The U.S. House of Representatives passed a continuing resolution (CR) - a short-term government funding bill - on February 6, which would fund the government through March 23 and avoid a government shutdown. Congress has until February 8 to approve a budget deal before government funding runs dry. House Republican leadership included several health extenders important to counties in the CR and an extra $30 billion in defense spending, a potential sticking point with Senate Democrats who are seeking an equal increase for non-defense spending. Sixty votes are needed for a CR to pass the Senate, requiring some Senate Democrats to support the bill.
The House-passed CR would impact several federal health programs important to counties, including Community Health Centers (CHC), funding for Disproportionate Share Hospital (DSH) payments and the Prevention and Public Health Fund (PPHF). The measure would extend funding for CHCs, which provide primary health services for over 20 million people, for two years and delay scheduled cuts to DSH payments for two years, ensuring county-supported hospitals would receive partial compensation for treating indigent patients. Unfortunately, the CR also includes deep funding cuts to the PPHF, which passes funds directly from the federal government down to state and local health departments, including over 1,900 county public health departments. Extending funding for the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, a federal-state partnership used by counties to enhance early childhood development, is not included in the legislation.
Also attached to the House version of the CR is the Family First Prevention Services Act (FFPSA) (H.R. 253), which would implement significant reforms to the nation’s foster care and adoption systems. NACo supports the goals in FFPSA of providing prevention services and reducing congregate care placements, but has encouraged federal lawmakers to address provisions in the bill that could shift costs to state and local governments by eliminating federal reimbursements for foster care and adoption benefits.
On top of these issues, Congress also faces additional dilemmas regarding immigration policies that could be attached to the CR. President Trump called on Congress to implement additional immigration restrictions in the bill, threatening a shutdown over the issue. Senate Democrats, meanwhile, still hope to see the Deferred Action for Childhood Arrivals (DACA) program extended through a CR, which the Trump Administration announced would end on March 5, 2018 unless Congress acts.
Congress is expected to continue negotiations on a budget deal this week as lawmakers seek a longer-term spending deal. NACo will continue tracking legislative developments on these programs and their potential impacts on counties.
For additional NACo resources on the appropriations process, please see the following links: