hog”. for the rest of their lives. Year after year, any reason we had to proud to be Americans is slipping away from us. It sickens me.

  7. Completely agree with all the comments, specially James. Let’s get to work. Unify forces and ideas to resolve the differences. Let’s think positive to find solutions for the citizens …

  8. I wonder how much money all of this animosity has cost the American people? [Probably enough to fund several FQHC’s.] Senators and Representatives are elected to represent their constituency. The ACA became law; the majority spoke! Now it’s time to get back to work.

  9. Sad to say, many people who complain about these elected officials and telling everyone to not re-elect probably don’t even go to the polls and vote themselves. How can you tell others not to re-elect them when you don’t practice what you preach. I do vote, and if it were in my power, I would vote for term limits and they would have to buy into the same health plans the American people do. It has been said countless times, it should be an honor to represent your state to be their voice – not a career where you are in it for the perks and lifetime benefits.

    1. “it should be an honor to represent your state”. For most of these people, it is not. You can say that countless more times and then try to imagine any one of them voting to let go of their perks and benefits. It does no good to say I’m fed up, but I am. I did not vote this last election because I am sick and tired of being lied to and these creeps get in office and do exactly as they like and to hell with the people who voted for them. I don’t ever see it changing with the way politics is run in this country. I had so much faith in Obama and look where we are. It scares the hell out me. I worry for this country in the coming years and for our kids and grandchildren. God help us all, NOW THEY ARE TRYING TO REMOVE HIM FROM OUR COUNTRY AS WELL.

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