Continuing resolutions are a key part of the federal budget process. They allow for the government to continue to meet its obligations on a temporary basis when congress fails to pass a full budget measure. However, when the federal government relies solely on temporary budget measures as it has for quite awhile, programs without automatic funding suffer. Some states are losing programs started through federal health care reform and are less than a year old for just this reason.
When federal health care reform was passed in 2010, the federal government provided a plethora of grants and loans to the states in order to help them meet the new state requirements outlined in the law. However, many of these funds were one-time capital infusions that expired if unused or on a given deadline. Some were meant to last longer than that, but still required that congress appropriate money each year manually through the budget process. Now, because congress has failed to pass a budget, and is instead working on serious of rolling temporary extensions, programs started using funds that have to be reappropriated manually each year are on the chopping block for cash strapped states.
One such casualty is in Texas, which is closing its Consumer Health Assistance Program less than one year after its creation due to the lack of of a federal budget measure. The program was created through grant funding provided as a result of health care reform. The program employed nine people who handled questions from citizens who were trying to determined what health insurance they qualified for under new and existing laws. But, without more money from the federal government and no indication when any might be forthcoming, the office will be closed. Citizen calls will be forwarded to the state department of insurance which handles all insurance related questions and does not maintain a specific health care related hotline.
Community health clinics, which provide care to mostly uninsured individuals have also faced steep cuts nationwide both through budget cuts and a failure to manually reauthorize funding. The failure of congress to provide a permanent answer on “doc fix,” through the budget also means that Medicare is no longer a guaranteed revenue stream for health care providers and may face a 24% cut.
In Maine, the Governor has proposed removing more than 65,000 people from MaineCare a health care program for low-income residents. The proposal also includes a measure that would close several assisted living facilities leaving another 5,000 people to look for a new residence in order to close a budget gap.
Health care is one of the biggest, if not the biggest chunk of most state budgets. The longer that federal funding remains uncertain, more of these programs will likely close or stall out before they begin as cash strapped states try to meet existing obligations.