Senate bill leaves out funds for launching reform

A new Senate funding bill omits resources the Obama administration sought to launch healthcare reform.

The $984 billion bill, unveiled late Monday, would keep the government funded through Sept. 30 and avert a federal shutdown slated for March 27.

The bipartisan measure avoided most provisions that would have drawn a Republican filibuster. That included $1 billion the White House had hoped to steer to the CMS for carrying out provisions of the Patient Protection and Affordable Care Act. The addition to the $3.8 billion CMS administrative budget, according to congressional Democrats, was primarily intended to help the launch of health insurance exchanges, which are supposed to begin enrolling beneficiaries in all 50 states on Oct. 1.

The federal costs of those exchanges likely have spiraled since 26 states deferred in February to the federal government to operate their marketplaces—far more than the law's authors had expected.

The House passed its version of the funding bill last week, and that measure also lacked the additional funds for the healthcare overhaul. Both bills also withheld $10 million of the $15 million the Affordable Care Act provided for the controversial Independent Payment Advisory Board. The panel was created by the healthcare overhaul to cut future Medicare growth that exceeds preset levels. Both funding measures also allow the continuation of the so-called budget sequester, which cuts $1.2 trillion in federal spending over 10 years, including reducing Medicare provider payments by 2%.

The Senate is expected to pass its spending measure by the end of this week.

Under the Senate bill, HHS would have to obligate all fiscal 2013 funds appropriated for community health centers by the end of the fiscal year. President Barack Obama's proposed budget for the current fiscal year had requested holding back $280 million of that money.

“This funding will help existing clinics offset increasing costs and allow new primary-care clinics to open across the country,” according to a summary.

The Senate bill also would rescind $200 million of $500 million appropriated in the healthcare overhaul for a program that aimed to move high-cost Medicare participants out of hospitals and into home-based care. The reduced funding was made possible by the program's lower-than-expected costs, according to the summary.

The National Institutes of Health, meanwhile, would get an additional $71 million under the Senate bill. An amendment expected this afternoon from Sen. Tom Harkin (D-Iowa) would boost that increase to $211 million.