Wednesday, June 15, 2011

PPACA funding: a useful tracking resource

The skirmishes in Congress these days over the future of PPACA take place on two fronts: 1) the future of specific provisions and 2) the amount of money appropriated to implement the Act's provisions.

With regard to appropriations, the latest update of a report from the Congressional Research Service does a good job of tracking individual PPACA appropriations and reporting on their current status. "Appropriations and Fund Transfers in the Patient Protection and Affordable Care Act" (R41301) also offers a brief primer on the way federal spending works, e.g., the differences between mandatory and discretionary spending, annual vs. multiple-year appropriations, etc...

Table 1 in the report offers a description of the PPACA program and its related appropriation (or, in some cases, Medicare Trust Fund transfer). Table 2 shows the amounts appropriated or transferred for each provision by fiscal year, over the 10-year period FY 2010 through FY2019.

Table 1 also offers recent updates on the implementation effort for a given provision. So, for example, by looking at Tables 1 and 2 we see that five billion dollars were appropriated without fiscal year limitation in order to fund the temporary high-risk health insurance pools established under Act Sec. 1101. However, we can also see from Table 1 that HHS recently reduced premium amounts and took other steps to boost enrollment in the program. Participation in (and therefore spending for) the program appears to be lower than originally planned.


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