Monday night, House and Senate Appropriators unveiled the Fiscal Year (FY) 2014 omnibus appropriations bill. The Consolidated Appropriations Act of 2014 (H.R. 3547) contains all 12 regular appropriations bills and adheres to the $1.012 trillion discretionary spending level set by the Bipartisan Budget Act of 2013, also known as the Ryan-Murray Agreement. The allocation for the Labor, Health and Human Services, Education, and Related Agencies (LHHS) bill is $156.8 billion, roughly the same as allocated for FY2013. The text of H.R. 3547 can be viewed here.
The bill includes level discretionary funding for the Health Centers program which, combined with already-appropriated mandatory funding for health centers available through the Affordable Care Act’s Health Center Fund, represents a $700 million increase in funding from FY2013. The bill includes language requiring that of the $700 million increase, $110 million be obligated for base grant adjustments to existing health centers and not less than $350 million be obligated for New Access Points (NAPs), Expanded Medical Capacity (EMCs) and service expansions. The language also requires that these specific funds be expended by October 1, 2014.
As you will recall, the Ryan-Murray Agreement did not repeal sequestration but instead, offset the scheduled sequester for FY2014 and FY2015 by extending both mandatory and discretionary sequestration for two additional years from FY2021 to FY2023. For FY2013, Health Center funding was impacted by sequester on both the discretionary and mandatory sides and funding increases were enough to protect health centers from reductions. Under Ryan-Murray, health center discretionary funding will not be subject to a sequester cut. However, the mandatory Health Center Fund will be subject to sequester but will continue to be capped at the 2 percent (per the Gramm-Rudman-Hollings cap specific to health centers). This 2 percent reduction should be applied to the $700 million increase and existing health centers should be insulated from any impact.
The federal government is currently operating under a Continuing Resolution (CR) which is set to expire Wednesday. On Tuesday, the House approved a three-day extension of government funding through January 18 to provide time for debate and passage of the omnibus in advance of the mid-January Congressional recess which is slated for next week. Please stay tuned to Health Centers on the Hill as we will continue to update you on the appropriations process as it moves forward.