S. 1916 would make certain skilled nursing facilities eligible for grants under the Universal Service Fund’s (USF’s) Rural Health Care (RHC) program. The Universal Service program is administered by the Federal Communications Commission (FCC) and is intended to promote the availability of telecommunications services at affordable rates. The cash flows of the USF appear in the budget as direct spending (for amounts distributed from the fund) and as revenues (for fund collections).
CBO estimates that enacting S. 1916 would increase direct spending by $197 million over the 2017-2026 period and result in increased revenue collections of $215 million over the same period, resulting in an estimated net reduction in the deficit of $18 million. CBO estimates that implementing the bill would have no significant discretionary costs. Pay-as-you-go procedures apply because enacting the legislation would affect direct spending and revenues.
CBO estimates that enacting the legislation would not increase net direct spending or on-budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2027.
S. 1916 contains no intergovernmental mandates as defined in the Unfunded Mandates Reform Act (UMRA). CBO expects the FCC would increase fee collections associated with the USF to offset some of the costs of expanding the Rural Health Care program. As a result, the bill would increase the cost of an existing mandate on private entities required to pay those fees. Based on information from the FCC, CBO estimates that the cost of the mandate would amount to no more than $25 million in any of the next five years. Thus, the aggregate cost of the mandate would fall below the annual threshold established in UMRA for private-sector mandates ($154 million in 2016, adjusted annually for inflation).