Congressional Corner

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Dec. 21, 2017

Continuing Resolution

Last night, legislation was introduced (H.R. 1370) to extend the Children’s Health Insurance Program (CHIP), fund the federal government through Jan. 19, and extend funding for other important public health programs. Unfortunately, this legislation uses a portion of the Prevention and Public Health Fund (PPHF) to offset the cost. A summary of the bill is here. Below, please find additional information about the public health provisions in H.R. 1370.

  • Federal Funding: The current continuing resolution (CR) funding the federal government expires tomorrow, Dec. 22. This bill would extend the CR through Jan. 19.
  • CHIP: Provides $2.85 billion for CHIP through Mar. 31, 2018.
  • Statutory Pay-As-You Go (PAYGO): Includes language to prevent the automatic sequester cuts to non-exempt mandatory programs.
  • Influenza: Provides $112 million in the public health and social services emergency fund to prepare for or respond to an influenza pandemic.
  • Community Health Centers: Provides $550 million for the first and second quarters of FY18.
  • National Health Service Corps: Provides $65 million for the first and second quarters of FY18 extended through FY18.
  • PPHF: This bill extends funding for CHIP and other important public health programs cutting PPHF by $750 million from FY19-FY22.

PPHF Funding Levels Table

MIECHV

Reauthorization of the federal home visiting program is not included in the short-term spending bill. However, it is expected to be addressed in the new year with the longer-term fix for CHIP and community health centers. ASTHO will continue to monitor this program.

Tax Bill and Market Stabilization

The tax bill (H.R. 1) approved by the House and Senate includes a change to ACA’s individual shared responsibility penalty, effective 2019. As the tax bill is written, it does not directly repeal the mandate, but lowers the penalty to $0. Having minimum essential coverage is still legally required, but there is not a penalty if individuals are not covered. Other provisions of ACA that support the individual mandate remain in place. For more details, Health Affairs has an informative blog post.

On Dec. 20, Sen. Alexander (R-TN) and Sen. Murry (D-WA) issued a statement announcing that they will postpone action on their health bill, which includes a state reinsurance program (S 1835) and extends cost-sharing subsidies for low-income people who purchased health insurance through the marketplace and qualify. The bill will most likely be considered next year when FY18 spending bills are finalized.

Emergency Supplemental Details Released

The House is expected to vote separately on an emergency supplemental bill (H.R. 4667) to provide funding to the states and territories affected by the recent disasters. This legislation includes $200 million for CDC and $177 million for the public health and social services emergency fund.

A summary provided by the minority appropriations committee can be found here. Portions of the Labor-HHS-Education section relevant to public health include:  

  • $200 million for CDC mosquito eradication, infectious disease response, environmental health, and repairs to facilities.
  • $20 million for SAMHSA to support behavioral health treatment, crisis counseling, and other related activities.
  • $15 million for NIH to repair or rebuild non-federal biomedical and behavioral research facilities.
  • $60 million for community health centers for renovation, construction, equipment, and operations.
  • $80 million for Preparedness and Response (ASPR) to hire emergency personnel, replace emergency medical supply caches, and upgrade equipment.

Please note: authorizing language includes allowing temporary direct hiring authority for CDC and ASPR emergency response personnel.

The current environment in Washington, D.C. remains extremely fluid. We will continue to actively monitor and update ASTHO members accordingly.