Staff: Laura Hanen

On Sept. 30, FY2013 ended, and because Congress had not successfully passed its appropriations bills or a continuing resolution to continue funding, “non-essential” government services were shut down, including 65 percent of the CDC workforce. NACCHO sent a letter to Capitol Hill calling on Congress to end the shutdown and to find a long term solution to sequestration.

On Oct. 16, ahead of a potential default on the national debt, Congress passed legislation to reopen the government until Jan. 15 and extend the debt ceiling until Feb. 15. The deal included provisions to:

• Reimburse state government and other grantees for costs incurred during execution of federal program that would normally be paid for by federal appropriations. This authority applies to any period in fiscal year 2014 in which a lapse in appropriations has occurred.
• Pay federal government employees who were furloughed during the shutdown retroactively to Oct. 1.

• Tighten requirements for verifying the income of individuals receiving health-insurance subsidies under the Affordable Care Act.

In addition, an informal agreement was reached to form a Budget Conference Committee to hammer out budget recommendations by Dec. 13. The 29 Budget conferees have begun discussions to reach a final resolution on FY2014 funding. The spending gap between the House and Senate is about $19 billion for FY2014. House Republicans are seeking to keep in place the $967 billion cap set by the 2011 debt deal, while Senate Democrats are pushing for raising it to at least $986 billion, which would match FY2013 funding. There are minimal expectations for long-term budget decisions or a “grand bargain.” Treasury Secretary Jacob Lew called on the Conferees to fix the sequester and find a solution that replaces it with “common-sense measures” to address the budget deficit.

NACCHO is focused on educating the 29 conferees on the impact of sequestration in FY2013 and the need to end sequestration in FY2014 and beyond. Now that the funding has trickled down to the local level, NACCHO will be asking local health departments for impact examples as we did with the shutdown. The Centers for Disease Control and Prevention (CDC) has released a memo providing guidance about FY2014 continuing resolution funding, which is in place until Jan. 15. CDC’s plan does not include any funding from the $928 million (post-sequester) available in FY2014 through the Prevention and Public Health Fund as it has not yet been allocated by the Department of Health and Human Services or Congress.

Sequestration in FY2014 requires further cuts of $109 billion to non-defense discretionary programs resulting in deep cuts to federal funding for health department programs. Therefore, the period between now and Dec. 13 offers a critical opportunity for local health departments to urge Congress to address sequestration through a balanced approach for FY2014.