With Omnibus Dead, How Will The Government Fund Health Reform Implementation?

Last night, citing overwhelming opposition from Republicans, Senate Majority Leader Harry Reid (D-NV) dropped the omnibus spending package that included some $1 billion in funding for health reform and instead opted for a much smaller continuing resolution (CR) to extend federal spending authority into the new year.

With the defeat of the omnibus, Republicans are pushing Reid to issue a CR at the 2008 levels, which may not include additional health care dollars since the Affordable Care Act passed after 2008. As Rep. John Boehner (R-OH) put it today in his briefing, “we ought to have a funding bill through September 30th at 2008 levels before the stimulus and before the bailouts and all the other nonsense that’s gone on here.” But all this now raises a key question: how will the government fund implementation?

During an appearance on MSNBC this afternoon, Secretary of Health and Human Services Kathleen Sebelius said that Affordable Care Act included some initial resources for funding implementation but conceded that the department was “waiting to see what our budget overall is going to be”:

SEBELIUS: I think, Andrea, the initial Affordable Care Act passed with some resources included in the bill and we’re going to continue to implement the law. Frankly, Congress hasn’t funded any of government and we are waiting to see what our budget overall is going to be…and I think the debate is on in the Senate whether or not they will take the House-passed continuing resolution, whether they will do a shorter-term continuing resolution. There is no question that the omnibus bill was a bit toppled a bit by the earmarks. […]

The debate in the Senate has been interesting to watch, but it’s hardly about health reform, it’s really been about the earmarks and how large a funding stream they want to have. I’m hoping that the same logic that Republicans used to pass the tax bill, that businesses needed some certainty, they’ll apply to the government. I think we need some certainty in terms of carrying out key services for the American public over the next year.

Watch it:

Earmarks may have played their part, but Republicans — who will be in charge of appropriating funding in the new year — used the health care funding in the omnibus bill to help defeat the measure. On Tuesday, the Republican Policy Committee issued a report which argued that the bill included $750 million for the new Prevention and Public Health Fund, a $175.9 million “adjustment” to implement the law’s Medicaid expansion and cuts to Medicare Advantage, $80.7 million to enforce new mandates and regulations and $3 million for a national health care workforce commission.


Future appropriations are expected to include a limited amount of health funding, as Republicans in the House have pledged to defund the law.