A Narrowly Averted Government Shutdown and a Chance for NHSC Advocacy

On September 30, 2022, President Joe Biden signed into law a continuing resolution (CR) that prevented a government shutdown just hours before federal funding was set to expire. The CR extended current funding levels through December 16th, giving both chambers extra time to negotiate an FY23 omnibus spending bill.

What Does All This Mean?

The Senate and House Committees on Appropriations are each divided into 12 subcommittees that are responsible for one annual appropriations bill that funds programs within its jurisdiction—for National Health Service Corps (NHSC) advocates and those caring for patients in medically underserved communities, the key subcommittees to track are the Labor-HHS subcommittee in the House and the Health subcommittee in the Senate. These subcommittees oversee annual appropriations—discretionary funding—for programs like the NHSC, Nurse CorpsHealth Centers ProgramTeaching Health Centers (THC) Program and more.

Every year, Congress aims to enact all appropriations bills by the beginning of the next fiscal year (FY), October 1. In reality, this deadline is often missed which requires Congress to pass a continuing resolution (CR), allowing more time for both chambers to work through the details of the appropriations measures, negotiate, and debate.

President Biden signs the Continuing ResolutionTo give a bit of context and history, for the current FY22 appropriations process, Congress originally passed a CR with a deadline of December 3, 2021. This CR was extended three more times through February 18, 2022, then March 11, and finally March 15, when President Biden ultimately signed the FY22 Omnibus Appropriations bill. This legislative package consolidated all 12 individual appropriations bills into one vehicle that required only one vote in each chamber to pass before heading to the President’s desk.

What Comes Next?

It is unlikely that Congress will follow last year’s timeline and require six months of fiscal year 2023 to pass the FY23 Omnibus Appropriations bill. At this point, the midterm elections will play the biggest factor in determining how long Congress will need to hammer out details in the appropriations process.

Washington, D.C.Democrats currently have the majority in both the Senate and House. Having the majority in both chambers has enabled the Democrats to move some pieces of legislation through Congress more quickly and, at times, without Republican support. Next month’s election stands to change the majority in one or both chambers of Congress, the impact of which could be significant for the appropriations process and critical funding for the programs vital to under-resourced communities.

Georgia, Nevada, and Pennsylvania are the top battleground states that could change the majority in the Senate, and many polls indicate that the majority is likely to change in the House as well. Already, in anticipation of possible election outcomes, a small group of Republicans in the house have expressed that if they win the House majority coming out of the election, they will oppose any consolidated appropriations bill—also known as an omnibus bill—that occurs before the next Congress starts, on January 3, 2023.

The good news is that regardless of who wins the majority in the House or Senate, the NHSC, Nurse Corps, Health Center Program and THC Program all have strong bipartisan support. But, the outcome of the election will have a direct impact on total funding and the timeline for when funding is determined. If you haven’t yet, be sure to check out how you and your health center can get more involved in civic engagement, voter registration, and get out the vote efforts (GOTV) with our resources and those of our partners at Vot-ER.

What Does the Continuing Resolution Mean for the NHSC & Health Centers?

Beginning October 1, 2022, the CR funds the government through December 16th—this means the National Health Service Corps and all other key programs will receive the same funding level as appropriated in FY22. A few key provisions in the FY22 omnibus package passed earlier this year that are pertinent to health centers include:

How Can Advocates & Health Centers Advocate Now?

To maintain their 501(c)(3) tax-exempt status, nonprofits are prohibited from participating in political campaign activities that support or oppose any candidate for elective public office. However, this doesn’t prevent health centers from engaging in nonpartisan political activities such as voter registration drives, candidate debates, and voter education.

Research has shown that civic and voter participation is strongly associated with health disparities: states and countries that have more accessible voting policies and higher levels of civic participation are healthier across multiple public health measures. Get started with our patient civic engagement resources and find more starting points at our partner organization Vot-ER as well as the Bureau of Primary Health Care.

With your help, the Association of Clinicians for the Underserved (ACU) is leading the effort to strengthen the NHSC and push for its expansion to all medically underserved communities in the future. We need to save and strengthen the program this year: and to be successful, we need your help! ACU is tirelessly advocating, but the bottom line is that the voice of advocates and the healthcare workforce is the most important part in this process—members of Congress and their staff need to hear from you and visit your health centers.

Congressional Visit to a Health CenterTake advantage of the fact that Members of Congress are home until the election. Invite both Democrats, Republicans, and candidates to tour your facilities so they understand how valuable your services are to the community. Continue to reach out after the election to ensure Congress, especially freshman (brand new) members in the 118th Congress, understand the importance of the NHSC, THCs, and Nurse Corps programs.

These key programs—the NHSC, Nurse Corps, THC Program, and health centers—should be at the core of any efforts aimed at improving coverage and access to care, particularly when it comes to supporting medically underserved populations in accessing care and health equity. Finally, don’t forget to use media outlets and local op-eds to get your stories out to the public!

Do you have further questions or need help getting started with advocacy at your health center? Please contact Jordan Marshall, ACU’s Deputy Director of Policy & Advocacy. Your voice is powerful, and your advocacy is ultimately what will make a difference in ensuring patients and medically underserved communities have the support and resources they need to achieve health equity for all.