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1 [1] (March 30, 2017)

handle is hein.crs/crsmthmbcbr0001 and id is 1 raw text is: CRS INSIGHT Expiring Funds for Primary Care March 30, 2017 (IN10677) I Related Authors *Elayne J. Heisler Elayne J. Heisler, Specialist in Health Services (ehei sler@,rs lc. ov, 7-4453) C. Stephen Redhead, Specialist in Health Policy (credheadcrs lc gov, 7-2261) The Affordable Care Act (ACA), enacted on March 23, 2010, appropriated billions of dollars of mandatory funds to support new and existing grant programs and other activities. Specifically, it provided support for three programs focused on expanding access to primary care services for populations that are typically underserved. The first two were existing programs-the Health Cen trs program and the Naion Helh i rps N -and they were funded through a new mandatory funding stream, the Community Health Center Fund (CHCF). The third program, created in the ACA, is the Teaching H calth Center Graduate Medical Education program (THCGME). The ACA appropriated funds for these three programs for each of FY201 1 -FY2015. Funding was extended for two more years-FY2016 and FY2017-in the Medicare Access and CHI ReA Act of 2015 (MACRA). No funding for these programs is currently appropriated for FY2018. Health Centers and the NHSC The Health Centers and NHSC programs are part of the federal government's efforts to expand access to primary care. The Health Centers program helps support about 1,400 community-based health centers operating over 10,500 delivery sites across the country. Health centers provide care to medically underserved populations regardless of their ability to pay. They provide care for more than 24 million 1eople annually, or an average of 1 in 13 Americans. The NHSC program awards scholarships and loan repayment assistance to certain health professionals-more than 8,500 in recent yQan-who agree to practice in federally designated health Drofessional shortage areas, often at health centers. To fund Health Centers and the NHSC, the ACA established the CHCF and gave it a total of $11 billion in annual appropriations over the five-year period FY20 11 -FY2015. MACRA appropriated two years of additional funding as follows: $16 billion for health centers nd ;3 10 million for th T for eah fFY2016 andFY2017. CHCF funding was initially intended to supplement the annual discretionary funds that the two programs receive through the regular appropriations proces. However, in more recent years, CHCF funds have replaced a significant portion of the Health Center program's annual discretionary appropriations, which have been reduced since FY2010 (see

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