By: Anne Morris
As we reported last week, House Speaker Boehner, Senate Majority Leader Reid, and President Obama reached agreement on a spending bill for the remaining six months of the fiscal year that cuts $38.5 billion in spending relative to the FY2010-enacted level. You may have already seen NACHC’s statement on the impact of the year-long Continuing Resolution, H.R. 1473, on health centers.
Summary documents from the House Appropriations Committee Majority indicate that H.R. 1473 would reduce discretionary funding for health centers by $600 million relative to the FY2010-enacted level of $2.19 billion. Because the bill is in the form of a Continuing Resolution, the Senate Appropriations Committee Majority has noted that in general it sets funding at the agency level, leaving some discretion over funding levels for many individual programs. However, the House Appropriations Committee document provides insight into the funding level for the Health Centers program and the proposed $600 million reduction. H.R. 1473 requires the Department of Health and Human Services (HHS) and other departments to provide a spending or operating plan within 30 days of the legislation becoming law.
Based on the $600 million cut to the Health Centers Program as outlined by the House Appropriations Committee, together with the $1.0 billion in FY2011 funding available for health centers through the Community Health Center (CHC) Fund from the Affordable Care Act (ACA), health centers would have a net increase of approximately $400 million in funding for FY2011. Unfortunately, most of this increase is needed to continue ongoing operations – specifically to build the ARRA New Access Points (NAP) and Increased Demand for Services (IDS) activities into the Health Centers program’s base operations.
While key policy decisions remain to be made by the Health Resources and Services Administration (HRSA), this proposal should provide sufficient funding to continue existing health center operations and services, including the 127 new centers and 3.7 million new patients added in the past two years through ARRA. However, H.R. 1473 leaves very limited funding to support expansion efforts as compared to approximately $700 million for growth if CHC Fund dollars hadn’t been used to backfill the cut on the discretionary side.
As you’ll recall, HRSA previously announced several FY2011 funding opportunities, including $250 million for NAPs, $270-$335 million for expanded services (ES), and $10 million for planning grant awards. At least 800 health centers submitted NAP applications, and virtually every health center nationwide applied for ES funding. H.R. 1473 leaves HRSA unable to fund all of these new opportunities; instead, the agency will have to make difficult choices about the few new awards to make.
Because H.R. 1473 relies on the vast majority of the FY2011 CHC Fund investment to backfill the discretionary cut – rather than promote expanded health center capacity:
-The ability for health centers to double their capacity and reach 20 million new patients by 2015 is undermined;
-Health centers will lose the ability to expand to serve 5 million patients over the next year; and
-$6.9 billion in annual cost savings to the health care system will be forgone.
NACHC opposes this legislation because of the short and long-term impacts of this discretionary cut. However, H.R. 1473 passed both the House and Senate on Thursday and was signed into law on Friday.