Last week Congress passed a bipartisan spending package that included an additional two years of funding for Community Health Centers, the National Health Service Corps (NHSC), and the Teaching Health Centers Graduate Medical Education (THCGME) Program. To add to the good news, we’re also happy to report that health center funding will increase by $600 million over the two year period; specifically, the Community Health Center Fund will increase from $3.6 billion per year to $3.8 billion in FY18 and $4.0 billion in FY19. Many more items were included in this spending package, as detailed below, but for health center leaders, staff, patients and supporters, we wanted to just take a moment to recognize this success at long last and say THANK YOU for your continued patience, determination, and persistence over the past several months.
Here are the details: In a dramatic fashion, Congress waited until the very last minute, even allowing the government to shut down for a number of hours, before finally voting on a bipartisan package that includes several health care policy priorities, sets spending levels for the next two years and keeps the government funded until March 23. The bill also includes disaster relief funding, a number of tax extender provisions, and lifts the debt limit until March 2019. The Senate voted 71-28 to approve the Bipartisan Budget Act of 2018 and shortly after the vote the House voted 240-186 to approve the package and send the bill to President Trump for his signature.
Here is a quick rundown of some of the major health care provisions included in the bill:
- Community Health Center Fund: two year extension with additional funding (FY18: $3.8B; FY19: $4.0B)
- National Health Service Corps: two year extension at current levels ( $310M/ year)
- Teaching Health Centers Graduate Medical Education: two year extension above current levels ($126.5M/ year)
- Children’s Health Insurance Program (CHIP): extends funding for an additional four years or through FY27
- Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program: extends funding for five years ($400M/ year)
- 2 year delay of reductions to Medicaid DSH payments
- Permanent repeal of the Medicare therapy caps
- 2 year increase to Medicaid caps for Puerto Rico and the U.S. Virgin islands: $4.9B
- Funding for state grants to address the opioid epidemic: $6B
- Special Diabetes Program: two year extension at current levels
- Extension of several other Medicare-related programs
- Repeal of the Independent Payment Advisory Board (IPAB)
We also wanted to highlight two additional health center related provisions included in the package. First, of the nearly $90 billion included in the package to address recent disaster relief efforts, $60 million is earmarked for Community Health Centers to support construction, alteration, renovation, equipment, and other capital improvement costs necessary to meet the needs of areas affected by hurricanes Harvey, Maria and Irma. Second, as part of the cliff fix, Congress also made some minor changes to the 330 statute, largely to eliminate outdated language and reflect current practices from the Health Services and Resources Administration (HRSA) more accurately. NACHC has prepared a summary of the changes to the statute, as well as a track changes version of the 330 language.
The bill also includes a number of health care-specific provisions that “pay-for” or “offset” the cost of funding for several of the programs listed above. Similar to earlier efforts by the House to extend funding for many of the expiring health care programs, the bill includes additional cuts to the Prevention and Public Health Fund. The bill also closes the “donut hole” for seniors, revises the physician fee schedule, adjusts Medicare premium subsidies for higher income beneficiaries, and makes a number of payment adjustments to other services and facilities.
While the bill passed both the House and Senate with bipartisan support, several Members on both sides of the aisle were not supportive of the final bill. In particular, some Members expressed concern for the additional spending that the package included. Other lawmakers took issue with the fact that immigration related provisions to extend protections for “Dreamers” were not included.
What was clear throughout the lead up to the vote, as well as the many months leading up to this point, is the overwhelming support for health centers in Congress – whether or not your Member voted for the final budget package. It is safe to say that support for health centers and the incredible work that you all do each and every day to provide high quality affordable health care to all those in need is greater now than ever.
For us here at NACHC, we cannot say thank you enough to all health center advocates for your incredible advocacy over the course of the past several months. We are so grateful for your unending energy, creativity, diligence, and dedication to health center advocacy.