September 30th, 2011 | View Archive
Congress Passes Temporary FY11 Continuing Resolution
For the third time in less than a year, the government faced a potential shutdown when the Senate and House disagreed on funding a continuing resolution for FY11 due to FEMA disaster relief funds and cost offsets.
After the Senate passed a temporary spending bill on Monday, the House passed the same measure on Thursday during a pro forma session. The bill funds the government through October 4, allowing them to return to Washington from their week long recess and vote for a longer CR that will fund the government through November 18.
The measure goes to President Obama to be signed into law before the end of the current fiscal year at midnight Friday.
HHS Announces Coordinated Care Initiative
HHS announced the Comprehensive Primary Care Initiative on Wednesday, that will increase Medicare payments to primary care providers who adopt a coordinated care model. CMS plans to oversee a four-year demonstration model beginning next year in five to seven health care markets. Providers in HHS-supported accountable care organizations will not be able to participate.
CMS seeks to place demonstration projects in areas with multiple interested public and private insurers. These insurers will help select about 75 practices in each market. Providers will be paid an extra $20 per month, on average, per Medicare beneficiary in the first two years; the funds will cover a little over 330,000 Medicare patients total. The money can be used at providers' discretion to build up infrastructure for coordinated care, likely with increased staff, longer hours of access and electronic health records.
Obama Administration Asks Supreme Court to Take Up Health Law
Last month, the 11th Circuit Court of Appeals in Atlanta ruled on the controversial portion of the Affordable Care Act, requiring individuals to obtain health insurance or pay a fine. The mandate was ruled unconstitutional but the rest of the law remains intact. The Justice Department asked the Supreme Court to review the appeals court decision. Republicans have asked the same in several states and both parties are gearing toward a verdict timeline around the 2012 election.
The Administration expressed confidence the law would be upheld if the case is heard by the Supreme Court. The Justice Department stated, "Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act and the Voting Rights Act, and all of those challenges failed. We believe the challenges to [the] Affordable Care Act — like the one in the 11th Circuit — will also ultimately fail and that the Supreme Court will uphold the law."
House Releases Labor-HHS-Ed FY12 Budget
The House Labor-HHS-Education Appropriations bill for fiscal year 2012 was released Thursday. The draft bill would provide $153.4 billion in discretionary spending, which is about $4 billion less than the current level. Republicans have set up a new political battle between the House and Senate by defunding the Affordable Care Act and the K-12 Race to the Top — two key health and education programs passed under Democratic leadership. Although the committee has released draft bill language, the subcommittee has yet to reschedule their mark-up.
Higher Education
While the bill eliminates many of the Administration's newly implemented K-12 education programs, it provides funding to maintain a maximum Pell grant award at $5,500. However, appropriators added language that would change how the grant is distributed, including limiting the lifetime eligibility to six years, down from nine; rolling back recent changes to the qualification formula; eliminating eligibility for students who attend school less than half-time or students who do not have a high school diploma; and limiting funding to the neediest students.
Other Highlights:
- International Education & Foreign Language (Title VI) is cut by approximately $10 million to $66.7 million from already reduced FY11 levels
- Federal Work Study is level funded at $978.5 million
- TRIO is level funded at $826.5 million
- GEAR UP is level funded at $302.8 million
- Investing in Innovation (i3) and the Fund for the Improvement of Post-secondary Education (FIPSE) are eliminated in the bill
Health Provisions
The draft bill drastically cuts funding for Title VII health professions programs, providing a total of $87.5 million, a $185 million (67.9 percent) cut. The draft eliminates funding for several Title VII health professions education programs, including the Health Careers Opportunity Program, Scholarships for Disadvantaged Students, Primary Care Medicine, Area Health Education Centers, and the allied health programs. The draft also substantially reduces funding for the Centers of Excellence and the public health and preventive medicine programs. Title VIII nursing education programs suffer similar cuts in the draft, which provides $106.8 million, a $135.6 million (55.9 percent) cut.
The bill appropriates money to NCRR, not the new NCATS as the Senate bill does. The bill also provides up to $10 million within the OD for the Director's Discretionary Fund, of which up to $2 million "may be used to establish the Cures Acceleration Board within the Office of the Director's Division of Program Coordination, Planning, and Strategic Initiatives to develop a plan with prioritized recommendations related to the Cures Acceleration Network for consideration in future appropriations."
The bill includes statutory language requiring the Director of NIH to support "at least 9,150 new and competing research project grants," an increase of about 450 from the fiscal year 2011 projection.
Other Highlights:
- Includes $193 million for the National Children's Study
- $488 million for Clinical and Translational Sciences Awards
- $331 million for Institutional Development Awards (IDeA) programs.
- Maintains funding for the Children's Hospitals Graduate Medical Education (CHGME) program at the FY 2011 level of $268.4 million
- Reduces the Agency for Healthcare Research and Quality (AHRQ) by $47.8 million (12.8 percent) for a total of $324.3 million
- Eliminates $295 million from the National Health Service Corps (NHSC) Fund created under the ACA for FY 2012. The bill also proposes a total FY 2012 appropriation of $142 million for the NHSC, a $173 million (55 percent) cut below the FY 2011 comparable level.
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