Recent weeks have involved an enormous amount of attention on Capitol Hill by the mass media, primarily due to events involving an effort to impeach President Donald Trump. Whatever the outcome of an attempt to unseat him as the White House’s occupant, a significant amount of important business continues to be pursued by members of both the Senate and the House of Representatives. Funding for key governmental operations is on temporary hold until disagreements can be resolved about what to fund and for what amounts.

Unable to complete business by the start of a new fiscal year on October 1, a continuing resolution (CR) was used to maintain operations until November 21. Recognizing that much appropriations business remains unfinished, members of both the House and Senate approved a second continuing resolution (CR) to fund the federal government through December 20. President Trump signed it on November 21.

The Patient Protection and Affordable Care Act of 2010 (ACA) resulted in the creation of the Patient-Centered Outcomes Research Institute (PCORI). As an example of that agency’s operations, on November 19 of this year its Board of Governors approved $70 million to fund 21 studies and related projects designed to improve care for health conditions that impose high burdens on patients, their families, and the healthcare system. Eighteen of the awards, totaling about $65 million, will fund studies comparing the most effective ways to treat a range of illnesses and health conditions. Three of these investigations focus on health issues of concern to older adults—two on hearing loss and one on safer prescribing of glucose- lowering drugs for individuals with Type 2 diabetes. Three other studies focus on children’s health issues; two seek to improve treatment of anxiety in children and adolescents; and one seeks to prevent obesity among preschoolers in rural, underserved areas.

Many federal initiatives, such as the Higher Education Act (HEA) and PCORI must be reauthorized at stated intervals to continue operating. Even when they no longer are authorized, there is pressure to enable them to continue functioning because of the essential functions that they perform. Some programs tend to be more vulnerable than others, however, and there always is a risk that an unauthorized entity could be eliminated. For example, the past few decades have involved several attempts to jettison the Agency for Healthcare Research and Quality. A way of reducing such danger is to seek the enactment of reauthorization legislation. A step in that direction was launched on November 19, 2019 with the introduction of S. 2897, a measure to reauthorize PCORI in order to boost research into health care costs.

Even when legislators agree on the importance of existing programs, technical difficulties can obstruct further progress. A case in point is funding for historically black colleges and other minority-serving institutions, which recently expired. Both Senate Republicans and Democrats support reauthorizing $255 million a year, but cannot agree on the best mechanism for doing so. A Republican proposal is to furnish permanent funding by including the measure in reauthorization of the Higher Education Act (HEA), which has not been reauthorized for the past six years. Critics among Democrats object to holding this form of support as hostage in a much larger bill that is not destined to go anywhere soon because of its complex nature.

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