Legislation would permit the federal government to recapture and spend outreach grant funding when states refuse to do so on their own
WASHINGTON - Continuing his efforts to promote Affordable Care Act (ACA) education, today U.S. Rep. Bill Pascrell, Jr. (D-NJ-09) introduced legislation that would give the U.S. Department of Health and Human Services (HHS) the ability to recoup unspent ACA education and outreach funding awarded to states if Governors continue to refuse to spend this funding. The legislation, the Ensuring Full Use of Federal Health Care Funding Act, would then allow HHS to reallocate the funding to qualified entities in the same state to carry out these same functions.
“The unspent outreach grant in New Jersey has been a frustration of mine for quite some time. Governor Christie has had almost two years to spend this money, and he has failed to respond to repeated requests from me and others to do so," said Rep. Pascrell, a member of the Ways and Means Subcommittee on Health. "While he chooses not to spend this money, health care advocacy organizations in New Jersey that did not receive federal funding are stretching their already tight budgets to engage in education and enrollment activities to help make up for the Governor’s inaction. This is unacceptable. Our Governor, and Republican Governors all across the country that oppose the ACA, are sitting on money to help educate people about a law that will provide meaningful benefits and affordable coverage for Americans. My bill will allow us to work around their willful obstruction.”
New Jersey was awarded a $7.67 million Section 1311 grant, which under the state’s current agreement with HHS, must be spent by February 20, 2014. To date, New Jersey has spent only $3,000. In October, Rep. Pascrell wrote to Governor Christie urging him to spend the remainder of the ACA grant in order to avoid losing the federal funds to help educate New Jerseyans about the ACA as well as facilitate enrollment. The grant, awarded in February 2012, has remained largely unspent and will be recaptured by the federal government next month.
New Jersey is not alone. Despite the fact that these grants have already been awarded and cost states none of their own funds, a good deal of this money remains unspent or has already gone back to the Treasury – primarily in states where Governors oppose the ACA. For example, Texas was awarded a $1 million grant, and Governor Rick Perry allowed $900,000 of that to return to the U.S. Treasury. The impact of this obstruction is evident in enrollment numbers in states with cooperative Governors when compared to states with uncooperative Governors.
A recent study from a Harvard University Professor found that fully cooperative states have enrolled 43% of their target Medicaid population, and enrolled 37% of their target population in private coverage. States where Governors refused to expand Medicaid or set up their own Exchange have only enrolled 1.5% of their potential Medicaid population and only 5.6% of their goal for enrollment in private insurance. In New Jersey, only 34,751 residents are enrolled in coverage through the Health Insurance Marketplace.
According to a December 2013 Kaiser Family Foundation poll, 44 percent of Americans feel that they don’t have enough information about the ACA to understand how it will impact them and their families. 62 percent have heard “only a little” or “nothing at all” about the Marketplace. In New Jersey, 31 percent of residents don’t believe they understand the law at all, according to a recent poll from the Monmouth University Polling Institute and the New Jersey Health Care Quality Institute.
These numbers show there is a clear need for additional outreach and education surrounding the ACA, and the federal Section 1311 grant can facilitate this at no cost to states, while helping the 32 million currently uninsured Americans get health insurance – many for the first time.
Grants made available through Section 1311 of the ACA provide states with a very flexible funding source to conduct education and outreach around the ACA, as well as facilitate enrollment. HHS has provided states with a detailed list of permissible uses for the funds.