Federal Funding Update

1. Federal Funding Update More Risks than Opportunities Federal Funds Information for States

2. Federal Budget Outlook: Deficits as Far As the Eye Can See

3. Risks of a Federal Budget Deficit: Putting a $1.4 Trillion Deficit into Perspective

4. Overview: Few Opportunities, Many Risks for States • Progress on the federal budget • FY 2011 update • Looking toward FY 2012 and beyond • The winding down of ARRA funds • The prospect for additional FMAP, other extensions • Potential offsets from unspent ARRA funds • Health Care Reform • Will the benefits exceed the costs? • Census: Winners and Losers

5. President’s FY 2011 Budget • Overall freeze on non-security discretionary spending for three years • States still would receive sizeable increases • Major Discretionary Programs: 6% Increase • Health and Human Services: 10% Increase • Major Mandatory Programs: 16% Increase • Assumes extension of some ARRA provisions

6. Congressional Action • No budget resolution, just overall FY 2011 limits • Behind schedule, even more than usual • Continuing resolution a given, omnibus bill likely, uncertain timing for final enactment

7. Overall Cap, Subcommittee Allocations

8. Overall Cap, Subcommittee Allocations, Cont.

9. Potential Funding Levels for Major Health and Human Services Programs

10. Potential Funding Levels for Major HHS Programs , Cont.

11. Potential Funding Levels for Major HHS Programs, Cont.

12. Looking Toward FY 2012 and Beyond • Deficit Reduction Committee • Focus on long-term budget deficit • Recommendations due December 1, 2010 • FY 2012 budget directive to agencies • Continue freeze on domestic discretionary spending • Budget request 5% below FY 2011 levels • Submit separate list of low-priority/low-performing programs

13. Performance Ratings for Select HHS Programs

14. Performance Ratings for HHS Programs: Potential Programs at Risk (or Not)

15. Expiring ARRA Provisions • September 30, 2010: • TANF Emergency Fund • Child Support Enforcement incentive match • Increase for Disproportionate Share Hospitals (DSH) • Obligation deadline for most HHS programs • December 31, 2010: • ARRA FMAPs • Transitional Medical Assistance (TMA) • Qualifying Individuals (QI)

16. Prospect for ARRA Extensions • ARRA FMAP Extension • Latest scaled-down version • TANF Emergency Fund • Child Support Incentive Match • No action since president’s budget • Future action likely to include ARRA rescissions

17. Health Care Reform: Will ACA Benefits Exceed Costs? • Funding the Medicaid Expansions • States still pay part of the cost • No help for administrative costs • Many new funding opportunities • Some programs received both authorization and appropriations in ACA • Most programs will require funding through the regular appropriations process

18. ACA Programs Receiving a Direct Appropriation

19. ACA Programs Receiving a Direct Appropriation, Cont.

20. ACA Programs Subject to Appropriations Process

21. ACA Programs Subject to Appropriations Process, Cont.

22. ACA Programs Subject to Appropriations Process, Cont.

23. ACA Programs Subject to Appropriations Process, Cont.

24. ACA Programs Subject to Appropriations Process, Cont.

25. 2010 Census: Impact on Federal Grants • Significant impact on health and human service funding • Medicaid matching rates • Social Services Block Grant • Degree of reliance varies by program, other formula factors may mitigate effect • Winners and losers • Actual population totals for April 2010 will be released in December 2010

26. Take-Aways • FY 2011 appropriations won’t happen until after the election; status quo for states • Few, if any, reauthorization bills will pass • ARRA FMAP extension unlikely in short-term, uncertain in longer-term • States face greatest risks in FY 2012 and beyond • Major restructuring of state-federal programs?

27. The End • Questions? • Check for updates at www.ffis.org • Almost all states subscribe to FFIS, please contact us for your password and to be added to the distribution list: ttomsic@ffis.org, 202-624-8577