The Affordable Care Act (ACA) reauthorized funding for numerous existing discretionary programs and created multiple new discretionary grant programs and provided for each an authorization of appropriations. Funding for all these discretionary programs is subject to action by congressional appropriators. A new report published
by the Congressional Research Service (CRS) summarizes all the discretionary spending provisions in ACA.
The ACA permanently reauthorized the federal health centers program and the National Health Service Corps (NHSC), which provides scholarships and student loan repayments to individuals who agree to a period of service as a primary care provider in a federally designated Health Professional Shortage Area. The ACA also reauthorized and expanded existing health workforce education and training programs under Titles VII and VIII of the Public Health Service Act (PHSA). In addition, the Act created several new programs to increase training experiences in primary care, in rural areas, and in community-based settings, and provided training opportunities to increase the supply of pediatric subspecialists and geriatricians. It also expanded nursing workforce development programs.
The ACA authorized several new grant programs with a focus on preventable or modifiable risk factors for disease (e.g., sedentary lifestyle, tobacco use) and leveraged mechanisms to improve the quality of health care, develop and disseminate innovative strategies for improving the quality of health care delivery, and support for care coordination programs.
The Congressional Budget Office (CBO) estimated that ACA’s discretionary spending provisions, if fully funded, would result in appropriations of approximately $100 billion by 2021.