House panel votes to end insurance exchange and school health center funding

The measures are part of the GOP's campaign to cut off spending to provisions in the health system reform law.

By Doug Trapp — Posted April 11, 2011

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The House Energy and Commerce Committee on April 5 adopted five bills that would repeal billions of dollars' worth of funding in the national health system reform law and subject some mandatory allocations in the law to annual approval by Congress.

The legislation, adopted along party-line votes, is the House Republicans' latest effort to roll back the health reform law. The House adopted a full repeal of the law on Jan. 19, but the Senate rejected the measure Feb. 2. The latest measures also face opposition from Senate Democrats and President Obama.

The bills would end federal funding for state health insurance exchanges and school-based health centers. One bill would require annual congressional approval for $230 million in health reform funding over five years for graduate medical education at qualified teaching health centers.

Rep. Michael Burgess, MD (R, Texas), said requiring appropriators' approval for graduate medical education spending is not an attempt to kill it. He questioned why other forms of GME support should be funded annually while this program faces no such approval. "There are programs here that I do support, but I don't think they should be valued above everything else in the federal budget."

Another measure would end the Prevention and Public Health Fund. The Dept. of Health and Human Services has awarded $1.25 billion from the fund so far for local tobacco cessation efforts, information technology upgrades for public health departments and research to monitor the impact of the health reform law.

House Republicans want to end funding to support construction of school-based health centers. The Health Resources and Services Administration is set to award $100 million in fiscal 2011 to help build these centers.

These funds and other provisions in the health reform law give the HHS secretary almost unchecked spending power, said Rep. Fred Upton (R, Mich.), chair of the House Energy and Commerce Committee, during a March 31 health subcommittee markup of the bills.

"If we are going to get our spending under control, we must set limits ... and we must prioritize our spending decisions," Upton said. HHS Secretary Kathleen Sebelius also has no apparent limit on the funds she can use to help states create health insurance exchanges, he said.

Democrats on the panel said Republicans have double standards for congressional oversight. Rep. Frank Pallone (D, N.J.) noted that the GOP in previous congresses had adopted spending measures for abstinence-only sex education that don't require further congressional approval. "This criticism of mandatory spending authority is simply not credible."

Rep. John Dingell (D, Mich.) said much of the funding targeted by these five bills would improve preventive health care in the U.S., which is sorely needed.

Rep. Phil Gingrey, MD (R, Ga.), said improving preventive health care, though a laudable goal, costs money and should be subject to the regular appropriations process. He said Republicans are trying to repeal and replace the health reform bill to fix the mistakes Democrats made.

But trying to repeal the health reform law without offering a viable alternative will come back to haunt Republicans, said Rep. Henry Waxman (D, Calif.), the highest-ranking Democrat on the Energy and Commerce Committee. "It served you well in the last election. I don't think it's going to serve you well in the next one."

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Rolling back reform

Five bills approved by the House Energy and Commerce Committee would chip away at the national health system reform law by defunding certain provisions or subjecting funding for certain programs to annual approval by Congress. The bills would:

  • Repeal funding to states for the creation of health insurance exchanges.
  • Repeal funding for school-based health center construction.
  • Repeal funding for the Prevention and Public Health Fund, created to support a variety of programs.
  • Subject funding for graduate medical education in qualified teaching health centers to annual congressional approval.
  • Subject funding for Personal Responsibility Education Programs to annual congressional approval. These programs teach young people about the benefits of abstinence and contraception to prevent sexually transmitted diseases, HIV/AIDS and pregnancies, among other education.

Source: House Energy and Commerce Committee

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