Health Center Federal Policy

A Deal Is Reached and the Shutdown Is Over; But Significant Work Lays Ahead for Congress To Avoid This Situation Again

The past 24 hours have been a whirlwind of activity on Capitol Hill. The 16-day government shutdown and threat of a first-ever U.S. default haves officially ended with a deal that was brokered in the Senate and agreed to by the House.  

The Continuing Appropriations Act of 2014, which ends the government shutdown and lifts the debt ceiling, passed the Senate by a vote of 81-18 and the House by a vote of 285-144. In the end, the House was able to pass the legislation with the help of the entire Democratic Caucus and a “minority of the majority” Republican Conference. The deal originated in the Senate and was worked out over several days of negotiations between Senate Majority Leader Harry Reid (D-NV) and Senate Minority Leader Mitch McConnell (R-KY) after a failed final attempt by House Majority Leader John Boehner to pass legislation end the shutdown. The legislation:

  • Reopens the federal government and extends federal funding through a Continuing Resolution (CR) until January 15, 2014 at the current sequestration spending level. More on this below.
  • Raises the debt ceiling until February 7, 2014.
  • Requires income verification in order for individuals to receive insurance subsidies under the Affordable Care Act.
  • Allows back pay for furloughed government workers.
  • Contains a provision allowing for a vote to disapprove suspending the debt limit in order to allow Members to go on the record opposing this particular provision.   

One important provision that was not included in the legislative text but that was a part of the agreement was the appointment of a bipartisan and bicameral budget conference committee to come up with a long-long term spending plan by December 13, 2013. The last budget conference committee was in 2009. The appointees to the conference committee are:  Senate Budget Committee Chair Patty Murray (D-WA), Senate Budget Ranking Member Jeff Sessions (R-AL),  Sen. Ron Wyden (D-OR), Sen. Bill Nelson (D-FL), Sen. Debbie Stabenow (D-MI), Sen. Bernie Sanders (D-VT), Sen. Sheldon Whitehouse (D-RI), Sen. Mark Warner (D-VA), Sen. Jeff Merkley (D-OR), Sen. Chris Coons (D-DE), Sen. Tammy Baldwin (D-WI), Sen. Tim Kaine (D-VA), Sen. Angus  King (I-ME), Sen. Charles Grassley (R-IA), Sen. Mike  Enzi, Sen. Mike Crapo, Sen. Lindsey Graham, Sen. Rob Portman, Sen. Pat Toomey, Sen. Ron Johnson (R-WI), Sen. Kelly Ayotte (R-NH), Sen. Roger Wicker (R-MS), House Budget Chair Paul Ryan, House Budget Ranking Member Chris Van Hollen(D-MD), Assistant Democratic Leader James Clyburn (D-SC), Rep. Tom Cole (R-OK), Rep. Tom Price (R-GA), Rep. Diane Black (R-TN), , and Appropriations Committee Ranking Member Nita Lowey (D-NY). 

The budget conference committee has been appointed to attempt to resolve the differences between the two versions of the FY14 budget passed by the House and Senate. In addition, if agreement on overall spending caps was reached, then regular order could theoretically be resumed and the 12 annual appropriations bills could move individually, ending the current cycle of extending funding under Continuing Resolutions (CR). The budget conference also presents an opportunity for Congress to repeal and replace sequestration before it hits for the second time.

However, it is important to note the Continuing Appropriations Act of 2014 extends federal funding at FY13 post-sequester spending levels until January 15th– after the budget committee deadline. If the conference committee fails, we could see a scenario where Congressional action will have to occur to continue FY2014 funding (through another CR or omnibus) around the time with the FY2014 sequester will be enacted.  This also means Congress could be in a very similar situation of having to once again extend federal funding in January and lift the debt ceiling again February.

What this means for health centers is we still have a long way to go before the FY2014 budget and appropriations processes are completed, but events will occur in a very short window of time. We have a lot of work left to do to secure our FY14 funding and sequestration is still looming in the background. A point for all health centers advocates to keep in mind is that the Senate Appropriations Committee-passed version of the Labor-HHS bill, which contained the full health center request, is based on the Senate budget’s discretionary number which is almost $91billion above the FY2014 post-sequester levels. This means that resolving the sequester issue is critical for health centers along with every other discretionary-funded program.

For now we can all breathe a sigh of relief that the current crisis has ended, but we will be gearing up soon for our next efforts. In the meantime, this excellent and straightforward post by the New York Times, which is must read for a play-by-play of the government shutdown and debt ceiling debate, can be read here.  We will continue to keep you posted as news comes from the Hill on the budget conference committee and the FY14 funding process.


  1. Abby can you please provide more information on the income verification. Does this happen at the point of enrollment or afterwards and any other implications you see for our CACs/Navigators?

  2. Abby Please explain the income verification, the navigators were told there would be a system that would verify the income, pulling from IRS? Is this correct or has this changed. Or are they talking about The Presumptive eligibility for hospitals?

    1. The text of the legislation requires HHS to submit a report to Congress by Jan. 1 to explain how the exchanges are verifying income. Then the HHS Inspector General has until July 1. to report to Congress on the effectiveness of the verification. As written, it should not have an impact on the current verification law/rules. The House passed a more stringent income verification bill earlier this year, but unlike that bill, this agreed upon text does not set up barriers to distributing subsidies.

  3. It means no “liar loans ” people will need proof of income, do our cash payers may be able qualify regardless of income

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