Overall, the 459-page bill includes nearly $40 billion in nondefense spending cuts and provides funding to keep the federal government operating for the remainder of fiscal year 2011, which ends Sept. 30. The legislation reduces spending for a host of healthcare programs, including more than $1 billion for HIV AIDS, viral hepatitis, sexually transmitted diseases and tuberculosis prevention, and about $600 million for community health centers, $78 million for research on health quality and outcomes, $35 million for rural health programs, and $17 million for Title X family planning and returns that the Title X funding back to fiscal year 2008 levels. All of those cuts are compared with the spending levels enacted for fiscal year 2010, according to a list of the reductions.
Meanwhile, the bill eliminates funding for the free choice voucher provision included in last year's Patient Protection and Affordable Care Act, as well as the Consumer Operated and Oriented Plan, or CO-OP, provision. According to HHS, the Affordable Care Act established the CO-OP as a way to foster the creation of qualified not-for-profit health insurance issuers that would offer health plans in the individual and small group markets. The law also required the Comptroller General to establish a 15-member advisory board—which happened last June—to make recommendations to the HHS secretary related to the awarding of grants and loans.
“My committee went line by line through agency budgets this weekend to negotiate and craft deep but responsible reductions in virtually all areas of government,” House Appropriations Committee Chairman Hal Rogers (R-Ky.) said in a news release announcing the final continuing resolution. “Our bill targets wasteful and duplicative spending, makes strides to rein in out-of-control federal bureaucracies, and will help bring our nation one step closer to eliminating our job-crushing level of debt.”
The bill would also eliminate about $3.5 billion in performance bonus payments under the Children’s Health Insurance Reauthorization Program in the Social Security Act, which is funding set aside for those states that hit enrollment targets for enrolling eligible children in the Medicaid program, according to Jocelyn Guyer, co-executive director at the Center for Children and Families at Georgetown University’s Health Policy Institute. If states exceed their targets, they receive bonus payments on a per-child basis. Guyer said her office estimates there is at least $7 billion in that fund, leaving more than enough money for these performance bonuses.
“We’re not even remotely alarmed about it,” Guyer said of the provision. “We think there is plenty of money to reward states for successful enrollment,” she said, adding that even if every state received as much as the highest amount rewarded last year—$54 million to Alabama—there would be enough to go around. Adding context to the provision, Guyer said 15 states received a total of $206 million in bonus funds last year.
The House is expected to vote on the continuing resolution this Thursday, according to a spokeswoman in House Majority Leader Eric Cantor's (R-Va.) office.