C. Stephen Redhead, Coordinator
Specialist in Health Policy
Sarah A. Lister
Specialist in Public Health and Epidemiology
Kirsten J. Colello
Specialist in Health and Aging Policy
Amanda K. Sarata
Specialist in Health Policy/Acting Section Research Manager
Elayne J. Heisler
Analyst in Health Services
ThePatient Protection and Affordable Care Act (ACA) reauthorized funding fornumerous existing discretionary grant programs and other activities. ACAalso created multiple new discretionary grant programs and provided foreach an authorization of appropriations. Funding for all thesediscretionary programs is subject to action by congressional appropriators.This report summarizes all the discretionary spending provisions in ACA. Acompanion product, CRS Report R41301, Appropriations and Fund Transfersin the Patient Protection and Affordable Care Act (ACA), summarizesall the mandatory appropriations in the law.
Among the provisions that are intended to strengthen the nation’s health caresafety net and improve access to care, ACA permanently reauthorized thefederal health centers program and the National Health Service Corps(NHSC). The NHSC provides scholarships and student loan repayments toindividuals who agree to a period of service as a primary care provider in a federallydesignated Health Professional Shortage Area. In addition, ACA addressedconcerns about the current size, specialty mix, and geographicdistribution of the health care workforce. It reauthorized and expandedexisting health workforce education and training programs under Titles VIIand VIII of the Public Health Service Act (PHSA). Title VII supports theeducation and training of physicians, dentists, physician assistants, andpublic health workers through grants, scholarships, and loan repayment.ACA created several new programs to increase training experiences inprimary care, in rural areas, and in community-based settings, and provided trainingopportunities to increase the supply of pediatric subspecialists andgeriatricians. It also expanded the nursing workforce development programsauthorized under PHSA Title VIII.
As part of a comprehensive framework for federal community-based public healthactivities, including a national strategy and a national education andoutreach campaign, ACA authorized several new grant programs with a focuson preventable or modifiable risk factors for disease (e.g., sedentarylifestyle, tobacco use). The new law also leveraged a number of mechanisms to improvethe quality of health care, including new requirements for quality measuredevelopment, collection, analysis, and public reporting; programs todevelop and disseminate innovative strategies for improving the quality ofhealth care delivery; and support for care coordination programs such asmedical homes, patient navigators, and the co-location of primary health care andmental health services. Additionally, ACA authorized funding for programs toprevent elder abuse, neglect, and exploitation; grants to expand traumacare services and improve regional coordination of emergency services; anddemonstration projects to implement alternatives to current tortlitigation for resolving medical malpractice claims, among other provisions.
The Congressional Budget Office estimated that ACA’s discretionary spendingprovisions, if fully funded by future appropriations acts, would result inappropriations of approximately $100 billion over the 10-year periodFY2012-FY2021. Most of that funding would be for programs that existedprior to, and whose funding was reauthorized by, ACA. Few new programs createdby ACA received funding in FY2011 or FY2012. ACA also appropriated $1billion to help cover the initial administrative costs of implementing thenew law. All those funds were obligated by the end of FY2012. ThePresident’s FY2013 budget requested more than $1 billion in discretionary fundingfor ongoing ACA administrative costs at the Department of Health and HumanServices and the Internal Revenue Service, though none of these funds wereincluded in the FY2013 continuing resolution under which the government iscurrently operating. It remains to be seen whether Congress will provideall of the requested ACA administrative funds.
Date of Report: January 15, 2013
Number of Pages: 41
Order Number: R41390
Price: $29.95
To Order:
R41390.pdf to use the SECURE SHOPPING CART
e-mail congress@pennyhill.com
Phone301-253-0881For email and phone orders, provide a Visa, MasterCard, American Express, or Discover cardnumber, expiration date, and name on the card. Indicate whether you want e-mailor postal delivery. Phone orders are preferred and receive priority processing.
Hiç yorum yok:
Yorum Gönder