By Chris LaPage
December 2010

The biggest news for the health sector funding landscape came in the form of the election results from November. The fact that the Republicans gained control of the House of Representatives (House) has fueled speculation that the health reform package that was passed earlier this year may be repealed. The health reform legislation, which is known as the Patient Protection and Affordable Care Act (PPACA), included appropriations for several demonstration projects and grant programs that are scheduled to open over the next several fiscal years. While the exact dollar amount is unknown, it is estimated that the total amount available through PPACA grants will reach ten figures. Many of the Republicans that came to office as part of the TEA Party (Taxed Enough Already) movement ran on a platform of repealing PPACA. In terms of political spin, the GOP has characterized their overtake of the House as a referendum on the health reform package. For readers that are new to federal funding, this is an important learning experience: in order to effectively monitor the grants landscape, you must track the political and legislative agenda.

While these factors do indeed offer a legitimate concern that PPACA will be repealed, several forces at play indicate many of the grant programs will remain intact and proceed as planned. First and foremost, Democrats still enjoy a narrow majority and control of the legislative agenda in the Senate and President Obama maintains his veto powers should any repeals pass Congress. Republicans do not have enough numbers (two-thirds majority) to overturn a presidential veto. Considering the results of the election, Obama and Democratic leaders in congress have admitted that modifications to the health reform package might be in order.

However, all remain opposed to a complete overhaul or any type of large repeal. In all likelihood, PPACA will remain mostly intact with some minor tweaking. How do we know the minor tweaking will not include repeal of planned grant programs? There are two other factors worth noting. The grant programs included in PPACA are among the least controversial components of the overall health reform package. The GOP has mostly taken aim at the big price tag items (and implications for raising taxes) and the effects on the insurance industry and small businesses. Secondly, the amount of money dedicated to potential grant programs in PPACA is inconsequential relative to the other provisions, which include allocations for government oversight and a public health insurance option.

While you will hear a lot about repealing health reform over the next several months to years, you should still continue to monitor the grant funding flowing from this monumental legislation. It is unlikely that the grant programs will be repealed, but even if they eventually are pulled, it will be well into next year after months of negotiation and debate. Fortunately, the bulk of the grant programs authorized through PPACA were front loaded with appropriations in fiscal years 2011 and 2012.