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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

Spending Bill Stalls As End of Fiscal Year Looms

September 23, 2016—The Senate Sept. 22 appeared to inch closer to consideration of a stopgap spending bill as Republican leaders released text of a spending package (H.R. 5325) to continue funding for most federal agencies through Dec. 9, fund the Department of Veterans Affairs (VA) through the end of FY 2017, and provide emergency supplemental funding for Zika and disaster relief efforts. But Democrats quickly objected to the bill as “Republican-only,” citing the need for continued negotiations to resolve outstanding issues before they can support the bill.

The spending package includes a continuing resolution (CR) to extend temporary funding for programs in 11 of the 12 annual spending bills, which would allow appropriators to resume discussions on final funding levels after the election. To ensure the bill adheres to the $1.067 trillion discretionary spending cap, the text applies a 0.496 percent cut to the 11 appropriations bills in the CR. The package also rescinds $400 million from various programs; most of the rescissions are from non-health agencies, but does include $168 million in unused funding from the Affordable Care Act to establish exchanges in U.S. territories.

In addition to the stopgap for other federal agencies, the package includes full text of the FY 2017 Military Construction-VA spending bill. It provides $675 million for VA Medical and Prosthetic Research, a $44 million (7 percent) increase over the FY 2016 level, as urged by the AAMC and the friends of VA Medical Care and Health Research (FOVA) coalition during conference negotiations [see Washington Highlights, June 24]. A press statement released by the Senate Appropriations Committee Majority indicates that enacting the bill “would mark the first time since 2009 that a regular appropriations bill has been signed into law before the end of the fiscal year.”

The Zika portion of the package provides $1.1 billion in emergency supplemental funding to be available through the end of FY 2017, with $933 million to the Department of Health and Human Services (HHS). Within the total, lawmakers include $152 million for vaccine development, diagnostics, and other Zika research through the National Institutes of Health (NIH), as well as $245 million for vaccine work through HHS’s Biomedical Advanced Research and Development Authority (BARDA).

The package also includes $6 million to assign National Health Service Corps (NHSC) clinicians – including pediatric subspecialists, who typically are not eligible for NHSC – to Puerto Rico and other areas affected by Zika.

Other HHS funds for Zika would support the Centers for Disease Control and Prevention ($394 million, including $44 million to restore funding withdrawn previously from the Public Health Emergency Preparedness, or PHEP, cooperative agreement); unreimbursed treatment costs and other expenses in areas with active or local transmission cases of Zika virus ($75 million); various services and projects in Puerto Rico ($60 million); and oversight activities ($1 million).

Unlike previous iterations of the Zika supplemental, the package does not include language that would have made certain family planning clinics in Puerto Rico ineligible for funding, a point of contention in previous iterations [see Washington Highlights, Sept. 16].

Democrats object to other, non-health related riders in the package, and believe aid to address lead-contaminated water in Flint, Mich., should be included in the bill, given $500 million the bill would provide for disaster relief efforts in Louisiana and other states.

Lawmakers are expected to continue negotiations over the weekend, and the next procedural vote in the Senate is expected to occur on or after Sept. 27. If the chamber is able to advance the package, it will need to be considered by the House, which has triggered its own procedural tactics to expedite consideration.

A stopgap must be enacted by Sept. 30 to avoid a government shutdown when the new fiscal year begins Oct. 1.

Contact:

Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525
Email: trasouli@aamc.org

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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org