Health Center Appropriations Letters- the Clock is Running Down!
By Kaitlin McColgan
With all the talk of health reform and the enormous stakes that the votes this week will hold for health centers and our future, it might be all too easy to lose focus of the other major effort that health center advocates have underway right now: the push to get signers on our annual appropriations letters. But, as we all know, there are some times that call for multitasking, or as I heard one savvy health center grassroots advocate put it last week, “dual strategies for success.” This is one of those times!
As of this writing, we currently have 158 Members on the Pallone-Granger letter and 39 Senators on the Senate Stabenow-Bond letter. These numbers are well short of our goals of 218 signatures on the House letter and 60 on the Senate letter. As those who’ve been through this drill before know, the more signatures we get on these letters, the better our chances of getting an FY2011 increase. We need more signatures!
I also wanted to take this chance to clear up a couple of “frequently asked questions” we’ve received over the last week. The first relates to whether signing this letter violates the recently passed rule of the House Republican Caucus that bans earmarks. The answer: no. The Health Centers program is a competitively awarded national program that is authorized in the law, it does not meet any definition of earmark, including the one in the House Rules that the Republican Conference rule cites.
The second question is whether or not it is true that appropriators never sign letters. The answer to that one is a little less clear cut. While many appropriators decline to sign any letters to the Appropriations Committee, some in fact do, and several are on this year’s letter. Indeed, in both the House and Senate we have an appropriations committee member as a co-lead on our letters. However, even if your Member of Congress is an appropriator who has a policy of not signing letters, you can and should still seek their support. Every member of the committee will have a means that they use (usually a personal request letter) to communicate their priorities to the Chairman and Ranking Member. You should ask for the Member to make the Health Centers program a part of that priorities letter/wish list.
Our appropriations letter leads have given us another bite at the apple in improving our numbers by extending the House letter deadline until the end of the day tomorrow and the Senate letter until Friday. Let’s take advantage of that extension and get these signatures up over our goal!
Health Reform’s Future and Your Role In It
By Craig A. Kennedy, MPH
We are definitely entering the stretch run for health care reform for this year (really we are this time!) and, perhaps, for many years to come. As someone who sits in the middle of the arena, my read is that reform is either going to pass in the next month or two (probably shortly after the Easter break), or it will not pass this year. With that in mind, there are a lot of groups working harder than ever to keep the momentum moving forward and to get reform passed (see the FamiliesUSA letters, among others). NACHC has signed onto a variety of letters supporting reform, and we have endorsed both the House and Senate bills because they meet our principles for reform. However, new legislation is being written right now that may have a tremendous impact on the health center-specific provisions we have worked so hard to get included. We are working with leaders in Congress and the Administration to preserve the health center priorities in the Senate-passed legislation (see my previous post), while also understanding that the big test will be navigating the process and winning votes in the House.
All indications are that the path forward is for the House to pass the Senate-passed health care reform bill as is, followed by a “fix” bill using the budget reconciliation process. Read more
“Getting to Yes” on Health Reform
by Kaitlin McColgan
In my old Congressional office, we used to employ the phrase “let’s get to yes” as one of our intra-office expressions. It was a half joking/half serious take on the bestselling book “Getting to Yes” by Roger Fisher and William Ury. Given the events of the last week, it is no wonder that phrase has re-entered my daily vocabulary.
President Obama this week took perhaps his strongest stance to date in health reform, essentially telling Members of Congress from both parties: let’s get health reform done, period. Democratic Congressional Leaders have declared that health reform will be enacted, and they will use all of the tools at their disposal to ensure that happens. There have been suggestions this could all happen by as soon as the Easter congressional recess.
How will health reform “get to yes”? Read more
Goodbye P&I, Hello Approps!
by Krystal E. Knight
Now that most of you should have recovered from the AMAZING time we all had at last week’s P&I, it’s time for us to focus our energy towards appropriations! The Hill visits you all scheduled went very well, and thanks to you, Congress is becoming more aware of Health Centers’ needs in FY 2011. But we’ve still got a long way to go to make a FY2011 increase a reality- and we need your help!
We have two “Dear Colleague” letters circulating Congress at this time. In the House, we are pleased to have Rep. Frank Pallone (D-NJ). joined by Rep. Kay Granger (R-TX) in leading the Pallone-Granger letter. In the Senate, we are equally grateful to have Senators Debbie Stabenow (D-MI) and Kit Bond (R-MO) lead our Stabenow-Bond letter once again!
In our letters, Health Centers are asking for a $370 million increase for the program, bringing our total to $2.56 billion, which is $80 million more than what the President proposed for Health Centers in his FY 2011 Budget. While we’re grateful to the President for his request, we all know that Health Centers are facing enormous demands and witnessing continuing unmet need in their communities, particularly during these tough economic times. We’re seeing more patients than ever before, and more of our patients are uninsured. Our requested increase will strengthen existing health centers by making Increased Demand for Services funding permanent, allowing for expanded dental, mental health, and pharmacy services, shoring up the FTCA fund, and expanding health centers to new medically underserved communities.
Please ask your representatives on the Hill to sign on to the Pallone-Granger and Stabenow-Bond letters today! The more signatures we have in support of our appropriations ask, the more likely our efforts will produce the necessary increase for FY 2011. We are keeping signatures up-to-date on the NACHC website so you can keep track of your representatives and either thank them for signing on, or encourage them to do so.
President’s Health Reform Proposal Released As Health Centers Get Ready to Head to the Hill
by Kaitlin McColganm
Yesterday, President Obama unveiled his health reform proposal, largely a series of proposed revisions to the Senate-passed health reform legislation.
You’ll remember that the Senate-passed health reform bill contained $8.5 billion in new funding for the Health Centers program over 5 years, $1.5 billion of that for capital. The House-passed health reform bill contained $12 billion over 5 years for health centers.
The President’s proposal echoes those two earlier bills by calling for guaranteed funding for health centers and proposing a compromise level of funding: $11 billion over 5 years, including a portion of that funding for capital. The President’s proposal also seems to leave intact the Senate-passed “Menendez” provision, providing health centers at least their Medicaid PPS rate under new private “exchange” plans.
The President’s proposal to increase the health centers funding over the Senate bill was unquestionably a positive development in the health reform process for health centers. Perhaps more important, however, was the affirmation this funding provided on the eve of a pivotal meeting between leaders of the House and Senate that access to care will remain a part of the discussion in the days to come.
This Thursday, members of both parties head to the White House for what may be the most candid debate on health reform by political leaders on both sides to date. The very same day, health centers from across the country head to Capitol Hill with our legislative agenda. One thing is for sure; it is going to be quite a week in the nation’s Capital for health centers. Hope to see you here!
White House Takes a Seat at the Head of the Health Reform Table
By Alexandra Sange
After a month in legislative hibernation, national health care reform will again take center stage in Congress. On Thursday, February 25th, the day of NACHC’s annual advocacy day on the Hill, President Obama will gather a bipartisan group of congressional leaders at the White House for a televised summit to reinvigorate the health reform debate and salvage the overhaul. In the face of both Democrats and Republicans admittedly mixed feelings about the summit’s value, White House Chief of Staff Rahm Emanuel and HHS Secretary Kathleen Sebelius have promised that the President will prepare and release his own legislation for leaders to discuss at the summit. Read more
Hanging with the Secretary
By Krystal E. Knight
This Monday, I headed over the Department of Health and Human Services (HHS) to watch Secretary Sebelius’ remarks on the FY 2011 Budget. I’m glad I braved the Washington, D.C. weather and made it out because Secretary Sebelius said some PHENOMENAL things about Health Centers!
- She deemed Community Health Centers the “backbone of the American health care system,” and said the $290 million increase the program received in the President’s Budget would “provide high-quality primary care” for 3 million patients.
- Secretary Sebelius said Community Health Centers will use the increase to provide additional health care access to those Americans who are without it, but she was careful to point out that the budget, including the Heath Center increase, is not a substitute for health reform.
- Secretary Sebelius called Health Centers a “platform” for health care reform, an example of what reform should look like in this country.
Those who heard Secretary Sebelius speak at last year’s CHI in Chicago already knew she was a true health center fan, but this briefing certainly confirmed it!
Health Centers Get Big Boost in President’s Budget
By Kaitlin McColgan
Today, the President released his FY2011 Budget. After all the talk of the discretionary spending freeze, health center advocates like many others were understandably 
wondering (and nervous about) what the budget would hold.
The answer?
The budget contained a significant increase for the Health Centers program: $290 million. Even more, though, it demonstrated an advanced understanding of the situation on the ground for health centers and medically underserved communities. For years, through our ACCESS for All America plan, NACHC and health centers have urged that increases to the Health Centers program preserve, strengthen and expand, and this budget does just that.
For starters, the budget appears to propose making the Increased Demand for Services or “IDS” funding to every health center in the country permanent. Making this funding permanent would essentially provide a $175 million base grant adjustment. This, combined with making the ARRA New Access Points permanent (at a cost of around $78 million), would provide funding for continued care to almost 3 million patients.
In addition, the budget calls for $40 million in growth funding above that, meaning possible service expansions, expanded medical capacity, and New Access Points (NAPs) for areas without a health center. We would have liked, of course, to see that growth funding significantly higher. As many know, there has not been an opportunity to apply to become a health center since 2007, and there is huge pent-up demand across the country for these grants. Our service and expanded medical capacity grants have also been incredibly competitive, with demand far, far outstripping need. This is one reason why NACHC’s requested increase may exceed even the President’s request.
However, on a day when so many programs are facing flat funding or minimal increases, health centers are at least in a better position than most heading into the long appropriations season. And, while this is without a doubt a positive first step in the process, there’s a long road ahead. In a year like this, we’ll need plenty of advocacy from the grassroots in the coming months to make this funding increase a reality.
Finally, if you are wondering how this funding interacts with the trust fund spending proposed in health reform, stay tuned for a future blog post on that very subject!
An Annual Ritual: Washington Waits for the Release of the President’s Budget
by Krystal E. Knight
It’s seems like only yesterday Congress passed the FY 2010 Omnibus Appropriations Act, which unfortunately level-funded the Health Centers program at $2.2 billion. Well, another appropriations season is upon us and it all starts Monday when the President releases his FY2011 Budget. The Department of Health and Human Services (HHS) has announced that Secretary Kathleen Sebelius will present the HHS portion of President Obama’s budget on Monday, February 1st. NACHC will have representatives at the presentation, but most of us will be anxiously monitoring the unveiling and analyzing the numbers from our desks the minute the budget is posted (most likely around 12:30EST on this web page for those who can’t just wait for the Washington Update) .
In his State of the Union address Wednesday night, the President confirmed media reports that he will request a 3-year freeze on discretionary spending. However, this freeze will not be across the board, rather some programs will be cut and others increased.
With the President’s budget unveiled, NACHC will be moving forward to implement our annual appropriations strategy, this year doing so in parallel to our continuing efforts to secure mandatory health center funding in health reform.
We’ll be back on Monday with an update on what the President’s Budget says about the Health Centers program, the National Health Service Corps, and other key programs.
Stay tuned!
Majority Leader Hoyer Says Jobs, Deficit, Health Reform On Democrats’ 2010 Agenda
By Ielnaz Kashefipour, NACHC Public Policy Intern
House Majority Leader Steny Hoyer (D-MD) delivered a speech at the National Press Club this morning on the Democrats’ 2010 legislative agenda. According to the Majority Leader, Dems will focus on job creation and deficit reduction – one and the same goal, as unemployment and a down economy drive the deficit up. Majority Leader Hoyer framed health reform as a powerful response to economic insecurity, as comprehensive reform would create millions of jobs and ensure middle-class Americans have stable health insurance coverage and lower health care costs. Read more
