APHA Legislative Update - June 2013
Monday, June 10, 2013
Posted by: Jon Noel
I. House allocation for health spending bill cut by nearly 19 percent
II. Farm bill reauthorization debate underway in U.S. Senate
III. House votes to repeal the Affordable Care Act again
IV. Rep. Capps introduces climate and health legislation
V. APHA launches summer advocacy campaign
VI. Policy watch: State update
House allocation for health spending bill cut by nearly 19 percent
On May 21, the House Appropriations Committee approved its FY 2014 302(b) allocations for the 12 annual spending bills that fund most of the federal government. The plan follows the post-sequestration $967 billion spending cap for discretionary programs in FY 2014. The Labor, Health and Human Services, Education and Related Agencies appropriations bill, which funds CDC and HRSA, would receive an allocation of $121.8 billion for FY 2014, an 18.6 percent cut beyond the FY 2013 post-sequester level – the largest reduction of any of the 12 allocations. President Barack Obama and committee Democrats are proposing a level of $165.8 billion in FY 2014 for the Labor, Health and Human Services, Education and Related Agencies appropriations bill. According to a letter issued by the Coalition for Health Funding, Coalition for Education Funding and the Campaign to Invest in America’s Workforce, an 18.6 percent reduction to the Labor, Health and Human Services, Education Appropriations bill would result in a $1.01 billion cut to CDC and a $1.087 billion cut to HRSA. The White House has already issued statements threatening to veto other 2014 spending bills with significantly reduced allocations and urged Congress to finalize a budget resolution before enacting spending bills at the current levels under the 2011 Budget Control Act. The Senate passed budget resolution would eliminate the 10-year sequester under the BCA while the House bill would not.
An amendment by Ranking Member Rep. Nita Lowey, D-N.Y., to substitute the chairman’s proposed allocation with Obama’s request of $1.058 trillion ($91 billion more than the House spending cap) for discretionary spending in FY 2014 was defeated on a party-line vote.
Timing for the House Appropriations Committee to consider the Labor, Health and Human Services, Education and Related Agencies appropriations bill is unclear at this point. Many observers believe the allocation provided for the House bill will make it extremely difficult to move the bill through the committee and on to the floor for a vote.
The Senate is expected to set its allocations in the coming weeks and advocates expect the Senate’s allocation for the Labor, Health and Human Services, Education and Related Agencies appropriations bill to be significantly higher than the House proposal.
Farm bill reauthorization debate underway in U.S. Senate
Following the Memorial Day congressional recess, the U.S. Senate returned to consideration of the Agriculture Reform, Food and Jobs Act of 2013, S. 954. The legislation would reauthorize federal farm and nutrition programs through 2018. The bill would provide $23 billion in savings over 10 years, $4 billion of those savings coming from the Supplemental Nutrition Assistance Program (formerly known as food stamps). At the beginning of the debate, APHA and other nutrition and public health advocates sent a letter to all members of the Senate urging them to reject any additional cuts to nutrition programs including SNAP and SNAP education.
During the initial debate on the bill, the Senate rejected a number of amendments that would have made additional cuts to SNAP. The Senate rejected an amendment by Sen. Pat Roberts, R-Kan., that would have further reduced SNAP benefits by limiting the link between a number of low-income programs in which recipients also automatically qualify for SNAP benefits. An amendment by Sen. James Inhofe, R-Okla., to block grant the SNAP program to the states was also overwhelmingly defeated. Unfortunately, an amendment by Sen. Kirsten Gillibrand, D-N.Y., supported by APHA and other public health and nutrition advocates that would have restored the more than $4 billion in cuts to SNAP contained in the base bill was also overwhelmingly defeated. Another amendment supported by APHA and offered by Sens. Dianne Feinstein, D-Calif., and John McCain, R-Ariz., to eliminate taxpayer subsidized crop insurance for tobacco production was also defeated. The Senate passed an amendment offered by Sens. Chris Coons, D-Del., and Mike Johanns, R-Neb., that would increase funding to purchase food aid from local and regional farms and producers closest to the populations of need. Local procurement is faster and more efficient than transporting U.S.-grown food, facilitates low-income countries in developing their own agricultural system, which leads to reduced dependence on aid and helps spur local economies.
On Thursday, the Senate voted 75-22 to limit further debate on the bill and Agriculture Committee leaders were working to move through several additional amendments and toward a vote on final passage of the bill by early next week. The House Agriculture Committee passed its version of the bill, the Federal Agriculture Reform and Risk Management Act (FARRM) Act of 2013 on May 16. The House bill would cut SNAP by more than $20 billion over the next 10 years. The full House could take up the farm bill as early as mid-June, but timing is uncertain at this point.
House votes to repeal the Affordable Care Act again
On May 16, the U.S. House of Representatives voted again to repeal the Affordable Care Act in its entirety, as well as to repeal the health care-related provisions of the Health Care and Education Reconciliation Act of 2010. The legislation passed on a mostly party-line vote of 229-195. Prior to the vote, APHA sent a letter to all members of the House urging them to vote against the bill. This marked the 37th time the House has voted to repeal, defund or block some portion of the ACA. In a statement released prior to the vote, APHA Executive Director Georges Benjamin, MD, said that "implementation of the ACA is critical to addressing a number of the biggest challenges facing our health system, including the escalating costs associated with our health care system; uneven quality and deaths due to medical errors; discriminatory practices by health insurance providers; and the shrinking ranks of the nation's primary care providers.”
The Senate has repeatedly rejected these attempts to dismantle the ACA and is not expected to take up the House-passed bill.
Rep. Capps introduces climate and health legislation
On May 16, Rep. Lois Capps, D-Calif., reintroduced the Climate Change Health Protection and Promotion Act, H.R. 2023. The bill, supported by APHA and numerous other health organizations, would require the Department of Health and Human Services to develop a national strategic action plan to help health professionals address the health-related impacts of climate change. The legislation would authorize much needed funding for the development, implementation and support of state, regional, tribal and local preparedness, communication and response plans to anticipate and reduce the health threats of climate change. In addition, the legislation would provide additional funding for research into the health impacts of climate change and for expanding and training the public health workforce to strengthen the capacity of state and local health departments to respond to and prepare for the health effects of climate change.
You can read more about the legislation on APHA’s Public Health Newswire.
APHA launches summer advocacy campaign
APHA is launching the 2013 Public Health Action (PHACT) Campaign to mobilize its members, affiliates and other advocates to educate their members of Congress on important public health issues that help to build and maintain healthy communities. During the Fourth of July (June 29-July7) and August (Aug. 3-Sept. 8) congressional recesses, we are asking APHA members and affiliates to reach out to their congressional delegations to express support for increasing critical funding for public health agencies as well as the Prevention and Public Health Fund and support for passing comprehensive legislation to reduce gun violence.
The PHACT Campaign toolkit offers sample questions for town hall meetings, sample emails and scripts for sending messages to or calling congressional offices, tips for setting up meetings with congressional district staff and tips for using social media to publicize advocacy activities. Advocates can also send a message to their members of Congress expressing the importance of public health funding, the prevention fund and gun violence prevention. Also, visit the PHACT website for information on where your state ranks on public health issues. The PHACT website will be updated throughout the summer with a list of town hall meetings in your community and other helpful resources to use in advocacy efforts.
Policy watch: State update
Minnesota ranks as healthiest state for seniors
The United Health Foundation reported that Minnesota is the healthiest state for seniors and Mississippi is the least healthy state, in the first comprehensive state-by-state analysis of senior health across the U.S. The report is intended to serve as a tool to evaluate a states’ preparedness and progress in providing important public health programs and other services for the growing older population. Additionally, the report is meant to encourage conversation and action to address the challenges in each state and mobilize local resources and assets. There are currently 40.3 million adults 65 and older in the U.S. and that figured is expected to more-than double by 2050. Common challenges include insufficient social and emotional support, physical inactivity, food insecurity and budget cuts for programs serving seniors. James Firman, president of the National Council on Aging, recognized the importance of "community organizations that encourage and promote healthy behaviors and, increasingly, link these networks to the clinical care side,” in a Kaiser Health News story in response to the report, and said that the healthiest states for seniors all have strong networks.
The original article can be found here.