Budget & Appropriations: Congress Approves Bipartisan Budget Deal

The House and Senate approved the Bipartisan Budget Act of 2019 (H.R.3877) on July 25 and August 1, respectively. This bill prevents scheduled discretionary cuts from taking effect and increases limits on discretionary spending. Additionally, it suspends the debt ceiling until August 1, 2021. The House of Representatives is likely to revisit its previously approved appropriations bills in order to reduce funding to comply with these caps. The Senate has been waiting for a budget deal before drafting its fiscal year (FY) 2020 appropriations bills. The new fiscal year begins on October 1, making it likely that a continuing resolution will be needed.

Budget & Appropriations: Senate Republicans Release FY 2020 Budget Resolution With Instructions That Could Affect Medicaid

On March 22, Senate Budget Committee Chairman Mike Enzi (R-WY) released a draft budget resolution for fiscal year (FY) 2020. The budget proposes to reduce the deficit by $538 billion over five years compared to current law, primarily through reductions in mandatory spending. Additionally, it provides reconciliation instructions for five committees to reduce the deficit by a total of $94 billion. To learn more about the budget proposal, see the committee website. Unlike the president’s budget, budget resolutions in the House and Senate can be enacted and have the force of law. While the Senate budget is not nearly as extreme as the president’s budget, it’s inclusion of reconciliation instructions is the first step to developing legislation that could change the structure and financing of the Medicaid program. The House would need to pass the identical measure for such legislation to be developed.

Budget & Appropriations: President Releases FY 2020 Budget Request Documents

On March 11, President Trump released his fiscal year (FY) 2020 Budget Request. The budget proposes $2.7 trillion in cuts over 10 years, including cuts to Medicaid, the Affordable Care Act programs, and non-defense discretionary (NDD) programs. NDD programs – which include education, employment, housing, transportation, and more – would be cut by $54 billion (9 percent from 2019 levels alone). Throughout the week, more detailed department budgets have been released, including those for the Departments of Education, Health and Human Services, Housing and Urban Development, and Justice. These department budgets reveal drastic cuts for numerous disability-related programs such as:

  • Office of Disability Employment Policy: -30%
  • Developmental Disabilities Councils State Grants: -26%
  • University Centers for Excellence in Developmental Disabilities: -20%
  • Lifespan Respite: -25%

Though the President’s Budget Request does not have the force of law, it can set the stage for the Congressional budgets which follow. Click here to see proposed spending levels for disability-related discretionary programs in the President’s FY 2020 Budget Request. For more information, see The Arc’s statement.

Budget & Appropriations – House Committee Passes Labor-HHS-Education Spending Bill; Senate Blocks Spending Bill; Continuing Resolution Expected

On July 14, the House Appropriations Committee passed a fiscal year (FY) 2017 spending bill for the Departments of Labor, Health and Human Services, Education, and Related Agencies (L-HHS-ED). The measure provides $161.6 billion in discretionary funding, a cut of $569 million from FY 2016 and $2.8 billion below the President’s budget. It was passed following a long debate on how to combat infectious diseases, including the Zika virus. Most disability-related programs were level funded, except for a few education programs that would take large cuts. Click here to see the line item funding levels and the percentage change from FY 2016. The measure also includes $300 million to address the Zika virus.

Also on July 14, the Senate was unable to clear a procedural motion to vote on a spending bill that includes $1.1 billion to address the Zika virus. The measure was blocked due to opposition to policy changes added to the funding bill, including one to prevent funding of Planned Parenthood clinics. Both chambers recessed that evening, leaving spending bills unfinished prior to their seven-week recess. One or more continuing resolutions are expected to fund the federal government after the start of FY 2017 on October 1.

House and Senate Advance Important Fiscal Year 2016 Spending Bills

Last week, the House and Senate advanced the most important spending bills for disability programs – Labor, Health and Human Services, Education, and Related Agencies (L-HHS-ED).  Both would maintain overall sequestration funding levels and include a number of substantial cuts to programs, earning the promise of a veto by President Obama.

L-HHS-ED – Senate – The Senate bill passed the Appropriations Committee along party lines on June 25.  The bill’s discretionary funding level is $3.6 billion below the Fiscal Year (FY) 2015 enacted level and includes numerous policy riders that would limit the activities of federal agencies.  Several federal agencies would receive significant cuts and a small number would receive increases. Notable examples include:

  • LABOR:  Includes a 4% cut for Workforce Innovation and Opportunity Act (WIOA) programs.
  • HHS:  Includes a 28% cut for the Centers for Medicare and Medicaid Services (CMS) program management that would restrict the agency’s ability to operate the Affordable Care Act programs, Medicare, and Medicaid.
  • EDUCATION: Includes a $1.1 billion cut for the Department.  However, the IDEA state grant program would receive a nearly 1% increase.

L-HHS – House – The House bill passed the full Appropriations Committee along party lines on June 24 and would provide discretionary funding at $3.7 billion below the FY 2015 level.  The bill also includes numerous policy riders. The House bill included spending cuts and select increases similar to those in the Senate bill:

  • LABOR: Includes a 2% cut for the Employment and Training Administration that helps to implement Workforce Innovation and Opportunity Act (WIOA) programs.
  • HHS: Includes a $344 million cut for CMS.
  • EDUCATION: Includes a cut of $2.8 billion to the Department of Education.  However, this includes an increase of $12 billion (4.3%) for IDEA grants to states.

See the funding levels for specific disability related programs.

Spending Bills Slowly Advance; House to Mark Up Labor, Health, & Human Services, & Related Agencies Spending Bill

The House and Senate continue to advance FY 2016 appropriations bills. The House has passed 6 of the 12 spending bills on the floor; the Senate has passed three bills out of committee but none has yet reached the floor (see status of all appropriations bills here). The fate of these measures is unclear as the President has threatened to veto any appropriations bills that have sequestration cuts in place for FY 2016. The President’s FY 2016 Budget proposed to end sequestration for FY 2016 by adding $37 billion for both non-defense discretionary and defense discretionary programs. Congress has been deeply divided over keeping in place the sequester cuts for non-Pentagon programs and shifting more funding to the war-related Overseas Contingency Operations fund (OCO) which is exempt from sequestration cuts. Some Members believe that equal relief should be provided for Pentagon and non-Pentagon programs. Despite speculation about a possible deal to adjust current discretionary sequester spending caps, a Continuing Resolution (CR) may be needed to fund programs when FY 2016 begins on October 1. Spending deals may also get wrapped into broader negotiations at the end of the year, when it will be necessary to increase the federal debt ceiling again.

On Wednesday June 17, the House Appropriations Subcommittee will begin marking up its spending bill for the Departments of Labor, Heath, & Human Services, Education, and Related Agencies (L-HHS-ED). The L-HHS-Ed appropriations bill includes funding for the majority of discretionary disability-related programs and will be made available on the House Appropriations Committee’s website on June 16. Most disability related programs have been cut substantially over the last few years. See a listing of specific human services programs and their funding reductions since 2010 when factoring inflation (disability-related programs are shown in highlight).

Concurrent Budget Resolution Passed in Senate

On May 5 the Senate approved a concurrent budget resolution for FY 2016 which begins October 1. The measure was approved by a vote of 51-48. The U.S. House of Representatives had approved the same plan the previous week by a margin of 226-197. While this budget framework is not legally binding, it serves as the blueprint for making decisions about spending and revenues in the coming fiscal year. The 2016 concurrent budget resolution includes several attacks on major programs that will harm people with disabilities, such as:

  • Possible permanent cuts and elimination of the entitlement to services in the Medicaid program. Medicaid provides the vast majority of long term supports and services (LTSS), including home and community-based services (HCBS), and many employment supports to people with intellectual and developmental disabilities (I/DD). The proposed block grants to the states would require fundamental structural changes to the basic Medicaid program which could lead to states restricting eligibility and services or increasing costs for individuals, or other options to replace the reduced funding.
  • Repeal of the Affordable Care Act (ACA). The ACA includes numerous protections and benefits for persons with disabilities, such as prohibiting private health insurance exclusions for pre-existing conditions, eliminating annual and lifetime caps in private insurance policies, and restricting the consideration of health status in setting premiums.
  • Dramatic cuts to non-defense discretionary (NDD) programs. NDD programs – which include early intervention, education, employment, housing, and much more – would be cut by another $496 billion from 2017-2025 on top of the sequestration cuts that extend through 2021. This would more than double the cuts in NDD programs over the coming decade. See the funding chart showing cuts to disability programs since 2010.

Learn more about the Congressional budget plan at http://www.cbpp.org/research/federal-budget/ten-serious-flaws-in-the-congressional-budget-plan.

Senate Expected to Vote on Budget Plan

The Senate is expected to vote early this week on the compromise concurrent budget resolution (Senate Concurrent Resolution 11) which lays out a budget plan for the Committees to fund programs for Fiscal Year 2016.  Once the Senate approves, the next steps will include the relevant committees writing legislation to implement the outline in the budget resolutions.  A budget resolution does not go to the President for approval and it does not become law.  However, the resulting legislation must be passed by both the House and Senate and signed by the President to become law.

House Passes Budget Plan

The House of Representatives voted (226-197) on Thursday, April 30, to approve a compromise concurrent budget resolution (Senate Concurrent Resolution 11) which lays out a budget plan for the Committees to fund programs for Fiscal Year 2016.  The resolution maintains the statutory caps on discretionary funding such as funding for education, housing, transportation, and other programs.  It would also repeal the Affordable Care Act.  In addition, the resolution could result in permanent cuts and elimination of the entitlement to services in the Medicaid program –  which provides the bulk of long term supports and services (LTSS), including home and community-based services (HCBS), and many employment supports to people with intellectual and developmental disabilities (I/DD).

The concurrent budget resolution would require that the House Energy and Commerce Committee and the Senate Finance Committee find at least $1 billion in savings in programs under their jurisdiction.  The resolution does not specify which programs must be cut to reach the $1 billion.  However, authorization of these cuts allows fundamental changes to the structure of the Medicaid program in order to achieve these savings.  Structural changes to Medicaid are likely to include block grants to the states and reductions in eligibility and services.  Furthermore, the cuts could be much greater than $1 billion or the Congress could proceed with more extensive cuts in future years once the Medicaid structural changes are in place.