Summary
The Affordable Care Act (ACA; P.L. 111-148 and P.L. 111-152) included more than 100 funding opportunities of interest to states. For some programs, the law included both authorizations and appropriations, thereby providing funding at the specified levels for the years cited in the law. The majority of programs, however, received only an authorization in the law. These discretionary programs require funding through the appropriations process. As such, Congress will determine if or when (and at what levels) these programs will be funded.
Some members of Congress have indicated their desire to eliminate funding for health care reform. It is those programs subject to the appropriations process that would be at most risk under such proposals. To eliminate funding for programs receiving a direct appropriation, Congress would need to amend the underlying law or specifically rescind the funding. Such legislation must be passed by both houses and signed by the president.