In early January the House of Representatives passed, with much fanfare, H.R. 2, a bill to repeal the Patient Protection and Affordable Care Act (PPACA). Senate Republicans attempted to attach this measure to an airport construction bill but that effort was soundly defeated and it is unlikely that H.R. 2 will be passed by the Senate.  Opponents of health reform seem to have pivoted from repeal and are now focusing their energies on slowing implementation of health reform through the appropriations process. 

As we have noted many times on Say Ahhh!, there is a lot of work to do between now and 2014 to ensure that children and families are able to access and utilize their new sources of coverage.  Even as challenges to the law make their way through the courts, states have continued the important work of establishing exchanges and laying the foundation for a world where 32 million more people will have access to health insurance. Against this backdrop, we come to the activities of this week – efforts to slow or halt implementation of health reform through the appropriations process.

On Friday, February 11th, Appropriations Committee Chairman Hal Rogers (R-KY) introduced H.R. 1, a continuing resolution to fund the government through the end of FY 2011. The previous continuing resolution, which was signed into law in December, expires on March 4th, 2011.  The CR proposes to cut tens of billions of dollars in discretionary spending for the remainder of FY 2011, including several billion from the accounts of the Department of Health and Human Services.  The base bill takes a somewhat hands-off approach to efforts to defund ACA implementation, instead singling out a handful of discrete provisions and programs (some authorized in the ACA, others not) for spending reductions such as community health centers and certain public health provisions.  It also takes steps to limit what agencies can do with appropriated administrative funds such as limiting the ability of the Centers for Medicare and Medicaid Services (CMS) to conduct research and demonstration projects. News reports have indicated that House leadership may instead allow Members to offer amendments to the bill, and indeed that seems to be what has happened. The House Rules Committee set a deadline of Tuesday evening for filing amendments in order for them to be considered during debate on the CR. As of this morning, hundreds of amendments, including several aimed at limiting the ability of the Administration to implement all or part of the ACA, had been submitted.  What remains to be seen is how many of these amendments will actually be offered, debated, and voted on and we are unlikely to know this until they receive action on the House floor in the next few days.

You can read the bill and amendments that have been filed so far on the House Rules Committee website here.  It is expected that the CR will come up for a final vote in the House on Thursday.  However, it is important to remember that this is just the House vote. After the House vote, the bill will have to be reconciled with whatever measure emerges from the Senate before it is sent to the President.  Stay tuned.