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Appropriations Bill Provides Funding for Crucial Health Care Programs

Advocate Masthead

However, ACP continues to advocate for legislation to fund efforts to fight the COVID-19 pandemic

April 1, 2022 (ACP) -- A newly passed federal spending bill is a tremendous boon for patients and physicians, especially in the crucial area of telehealth, but the American College of Physicians continues to push for appropriate spending to combat the COVID-19 pandemic.

“Overall, the spending bill is a step forward for ACP's top funding priorities in a tight funding environment,” said Jared Frost, ACP senior associate of legislative affairs. “What's really concerning is that $15.6 billion in supplemental COVID-19 funding was removed from the bill.”

The bill is partly retroactive, encompassing the federal fiscal year that began on Oct. 1, 2021. “The federal government had been kept running by a series of temporary funding measures called continuing resolutions,” Frost said, as debates over the bipartisan infrastructure and Build Back Better bills delayed a final decision.

Congress finally acted in March of this year as it faced pressure to provide emergency funds to support Ukraine. Both the Senate and House passed the bill, and President Biden signed it.

“The bill funds the entire U.S. Department of Health and Human Services, which received $15 billion more to fund physician workforce programs and medical research, fight the COVID-19 pandemic, administer the Medicare and Medicaid programs and support other ACP priorities,” Frost said.

The Health Resources and Service Administration, which supports training of medical professionals, received almost $9 billion. However, ACP is disappointed that funding did not increase for the Primary Care Training and Enhancement program, Frost said.

In addition, the Centers for Disease Control and Prevention received about $8.5 billion, a jump of about $500 million over the previous year, and the budget for the National Institutes of Health grew by $2 billion to $45 billion. Funding for firearm prevention research received $25 million, and the Public Health and Social Services Emergency Fund received $3.5 billion, an increase of about $352 million. This fund contains programs such as the Biomedical Advanced and Development Authority and the Strategic National Stockpile.

“While the Public Health and Social Services Emergency Fund has received billions in emergency funding through major legislative packages for COVID-19,” Frost said, “ACP believes that it must remain well supported during the regular annual appropriations process so that our country is ready for new variants of COVID-19 as well as the next pandemic.”

In a major victory for ACP, the bill extends flexibilities for physicians to provide services by telehealth to patients who are enrolled in Medicare for five months after the end of the declared public health emergency due to the COVID-19 pandemic. “ACP has strongly advocated for extending those flexibilities,” Frost said. “The bill also includes extending the lifting of geographic site restrictions so telehealth services can continue to be provided to those in both rural and urban areas and allows for audio-only telehealth services past the end of the declared public health emergency.”

According to Frost, ACP believes the extension will provide more time to study the impact of these policies and decide which of the flexibilities should be made permanent. “It will also allow Congress time to hopefully enact permanent extensions,” he said, “or at the very least extend the flexibilities for a number of months to continue the health care delivered to patients through telehealth.”

In other areas, ACP is glad the bill will allow the U.S. Food and Drug Administration to regulate synthetic nicotine in cigarettes and is also pleased that the Violence Against Women Act has been reauthorized. “ACP is disappointed, however, that the bill does not include a provision to prohibit persons convicted of domestic violence who do not live in the same household of the victim from acquiring firearms — the so-called ‘boyfriend loophole’ — and urges Congress to take this up in future legislation,” Frost said. “That particular fix is probably unlikely in the time left during this Congress, which ends this year.”

Finally, ACP is frustrated that $15.6 billion in supplemental COVID-19 funding was removed from the spending bill. “There was disagreement both internally among Democrats and disagreement between Democrats and Republicans,” Frost said, regarding the details of the spending. “Without these funds, the effort to fight the COVID-19 pandemic will fail. Sustained and adequate funding is essential for the federal government and public health agencies to support the country's ongoing efforts to prevent and mitigate the harmful effects of COVID-19 on patients.”

Among other things, new funding is needed to support booster vaccines — including potential fourth shots, which have now been authorized for those ages 50 and above — and for variant-specific vaccines if needed in the future, Frost said. In addition, “the federal government will also not be able to obtain enough supplies of monoclonal antibody treatments and could run out as soon as the end of May. The robust COVID-19 testing capacity built up over the preceding months could start declining in June, and some COVID-19 surveillance programs may have to be discontinued if a new infusion of funding is not provided.”

Frost added that “a particularly urgent issue is that physicians are now not able to submit claims for the testing, treatment and vaccination of their uninsured patients as of March 22, leaving some of the most vulnerable patients at greater risk and putting additional burden on safety net clinicians.”

ACP will continue to advocate for appropriate COVID-19 spending.

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Back to the April 1, 2022 issue of ACP Advocate