Wednesday, June 4, 2008

Legislative Bulletin: H.R. 1343, Health Centers Renewal Act

Order of Business:  The bill is scheduled to be considered on Wednesday, June 4, 2008, under a motion to suspend the rules and pass the bill.

Summary:  H.R. 1343 would reauthorize the Health Centers Program through FY 2012.  The program, which is administered by the Health Resources and Services Administration, awards grants to Health Centers that provide treatment to traditionally underserved communities.  H.R. 1343 authorizes annual funds for the Health Center Program as follows:

  • $2.188 billion in FY 2008
  • $2.451 billion in FY 2009
  • $2.757 billion in FY 2010
  • $3.116 billion in FY 2011
  • $3.537 billion in FY 2012

The bill authorizes a total of $14 billion in spending over the next five fiscal years, subject to annual appropriations.  In addition, the bill would expand the scope of an existing government program to extend federal liability protection under the Public Health Service Act to volunteer medical practitioners working at community health centers.

Additional Information:   According to findings listed in the bill, there are over 1,000 federally-aided health centers in the U.S., which serve 16 million people annually.  Among those facilities there are many different types of Health Centers, serving a varied group of the population:

  • Community Health Centers receive funds to serve an assortment of people in historically underserved geographic areas across the country.
  • Migrant Health Centers receive grants for serving seasonal agricultural workers.
  • Healthcare for the Homeless Health Centers are given grant awards for providing primary and substance abuse care to the homeless.
  • Finally, Public Housing Primary Care Programs are located near public housing and serve the residents who live there.  All four of these programs are funded through the Health Centers Program.

In 2002, President Bush unveiled a new Health Center initiative, which aimed to utilize the Health Center Program to increase access to primary care.  According to HRSA, “Through this Initiative, investments in the Health Center Program have nearly doubled—growing from a little more than $1 billion in FY2000 to the nearly $2 billion it is today—and Health Centers have experienced an unprecedented period of sustained expansion and quality improvement.”  Despite the apparent success of the President’s earlier initiative and the increased investment in the program, H.R. 1343 drastically increases authorized funding for the Health Centers Program.  Legislation that passed the House in 2006 would have reauthorized the health centers program at $10.1 billion over five years; H.R. 1343 would provide a $14 billion, five-year reauthorization for the Health Centers Program—increasing authorization levels by 40% from two years ago.

Possible Conservative Concerns:  Some conservatives may have several concerns regarding this legislation, including but not limited to:

  • Funding for Illegal Aliens:  According to the Congressional Research Service, Migrant Health Centers are not required to check a patient’s immigration status prior to providing medical care.  Some conservatives may be concerned that Migrant Health Centers may be using taxpayer funds to provide illegal immigrants with free health care through the Health Center Program.
  • Funding Levels.  Some conservatives concerned that the amount of spending contemplated by this legislation—which would provide a 40% increase in funding over a bill the House passed in 2006, and authorize 15% more funding for FY2009 than the White House budget request.  Some conservatives may believe that the significant increases in funding to community health centers provided under the current Administration mean that additional increases in authorization and appropriation levels are not warranted at this time.
  • Congressional Findings.  Some conservatives may also be concerned that the legislation’s stated goal of doubling the number of patients treated at community health centers by 2015 may be used as a justification for further spending increases in future years.
  • Process.  Some conservatives may believe that a $14 billion authorization measure should not be considered under expedited House procedures normally reserved for matters such as the naming of post offices.
  • Expansion of Government Liability Program:  Some conservatives may be concerned with a proposed expansion of a federal liability program for health center workers that has its roots in the flaws of the current medical liability system.  Some conservatives may instead champion the comprehensive liability reform that all medical practitioners—private and public, volunteer and paid—need in order to restore the integrity of the doctor-patient relationship and reduce the amount of harmful litigation.
  • Native Hawaiians:  Some conservatives may be concerned that the bill funds health care services specifically for Native Hawaiians.  Native Hawaiians are a racial group, not a tribe, and dispensing benefits to them would likely be subject to strict scrutiny in federal courts.  Providing additional assistance to this group is not only duplicative of numerous current federal education programs, but is also likely unconstitutional.

Committee Action: H.R. 1343 was introduced on March 6, 2007, and referred to the Committee on Energy and Commerce Subcommittee on Health.  The Subcommittee held a mark-up on April 23, 2008, and reported the bill to the full committee by voice vote.  On May 7, 2008, the full committee held a mark-up and reported the bill by voice vote.

Cost to Taxpayers:  A CBO score for H.R. 1343 was not available at press time.

Does the Bill Expand the Size and Scope of the Federal Government?   Yes, the bill would expand access to a federal liability protection program under the Public Health Service Act for volunteer practitioners at community health centers.

Does the Bill Contain Any New State-Government, Local-Government, or Private-Sector Mandates?   No.

Does the Bill Comply with House Rules Regarding Earmarks/Limited Tax Benefits/Limited Tariff Benefits?   A Committee Report citing compliance with rules regarding earmarks, limited tax benefits, or limited tariff benefits was not available.

Constitutional Authority:  A Committee Report citing constitutional authority was not available.