By a vote of 254 for and 151 against, the House failed to achieve the two-thirds majority needed to pass a bill to continue categorical grant funding of health centers in areas with inadequate medical care.
The special majority was needed because the bill was debated under a short-cut parliamentary procedure that barred floor amendments and abbreviated debate. The bill (HR 2418) authorized $893 million over two years for community health centers in areas lacking adequate medical care and for migrant health centers to serve seasonal workers. Most individuals using these facilities cannot qualify for Medicaid coverage.
Largely at issue was the provision to continue categorical grants rather than fold these programs into the federal block grant for primary health care.
As the block-grant approach has come into wide use during the Reagan Administration, many specific federal missions have been turned over to states and localities, which have wide latitude in determining how to administer the programs and spend the accompanying federal payments.