Health Center Federal Policy, Uncategorized

The Year in Review- Health Center Appropriations and Growth

by Krystal E. Knight, MPH

This year was full of activity related to health center funding, and there was action on multiple fronts. With all that has transpired in this historic year for health center growth, it is almost difficult to recall where we began. In February, President Obama released his annual Budget, which included a $290 million increase to the Health Centers program’s FY2010 funding level of $2.19 billion. Building on the momentum of the Budget’s release, health centers from across the country took to Capitol Hill during the 2010 Policy and Issues Forum (P&I) to advocate for a $370 million increase to the program ($80 million more than what the President had requested in his Budget). Health centers encouraged their Members of Congress to sign onto two ‘Dear Colleague’ letters—one in the House and one in the Senate—in order to show support for the $370 million increase. In the House, we were pleased to have Reps. Frank Pallone (D-NJ) and Kay Granger (R-TX) lead the Pallone-Granger letter. In the Senate, we were equally grateful to have Senators Debbie Stabenow (D-MI) and Kit Bond (R-MO) lead the Stabenow-Bond letter once again.

Fast forward to March 23, 2010, when the world watched as President Obama signed the Patient Protection and Affordable Care Act and later the Health Care and Education Reconciliation Act of 2010, collectively known as Health Reform or “the Affordable Care Act” (ACA) into law. With passage of health reform, the Health Centers program stands to receive $11 billion via a new Community Health Center Fund to provide for health center capital projects ($1.5 billion) and operations ($9.5 billion). This new funding will serve to expand the capacity of existing health centers and add new health centers in communities that need them. This funding will be disbursed annually in addition to existing base discretionary appropriations (see projections here). In light of health reform’s enactment, NACHC adjusted its appropriations ask; the message to Congress was to keep the Health Centers program’s discretionary funding at the FY2010 level of $2.19 billion in FY2011. This level funding, along with the $11 billion in new funding and other provisions to expand Medicaid eligibility and ensure health centers’ participation in the new healthcare landscape, have the potential to double the capacity of the Health Centers program from 20 million patients to 40 million patients over the next 5 years.

After months of advocacy, in mid-July health centers received great news that the House Labor-HHS Subcommittee on Appropriations had proposed that the Health Centers program be funded at $2.19 billion in FY2011. In the meantime, NACHC continued to advocate for level discretionary funding in the Senate. That outreach paid off as well when the Senate Labor-HHS Subcommittee on Appropriations marked-up the draft of its annual spending bill and also proposed that the Health Centers program receive level funding in FY2011. Thanks to great grassroots advocacy efforts, both the House and Senate were in agreement on maintaining our discretionary funding at the FY2010 funding level. However it became clear that we would have to work to keep this level throughout the rest of the appropriations process.

As the year, and the 111th Congress, drew to a close, there was much speculation regarding what the final discretionary appropriations level overall would be and what the path forward for enacting FY2011 appropriations bills into law would look like. There were several scenarios on the table. Ultimately, Congress passed a Continuing Resolution that will keep the government running and allow the Health Centers program to continue to receive the FY2010 level of funding until March 4, 2011. Health centers will need to advocate with the new 112th Congress for level funding at $2.19 billion for the remainder of the FY 2011 fiscal year once the Continuing Resolution expires.

Every discretionary program, including the Health Centers program, is at risk for funding cuts as Congress attempts to reduce spending. Specifically, the incoming House majority has indicated plans to cut domestic discretionary spending by at least $100 billion (or 20%).  As always, health centers will need to make the case for continuing the expansion of the cost-effective, high quality health center model of care.