House-Passed Bill Would Eliminate Mandatory Funding in Health Overhaul

By Frances Symes, CQ Staff

The House on Wednesday passed the first in a series of Republican measures aimed at eliminating mandatory funding in the 2010 health care overhaul.

The legislation (HR 1217), sponsored by Joe Pitts, R-Pa., would repeal the section of the health care law that establishes and allocates funding to the Prevention and Public Health Fund, which provides support for programs aimed at preventing tobacco use, obesity, heart disease, strokes and cancer.

It passed, 236-189, with four Democrats joining the entire Republican caucus in supporting the measure. The Democrats were Jason Altmire of Pennsylvania, Dan Boren of Oklahoma, Collin C. Peterson of Minnesota, and Mike McIntyre of North Carolina.

Despite House passage, the measure is unlikely to become law. President Obama has vowed to veto it, while the Senate has already rejected attempts to roll back the health care overhaul.

The Obama administration issued a statement of administration policy on Wednesday that pledged a presidential veto because the bill “could worsen the nation’s health and increase system costs by defunding prevention activities.”

Republicans, however, criticized the provision mandating the prevention spending as a “slush fund,” and expressed outrage at what they called the lack of accountability for spending under the program.

“I support prevention,” Pitts said, but “no one knows where this money will be spent.”

Democratic opponents countered by stressing the importance of investing in preventive care, arguing that it would in turn help lower health care costs. Democrats also bemoaned the move to repeal a provision that they said had received bipartisan support during the health care debate in the last Congress.

The American Cancer Society released a statement Wednesday urging members to vote against it, saying it “would reverse an unprecedented nationwide effort to refocus the health care system on keeping people healthy instead of treating them when they get sick – an approach that has long been supported by numerous public health experts.”

The health care overhaul laws authorize and appropriate funding to the Prevention and Public Health fund, allowing it to receive federal dollars that are not subject to the annual appropriations process.

The Health and Human Services Department announced in February that it was allocating $750 million in funds in fiscal 2011, focusing on four areas in community and clinical prevention, public health infrastructure, and research and data collection.

The law provides $500 million for fiscal 2010, with funding increasing gradually in the following years until fiscal 2015, when it would be funded at $2 billion per year that year and going forward.

The Congressional Budget Office (CBO) estimates the bill would decrease direct spending by more than $6 billion from fiscal 2012 through fiscal 2016, and by $16 billion over the period of fiscal 2012 through fiscal 2021.

The bill is one of five measures aimed at blocking funding for key provisions of the health care laws, all of which are likely to be brought to the floor in the coming weeks. As one of its first actions in January, the House passed a bill (HR 2) that would repeal the entire health care overhaul.

The Senate, however, rejected a repeal effort in an amendment vote in February. The House also targeted the law in its fiscal 2011 funding proposal (HR 1) later that month, and, in a short-term spending measure passed last week included a provision that would have transferred funds from the Prevention and Public Health Fund to the Centers for Disease Control and Prevention.

That provision was not included in the fiscal 2011 spending agreement (HR 1473) reached by leaders last week and set to be voted on soon in both chambers. As part of the agreement, however, both chambers will stage what will likely be only a symbolic vote on an enrollment resolution (H Con Res 35) that would block funding for implementation of the health care law.

Before passage, the House considered three Democratic amendments. It adopted by voice vote an amendment offered by Sheila Jackson Lee of Texas that would direct HHS to provide public notice of the rescission of the fund on its website, while rejecting two amendments by Kathy Castor of Florida that would direct the GAO to study the impact that repealing the fund would have on health and the economy.

It also rejected, 189-234, a motion to recommit offered by Dave Loebsack, D-Iowa, aimed at preserving the Prevention and Public Health Fund for prevention, wellness, and public health activities for individuals 65 years or older, and shift funding for the program from mandatory to discretionary spending, thus making it subject to the annual appropriations process.

Melissa Attias contributed to this story.

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