New Congress Kicks Off, Plans for Health Reform Repeal Vote
The lame duck session of Congress during the final months of 2010 saw a surprising amount of legislative activity. As one of its final acts, the 111th Congress passed the FDA Food Safety Modernization Act and sent it to the President for his signature. This bill expands the recognition of the local and state roles in prevention and surveillance of foodborne illness and authorizes capacity building grants for state and local governments. The bill directs the Secretary of Health and Human Services to improve training of state, local, territorial, and tribal food safety officials and authorizes grants for training, conducting inspections, building capacity of labs and food safety programs, and other food safety activities. Appropriations are required to fund these grant programs, and it will be challenging to gain money for any new activities in the coming year.
Appropriations for FY11, which started Oct. 1, 2010, stalled in the lame duck session, and Congress passed a continuing resolution to fund the government through March 4, 2011. Since the Republicans have taken over the majority in the House of Representatives, it is unclear what will happen with FY11 funding after the continuing resolution expires. There is $750 million in mandatory spending available from the Prevention and Public Health Fund in FY11, which it appears the President may allocate, as was done with the $500 million in FY10 funding. NACCHO has sent a joint letter with the Association of State and Territorial Health Officials to the administration advocating for continued funding for the public health infrastructure program from the fund in FY11.
The current climate presents local health departments with a conundrum and NACCHO with a dual challenge. On the one hand, there will be efforts to repeal the Prevention and Public Health Fund, so strong defensive action will be needed. On the other hand, Administration and state work to implement the Affordable Care Act will continue, so it is equally important to articulate and represent the interests of local health departments as local, state, and federal implementation work moves forward.
NACCHO has participated in various activities to provide input to Health and Human Services (HHS) staff drafting the National Prevention Strategy (NPS), including a joint meeting with the Association of State and Territorial Healthcare Officials (ASTHO) to discuss how governmental health departments might participate in implementing each of the 10 strategic directions in the current draft of the NPS.
The House of Representatives is expected to vote in January on a bill to repeal the health reform law. This bill will most likely pass the House, but is not expected to be voted on in the Senate. It is more likely that we will see attempts this year to chip away at the health reform law and that the Prevention and Public Health Fund will be a particular target. We will need to simultaneously guard against efforts to eliminate the fund and provide input on implementation as the administration moves forward in its efforts to roll out pieces of the law.
It is unclear what will happen with FY12 funding. The new Republican leadership is vowing to make substantial cuts in government spending, reducing government spending to FY08 levels. The President's budget is due to be released Feb. 14, and he has also pledged to take steps to cut the deficit. NACCHO will continue to advocate for appropriations for key programs that benefit local health departments.
The new leadership in the House is as follows:
The Senate leadership remains Sen. Harry Reid (D-NV), Majority Leader. Senator Tom Harkin (D-IA) remains the chair of the Health, Education, Labor and Pensions Committee and the Senate Labor, Health and Human Services, Education Appropriations Subcommittee.