November 30, 2018 Cost Estimate As reported by the Senate Committee on Health, Education, Labor, and Pensions on November 29, 2018 View Document104.67 KB Summary H.R. 315 would direct the Health Resources and Services Administration to identify geographic areas experiencing a shortage of health professionals practicing in maternity care. Enacting the bill would not affect direct spending or revenues; therefore, pay as-you-go procedures do not apply. Implementing H.R. 315 would result in spending subject to appropriation, but CBO has not completed an estimate of those amounts. CBO estimates that enacting that legislation would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2029. The bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.