House extends SRS, CHIP

On March 26, the U.S. House of Representatives overwhelmingly passed legislation that would extend several federal programs important to counties, including Secure Rural Schools (SRS) and the Children’s Health Insurance Program (CHIP). House lawmakers passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, by a vote of 392–37. Under the legislation, SRS would be reauthorized for FY14 and FY15, and CHIP, along with other key health care programs, would be extended. H.R. 2 must now be taken up and passed by the Senate, likely after returning from recess on April 13.
Crafted by House Speaker John Boehner (R-Ohio) and Minority Leader Nancy Pelosi (DCalif.), H.R. 2 is a compromise bill that would permanently correct the formula by which physicians are paid under Medicare. 
Importantly for counties, the bill also addresses several federal programs:

• Secure Rural Schools (SRS) Extension: H.R. 2 would provide two years of critical SRS funding to rural counties and school districts affected by the decline in revenue from timber harvests on federal lands. It would authorize $500 million to support local schools, roads, law enforcement and other critical services in more than 720 counties and 4,000 school districts across 41 states. H.R. 2 also includes provisions to expedite SRS payments to counties by requiring the federal government to make SRS payments within 45 days of the bill’s enactment and provides greater flexibility for how counties may spend SRS funds.
• Children’s Health Insurance Program (CHIP): CHIP is a federal-state partnership that provides low-cost health coverage to more than 8 million children and pregnant women in families that earn income above Medicaid eligibility levels. Current funding for CHIP expires in September 2015 and H.R. 2 extends funding for two years.
• Disproportionate Share Hospitals (DSH): H.R. 2 also supports the financing and delivery of Medicaid services by delaying the scheduled reductions in payments to hospitals serving a disproportionate number of Medicaid beneficiaries and the uninsured, called Disproportionate Share Hospitals (DSH), by one year from 2017 to 2018. Delaying these cuts further allows the 960 county-supported hospitals and others that serve Medicaid beneficiaries and the uninsured across the country to continue to stabilize local health care systems.
• Community Health Centers, National Health Service Corps, and Teaching Health Centers: Community health centers, known as federally qualified health centers (FQHC), provide primary health care services to almost 23 million people at more than 9,000 sites in rural and urban areas. The National Health Service Corps helps bring health care professionals to underserved areas and the Teaching Health Centers program provides expanded residency training in local communities. Funding for each of these programs also expires this year and H.R. 2 extends funding for two years.
• Maternal, Infant, and Early Childhood Home Visiting Program: This program supports pregnant women and families and helps at-risk parents of pre-school children by using evidence-based, cost-effective models that improve maternal and child health, prevent child abuse and neglect, encourage positive parenting and promote child development and school readiness. H.R. 2 provides funding for two additional years.
• Qualifying Individuals (QI) Program: QI is a Medicaid program to help low-income Medicare beneficiaries pay for their Medicare Part B premium. H.R. 2 permanently extends this program.
• Transitional Medical Assistance Program: Allows low-income families to maintain Medicaid coverage
• for up to one year as they transition from welfare to work. The bill permanently extends this program.

The Senate must now take up H.R. 2. Senate Majority Leader Mitch McConnell (R-Ky.) promised swift action on the legislation following the Senate’s two-week recess and expressed optimism that the measure
would pass with broad support. Senate Minority Leader Harry Reid (D-Nev.) noted that there could be a limited number of amendments offered on H.R. 2.