It’s been a big year on Capitol Hill for our nation’s health centers. One may have thought that, following an historic victory in 2015 getting a 2-year extension of funding, this “off year” would be a time for resting on our laurels and rebuilding for the fights to come in 2017. While certainly plenty of time and energy has been devoted to looking ahead to the big questions on the table next year, this year itself has been filled with important policy debates, record-breaking advocacy, and some important legislative wins for health centers.
Early in the year, health center advocates descended on Capitol Hill for the 2016 Policy and Issues forum in Washington, DC, where NACHC highlighted health center innovation in a well-attended Congressional Briefing, and put the spotlight on the workforce challenges being faced at health centers with the release of a new research report. Health Center advocates succeeded in breaking records on our annual appropriations letters – with over 300 House Members signing onto the Bilirakis-Green letter in the House and over 60 Senators signing onto the Stabenow-Wicker letter in the Senate. With that many members on record, both House and Senate appropriations committees passed FY2017 legislation keeping health center funding level, in line with NACHC’s official request.
Following action in those Committees, the appropriations process stalled out over larger political conflicts (and indeed, is technically still underway – the government is operating under a stop-gap “continuing resolution” until next April). But even as work on the funding issues slowed, health centers were at the center of several other debates and conversations on health policy on the Hill.
Efforts to fund a response to the Zika virus, especially in Puerto Rico and the other U.S. territories, finally were passed into law in late September after months of back and forth on Capitol Hill. The final package contained $40 million for health centers in Puerto Rico and the territories, which was allocated last week.
The opioid epidemic that has been raging throughout much of the nation moved Congress to take action this year, culminating in the eventual passage of the Comprehensive Addiction and Recovery Act (CARA) which outlines a number of new measures to combat the epidemic. Health Centers have been on the front lines of that fight for years, and last year, 271 health centers were funded specifically to expand and enhance their substance use disorder treatment services.
Alongside the debate over substance use disorder policy, Congress spent a lot of time this year looking at the mental health system. Bills were passed in the House and Senate, and eventually reconciled into a larger package that passed at the end of the year. While advocates were not successful in securing a requirement for same-day billing for mental health visits under Medicaid (a top – but expensive – priority for health centers), the bill did contain several provisions of note. In particular, it included both a long-sought provision expanding health centers FTCA Medical liability coverage, or FTCA coverage, to volunteer providers, as well as a provision allowing health centers to assign patients to Accountable Care Organizations (ACOs) at the FQHC level. More on both of those provisions and what they mean for health centers here.
Even with all the different pieces on the chess board in 2016, we’ve spent an equal or greater amount of time (especially since the November elections) focused on what lies ahead in 2017. Big issues will need to be dealt with, and could have enormous implications for health centers and their patients. In particular, the two-year extension of funding mentioned earlier is up this fall, meaning a loss of 70% of federal grant funds to health centers (and elimination of the National Health Service Corps and Teaching Health Centers programs) if Congress fails to take action. Equally critical, the Medicaid program will be very much “on the table” given the expansion under the ACA and the desire on the part of many in Congress to fundamentally restructure the program.
More than 1,000 advocates joined our team for a Policy and Advocacy Webinar last week (missed it? Here’s the recording), during which we reviewed the election, some of the new faces in DC, our top priorities and the outlook for 2017. This is now something we’ll be doing on a monthly basis moving forward. Here’s the link to register for the next one, which will be at 3:30 PM EST on January 18th. As we enter a complex and uncertain year, these webinars, as well as our new “Making the Case” Resource Hub website, are the best ways to stay in touch and stay engaged.
From our team to yours, happy holidays and happy new year. Rest up, we’re going to have our hands full in the new year!