Last week in Washington saw movement on some major legislation after the House and Senate reached an agreement on the FY 2017 spending bill, which many feared would lead to a government shutdown. In the House, Republicans managed to pass the American Health Care Act of 2017 (AHCA) in an extremely close vote, and it will now head to the Senate — where it will likely not retain its current form.
Health Workforce Funding Almost Unscathed in FY 2017 Omnibus Appropriations Bill
There was some good news for PAs in the appropriations bill signed by President Trump last week. Health workforce funding remains basically intact, with Titles VII and VIII receiving only a 0.6 percent cut. The Primary Care Medicine line, which includes funds for PA training through the Primary Care Training and Enhancement Grant Program, was flat-funded at $38.9 million. We do not know if there will be a competition for the PA training grants, but we remain in communication with Health Resources and Service Administration (HRSA) staff about funding for PA education.
The Health Careers Opportunity Program, Faculty Loan Repayment, and Scholarships for Disadvantaged Students were also flat-funded. This is a major victory, as the original Trump Administration budget blueprint had called for major cuts in these programs. Strong advocacy efforts by a host of health care organizations and coalitions, including PAEA, helped to save these funds.
These budget lines were part of a bipartisan $1.1 trillion spending bill that was signed by President Trump on May 5. The bill includes expanded funding for defense programs and border security, as well as $34 billion for the National Institutes of Health (NIH), which is an increase of $2 billion over current NIH funding levels. An additional $103 million was allocated for efforts to combat opioid abuse. The cuts to domestic programs that were initially proposed by the Trump Administration were also largely avoided.
Speaking of HRSA, there is a new administrator: George Sigounas, PhD, MS, a cancer researcher from East Carolina University (ECU), assumed the role on May 1. While he was a professor of medicine at ECU, he established the university’s bone marrow transplantation program. We look forward to learning his priorities for HRSA and working with Dr. Sigounas and his staff to provide expanded opportunities for PA programs.
The AHCA Passes in the House
On May 4, by a 217–213 vote, the House passed their Obamacare repeal bill, HR 1628: the American Health Care Act. The vote was largely along party lines; however, 20 Republicans voted with Democrats against the bill. For weeks, there had been uncertainty about whether Republicans would have sufficient votes to pass the legislation.
The AHCA cuts the Prevention and Public Health Fund, slashes Obamacare taxes, removes essential benefits, and hikes premiums for patients with pre-existing conditions, among other changes. Of huge concern to many health care advocates is the $839 billion in cuts to Medicaid, which will end Medicaid expansion and the program in its current state. The bill now moves to the Senate where it faces an uncertain future, particularly with Republican senators who have expressed concern about the limited debate and lack of amendments and a CBO score. It is expected that the Senate will draft its own bill. The AHCA CBO score is expected to be released early the week of May 22.
For more information on the specifics of the House bill, please check out this commentary from the Heritage Foundation and this information from the Center on Budget and Policy Priorities.