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Tuesday, October 15, 2013

Affordable Care Act (ACA) and the Appropriations Process: FAQs Regarding Potential Legislative Changes and Effects of a Government Shutdown

Charles S. Redhead
Coordinator Specialist in Health Policy

Congress has yet to complete legislative action on any of the 12 regular appropriations bills to fund the routine operations of federal agencies for FY2014, which begins on October 1, 2013.
One or more continuing appropriations bills, or continuing resolutions (CRs),2 may be enacted to provide funding for part or all of the new fiscal year. Some lawmakers opposed to the Patient Protection and Affordable Care Act (ACA),3 the health reform law enacted in March 2010, have advocated the use of the appropriations process to eliminate funding for the law’s implementation.

On September 20, 2013, the House approved an FY2014 CR (H.J.Res. 59) to provide temporary funding for the federal government until December 15, 2013. H.J.Res. 59, as passed by the House, incorporates three provisions aimed at defunding the ACA , including language that would prohibit the use of any federal funds to carry out the law. The Senate amendment to H.J.Res. 59 does not incorporate the House ACA language. The chambers have yet to resolve their differences on H.J.Res. 59.
4 If continuing appropriations are not enacted by October 1, 2013, the federal government would begin a shutdown of programs that lack budget authority5 to continue operations in FY2014, except in certain circumstances.

The current legislative debate over using the FY2014 appropriations process to defund implementation of the ACA has prompted a number of questions about the law’s core health reform provisions and how their implementation affects federal spending. Questions have also been raised about the legislative actions already taken by lawmakers to defund or otherwise amend the ACA, and about the various legal and procedural considerations arising from the current efforts to use the appropriations process to defund the law. Finally, there is the question of what impact a government shutdown would have on ACA implementation in the event that Congress is unable to reach agreement on FY2014 appropriations legislation. This report, which
will be revised and updated to reflect key legislative developments, provides brief answers to these questions.

Date of Report: September 27, 2013
Number of Pages: 23
Order Number: R43246
Price: $29.95

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