09 Sep Notes from DC — 2019 Summer Wrap Up
With Labor Day in the rear view mirror and Congress slated to return this week, there are multiple issues to address, including the swelling budget deficit, gun control, disagreement regarding policy to limit to surprise medical bills, and avoiding a government shutdown. Most important for health center advocates, is that with the clock ticking toward September 30th, leaders in Washington have yet to agree on the best pathway forward for extending mandatory funding for Community Health Centers, the National Health Service Corps (NHSC), and Teaching Health Center Graduate Medical Education Program (THCGME) before funding expires. Currently, dollars from the Community Health Center Fund (CHCF) flow to every Community Health Center to support expanded services, such as substance use disorder treatment and telehealth, open new sites and access points, and boost the quality of care provided at health centers. In fact, there’s little doubt amongst Members of Congress about the importance of the CHCF and no debate at all about whether to provide an extension. The questions remaining are how and when both chambers will find agreement and advance an extension of health center funding as a part of comprehensive bill.
There are signs of progress in Washington. The House Energy & Commerce Committee and the Senate Health, Education, Labor, and Pensions (HELP) Committee have respectively passed four-year and five-year extensions of these primary care programs. While each of these bills only provide funding at the current level ($4 billion/year in the case of health centers, $126.5 million/year for Teaching Health Centers, and $310 million/year for the National Health Service Corps), they serve as the foundation of Congress’ current work to extend funding. These committee-passed bills represent long-term renewals compared to the previous two extensions in 2015 and 2018, both of which lasted for just two years. With your continued support and advocacy, we’re hopeful that Congress’ final package to renew these important programs will be longer and more robust than any previous extension.
One major hurdle is for Congress to agree upon how to offset the costs associated with extending funding for all three programs. The legislation advanced in both the House and Senate Committees would pay for an extension of the CHCF, NHSC, and THCGME by limiting surprise medical bills, but legislators are trying to settle disputes between providers, insurers, hospitals, and others about the details of that policy before choosing a path forward. The federal government saves more money if Congress can limit instances of surprise medical bills, but stakeholders disagree about the best way to do it. An ad campaign in Washington is also hampering the probability that Congress will find agreement and use these savings to pay for an extension of our programs. Stay tuned.
Congress isn’t only discussing our mandatory funding – annual discretionary funding is also a hot topic in Washington. The Labor, Health and Human Services, Education, and Related Agencies spending bill, the largest of the 12 spending bills, currently provides $1.63 billion for health centers – an investment that is especially important for delivering health care services to patients across the nation. Before the August recess, legislators also passed a comprehensive budget deal, which increased spending caps by $320 billion over two years and delayed the debt ceiling through 2021. Normally, a budget deal of this size and scope would set the stage for Congress to easily fulfill its constitutionally-required duties and pass all 12 discretionary spending bills before September 30 to avert a government shutdown. However, with just 14 legislative days – roughly 3 weeks – to pass the 12 required annual spending bills through both chambers of Congress, leaders in Washington remain embroiled in partisan political fights. Additionally, with the House of Representatives having passed 10-of-12 annual spending bills, and the Senate having passed none (but planning to review four spending bills this week including the Labor-Health-Education spending bill) legislators are already discussing a two-month short-term spending patch to keep the government open.
So what does all of this mean for health centers? It means that even though we’ve made a lot of progress this year in moving forward long-term funding extensions for the CHCF, NHSC, and THCGME and securing robust annual appropriations funding, we still have a long way to go and lots of work ahead of us. That’s why we need you to join us and lend your voice to our unrelenting advocacy efforts throughout the month of September and every day until we meet our goals. We’ll keep you posted on all the latest from Congress, but in the meantime please visit http://www.hcadvocacy.org/takeaction/ to find out how you can help get our funding across the finish line!