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April 2011

FY11 Funding Resolution

The President has signed HR 1473, which funds the federal government through the end of September, providing $1.055 trillion in discretionary funding for FY 2011 and reducing federal agency budgets by more than $38 billion. The bill provides $158 billion in discretionary funding for programs in the Labor-Health and Human Services (HHS)-Education funding bill, which is $5.5 billion (3 percent) less than the FY 2010 levels.

HR 1473 provides an overall number for the agencies giving great discretion to the executive branch in determining how to distribute the cuts. The Administration must submit a spending plan to Congress within 30 days on how they plan to allocate the large general reductions. Programs that are proposed for cuts or terminations in the President’s FY12 budget proposal may be particularly vulnerable during the next 30-day decision period.

The Centers for Disease Control and Prevention (CDC) was cut by $730 million, of which approximately $380 million is unspecified or “unallocated.” $100 million of the unallocated amount is assumed to come from “administrative savings” internal to CDC. Since the bill does not specify how the remaining $280 million of cuts should be allocated, the decision will be left to CDC and HHS.There is also a .2 percent across the board cut to all non-defense agencies.

One bright note is that the $750 million in the Prevention and Public Health Fund remains intact leaving it to HHS to determine how it should be directed. HHS does still have the option to use the Fund to supplant the FY2011 cuts to discretionary funding, rather than the allocation previously announced.CDC received $192 million from the Fund in 2010, and is expected to receive $611 million in 2011. Details of CDC’s decision won’t be known until May 15th when they report to Congress.

NACCHO, in collaboration with the Association of State and Territorial Health Officials (ASTHO), has continued to advocate that drastic cuts to public health programs are short-sighted and would harm the public’s health. View a joint letter sent by NACCHO and ASTHO here.

FY12 Funding and Beyond

On April 15, the House passed their Fiscal Year 2012 Budget Resolution. This is the first step of the FY12 funding process and is the development of the non-binding spending blueprint for the year and beyond known as the budget resolution. The resolution proposes to reduce spending by $5.8 trillion over the next decade, and includes the following: 

  • Holds overall domestic discretionary spending below 2008 levels and holds this category of funding to a five year freeze. The budget also proposes a binding cap on total spending as a percentage of the economy.
  • Repeals the Affordable Care Act (ACA) (The plan keeps Medicare cuts but repeals the remainder of the law.)
  • Converts the federal share of Medicaid spending into a block grant indexed for inflation and population growth.  In addition to creating a block grant the budget proposal rolls back the Medicaid expansion authorized by the ACA.

The budget resolution will shape the FY12 allocations that are received by the Appropriations subcommittees. The Senate budget resolution currently being drafted by Senate Budget Chairman Kent Conrad (D-ND) is not expected to include such draconian cuts as the House budget resolution. The House and Senate do not need to agree on a budget resolution; however, if their overall appropriations numbers for FY12 are widely divergent, they will need to agree on funding levels for final appropriations bills to be passed and sent to the President.

Complicating the FY12 funding process is the matter of raising the debt ceiling. Many members of Congress want a plan for reducing the deficit before voting to raise the debt ceiling. The House Budget Resolution is one proposal. On April 14, President Obama laid out his proposal. The President proposes to reduce the deficit by $4 trillion over the next 12 years. Building on the cuts in FY 2011, the President proposes to cut non-security discretionary spending by $770 billion by 2023, as recommended by his Fiscal Commission. The President would cut security spending—defense, homeland security, and veterans affairs—by $400 billion in the same timeframe. The White House has released a fact sheet with the particulars of the plan.

NACCHO Government Affairs staff are continuing to meet with staff representing the members of the Labor-HHS-Education Appropriations and Agriculture-Rural Development-Food and Drug Administration Appropriations subcommittees in the House and the Senate regarding funding for public health programs in FY12.

Prevention and Public Health Fund

On April 13, the House of Representatives passed HR 1217 to repeal the Prevention and Public Health Fund by a vote of 236-183. Four Democrats supported the bill Representatives Altmire (PA), Boren (OK), McIntyre (NC), and Peterson (MN). The Senate is not expected to bring this bill up for a vote at this time. The White House sent a Statement of Administrative Policy opposing the bill saying "If the President is presented with legislation that would eliminate funding or repeal the Prevention and Public Health Fund, his senior advisors would recommend that he veto it."

NACCHO sent a letter to the House with ASTHO prior to the vote. NACCHO also signed a letter authored by Trust for America’s Health signed by 75 associations. NACCHO staff continue to prioritize continuation of the Fund in our Hill visits with appropriators in both the House and the Senate. It is an important time for NACCHO members to communicate with their Senators about the importance of preserving the Fund. A sample letter to send to your Senators can be found here.

Please contact Eli Briggs, NACCHO Senior Government Affairs Specialist, with any questions.