National WIC Association


June 22, 2015

Appropriations Update:
The House Agriculture, Rural Development, Food & Drug Administration and Related Agencies Appropriations Subcommittee, Rep. Robert Aderholt (R-AL), Chair, Rep. Sam Farr (D-CA), Ranking, completed its markup and released a draft of its FY 2016 Agriculture Appropriations bill last Thursday, June 18.

The draft bill funds WIC at $6.484 billion, including $60 million for breastfeeding peer counselors, $55 million for management information systems (MIS), including WIC EBT systems and activities, and $14 million for WIC infrastructure. The Subcommittee did not provide monies for the contingency fund.

The Subcommittee’s funding level is $139 million below the FY2015 WIC funding level in recognition of WIC’s declining caseload, from a high of roughly 9 million participants in 2012 to just under 8 million as recently as March 2015. It is $200 million below NWA’s request which in addition to providing monies for a somewhat higher projected caseload, also included $30 million more for breastfeeding peer counselors, $25 million more for MIS/EBT, $5 million for rigorous health outcomes research, and an additional $6 million for cash value voucher (CVV) for fully breastfeeding women, bumping their CVV from $10 to $12.

While NWA is disappointed that the Subcommittee did not fully fund breastfeeding peer counselors at the full authorized level of $90 million, MIS/EBT at our recommended level of $80 million, or meet our requests for health outcomes research and additional resources for CVV’s for fully breastfeeding women, we recognize the dilemma that the Subcommittee faces with WIC’s downward trending caseload.

At the same time, it is important to realize that WIC’s downward trending caseload – a symptom of WIC client uncertainty – is not unrelated to funding uncertainty caused by the federal government shutdown, sequestration, and shrinking domestic discretionary budget caps. It is absolutely the case that WIC NSA funding is stretched thin. And each of the imposed funding challenges have had real consequences including the redirection of NSA dollars to cover mandated MIS/EBT development, clinic closings and consolidations, formal or informal hiring freezes, and reduced staff and service hours. These consequences have commensurate negative impacts on the delivery of essential WIC services – nutrition and breastfeeding counseling and education, health and social service referrals – impacting the extent of WIC’s long term effectiveness.

The Senate Appropriations Subcommittee on Agriculture Rural Development, Food and Drug Administration, and Related Agencies is tentatively expected to markup its Appropriations bill on Tuesday, July 7. The bill is then expected to face a markup by the Full Senate Appropriations Committee on Thursday, July 9.

Affordable Care Act:
Republican lawmakers continue their effort this week to chip away at the Affordable Care Act (ACA), slowly undermining its components in an attempt to eventually repeal the entire act. H.R. 1190, which would repeal the Independent Payment Advisory Board, a panel created by the ACA to identify ways to slow the growth of Medicare costs, will be considered this week by the House. The $7 billion cost of repealing the board would be offset by reducing funding for the Prevention and Public Health Fund created under the ACA, which funds numerous community-based public health projects across the country each year.

As Republicans in Congress attempt to repeal the ACA, it is important to consider the potential costs associated with repealing this important piece of legislation. The Congressional Budget Office (CBO) released a report Friday indicating that repealing the ACA would increase the federal budget deficit by $353 billion over the next decade.  

Ending the ACA would raise spending on Medicare while reducing the amount of money set aside for health-insurance subsidies, Medicaid, and coverage for poor children, CBO said in its report. If the law were undone, about 19 million more people would become uninsured next year, rising to 24 million by 2020, the CBO said.

On the other hand, the report also found that repealing the law would most likely boost the economy as more people sought work to get employer-paid health insurance, reducing the net cost to $137 billion. In addition to potentially increasing employment, repealing the ACA would also result in some additional cost savings, the report found. Eliminating subsidies that reduce premium costs for people purchasing health insurance through government-run marketplaces (also known as exchanges) would eliminate $822 billion in spending over the next 10 years. This key provision is the subject of a Supreme Court case, King v. Burwell, that is expected to be resolved by the end of June. A ruling against the government in this case would eliminate subsidies for more than 6 million people who enroll using the system. Thus, although eliminating this provision would produce short-term cost savings, it would also mean that millions of Americans would no longer be able to afford health insurance, resulting in long-term societal costs.