House panel OKs bills targeting reform funding

The House Energy and Commerce's Health Subcommittee has approved five bills that aim to limit the HHS secretary's spending authority under the health reform law and also subject some of the statute's mandatory spending to the annual appropriations process.

On Thursday, the subcommittee voted 14-11 to approve legislation that would change a provision in the Patient Protection and Affordable Care Act that gives the HHS secretary an unlimited amount of funds for state-based exchange grants. This bill would cancel unlimited direct appropriation and also rescind any unobligated funds.

In another 14-11 vote, the subcommittee approved a bill from Subcommittee Chairman Joe Pitts (R-Pa.) to repeal the section of the Affordable Care Act that creates a prevention and public health fund and gives the secretary full authority to administer that funding, which totals $17.75 billion from fiscal year 2012 to 2021.

Rep. Michael Burgess (R-Texas), a physician, wrote a bill that eliminates the section of the law that authorizes the secretary to award grants to support the construction of school-based health centers but that prohibits using the funds for personnel or to provide health services. That also passed in a 14-11 vote. Reps. Lois Capps (D-Calif.) and John Dingell (D-Mich.) issued a joint statement calling it a "Republican myth” that there will not be money to staff school-based health clinics. “All schools applying for funds must demonstrate they have adequate funding to staff the clinics,” the statement said.

Meanwhile, Rep. Bob Latta (R-Ohio) wrote a bill that makes changes to the section of the law that establishes grants for personal responsibility education programs and provides $75 million for each fiscal year between 2010 and 2014. Latta's bill—which passed 15-11—converts the appropriation into an authorization that would require Congress to determine funding through the appropriations process. The bill would also revoke any unobligated funds.

Finally, Rep. Brett Guthrie (R-Ky.) authored a bill that would convert mandatory appropriations into authorization that would also require Congress' appropriations process to the provision in the law that authorizes the secretary to award teaching health centers development grants and appropriates $230 million for 2011 through 2015. The subcommittee approved that bill in a 14-11 vote.

These provisions were the subject of a subcommittee hearing a few weeks ago, after which Subcommittee Chairman Joe Pitts (R-Pa.) suggested other provisions could also be targeted, and that the subcommittee had started with just these five.