Health Center Federal Policy, Uncategorized

House Energy and Commerce Takes on Mandatory Funding in ACA

By: Scott Haber

Last Tuesday, the House Energy and Commerce Committee approved five bills that seek to eliminate mandatory funding contained in the Affordable Care Act (ACA).  None of these bills proposes to eliminate any of the mandatory funding from the “Health Center Fund” which provided funding for Section 330 health center operations and capital funding. Of these five, however, there are three bills that might be of particular interest to health centers: H.R. 1216, H.R. 1214, and H.R. 1217.

H.R. 1216, authored by Congressman Brett Guthrie (R-KY), rescinds the unobligated portion of the $230 million in total mandatory funding available to support Teaching Health Centers (THCs) for FY2011-FY2015. Instead, this bill would make the program subject to the annual appropriations process.  The legislation specifies that $46 million per year for FY2012-FY2015 would be authorized to fund THC activities.

–  As you may recall, earlier this year HRSA announced 11 THC grantees,  of which 9 are community health centers. If enacted into law, H.R. 1216 will make it challenging for these 11 programs that have already made the decision to participate in this program, in consultation with key stakeholders, based on the expectation that continued funding would be available.  This legislation does not guarantee any funding for this program since the THC program, like other discretionary programs, would have to fight for limited discretionary funding each year. In this difficult budget climate and with House Republicans reluctant to support the implementation of health reform, despite clear statements by Energy and Commerce Members on both sides of the aisle that this legislation advances a worthy goal of training more primary care physicians, if H.R. 1216 were to become law it puts the new THC grantees future funding in jeopardy.

H.R.  1214, authored by Congressman Michael Burgess (R-TX), repeals the $200 million in mandatory funding for school-based health center construction between FY2010 and FY2013 and rescinds unobligated funding.

–  School-based health centers (SBHCs) provide primary care to children across the nation, and roughly one-fourth of SBHCs are sponsored by a Section 330 health center.  Health centers are among entities eligible to receive SBHC construction funding and if this bill were to become law, all those entities that submitted applications would not receive construction funding.

H.R. 1217, authored by Congressman Joe Pitts (R-PA), repeals the Prevention and Public Health Fund that makes mandatory funding available for prevention and wellness activities in FY2010 and each subsequent year.  The legislation would similarly rescind unobligated funding.

–  Half of the FY2010 allocation of $500 million went to support efforts to increase the number of primary care providers and strengthen the primary care workforce, including at community health centers.  Also, it’s clear from the FY2010 funding breakdown, that the Prevention and Public Health Fund represented a significant investment in public health, including efforts to promote wellness and prevent chronic diseases that develop due to a poor diet, tobacco and excessive alcohol use, and physical inactivity – among other risk factors. Future plans for the Prevention and Public Health fund included funding for community-based entities for community prevention and wellness activities.

All three bills will now be advanced to the full House for a vote on final passage.   In fact, H.R. 1217 is scheduled to be brought to the House floor on Wednesday.  While these bills are expected to pass the House, there is no indication as of this writing that the Senate plans to take up these measures.

NACHC will continue to follow these pieces of legislation and keep you posted on new developments!