At a Wednesday hearing of the Energy and Commerce Health Subcommittee, lawmakers and witnesses discussed five sections of the law to determine if they required funding; if they are funded responsibly; and if they should be considered mandatory or discretionary.
These sections included unlimited mandatory spending for state-based exchange grants issued by the HHS secretary, as well as the funding for the law’s prevention and public health fund; construction and capital cost for school-based health centers; the personal responsibility education program; and teaching health center development grants.
“Last Thursday I asked Secretary Sebelius whether she needed further congressional approval to spend the money from the 4002 fund, and she answered no,” said Rep. Joe Pitts (R-Pa.), the subcommittee’s chairman, referring to section of the law pertaining to the prevention and public health fund. “I then asked her if she could fund activities above and beyond the level Congress appropriated, and she said yes,” he continued. “This should concern every member that we have created a slush fund that the secretary can spend from without any congressional oversight or approval.”
After the hearing, Pitts talked about the subcommittee's next steps. “We’ll introduce legislation and have a markup on some of the ‘cut bills,’ if you will,” Pitts said. “Changing mandatory to discretionary or authorization—or actually eliminating some of them,” he said, adding that it’s possible other programs would be considered later. “We’ve started with the five.”