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1 1 (February 10, 2020)

handle is hein.crs/govcafi0001 and id is 1 raw text is: ICong ressin, l Resea rch Sevice Congress May Consider Options to Extend Expiring Funds for Primary Care Updated February 10, 2020 The Affordable Care Act (ACA, enacted in March 2010, appropriated mandatory funds to support three programs focused on expanding access to primary care services for populations that are typically underserved. These three programs are the Health Centers program, the National Health Service Corps (NHSC), and payments to support medical residents training at teaching health centers-outpatient health facilities that primarily provide care to underserved populations. The mandatory ACA funds for these programs were initially provided for five years. Funding for each of these three programs had been subsequently extended through the end of FY2019.The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, P.L. 114-10) provided the funding extensions for FY2016 and FY2017. The Bipartisan Budget Act of 2018 (BBA 2018, P.L. 115-123) provided the funding extensions for FY2018 and FY2019. BBA 2018 also included a number of changes to each program's authorizations and increased funding for health centers and for teaching health centers. Partial FY2020 funding has been provided in P.L. 116-94 through May 22, 2020. A longer funding extension has not been enacted, but a number of bills to provide longer extensions have been introduced, as discussed below. Community Health Center Fund The ACA established the Community Health Center Fund (CHCF) to help support the Health Centers and NHSC programs. CHCF funding was initially intended to supplement the annual discretionary funds that the two programs typically received through the regular appropriations process. However, CHCF funds have replaced a significant portion of the Health Center program's annual discretionary appropriations (see Table 1). Since F2015, CHCF funding has represented more than 70% of the Health Center program's funding. In the case of the NHSC program, no annual discretionary appropriations were provided from FY2012 through FY2017, but subsequent discretionary appropriations provided funds for loan repayment for NHSC opioid treatment providers in FY2018-FY2020. Discretionary appropriations for FY2019 and FY2020 also included an additional $15 million for loan repayment to NHSC providers placed at Indian Health Service facilities. For FY2020, partial-year CHCF funding represents approximately 60% of each programs' funding. CRS NStGHT Prepared for Mbernhers and Com-n ittees o C nqress ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

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