BUDGET: Clinton Unveils $1.7 Trillion Plan
President Clinton yesterday unveiled a FY 1999 budget plan that, in addition to including a number of health care initiatives, would balance the federal budget for the first time in three decades. The New York Times reports that the Clinton plan asks Congress to expand Medicare to the near elderly, a plan he says is "self-financing, because over time participants pay the full cost of their coverage." Clinton predicted that the "buy-in policies" would cost $1.5 billion over the next five years. Clinton also proposed "to let elderly Medicare patients participate in clinical trials testing experimental treatments for cancer." The president proposed a Medicaid expansion as well, asking Congress to "allow states to provide Medicaid coverage to legal immigrants under the age of 18 who have arrived in this country since August 1996 and those who arrive in the future." Another Medicaid-related request asks that Congress provide "$900 million over the next five years to locate and sign up 3 million children who are eligible for Medicaid but not enrolled in the program" (Pear, 2/3). CongressDaily notes that Clinton's "budget proposes $100 million in seed money for states to establish voluntary purchasing cooperatives to help small employers purchase health insurance for their workers" (2/2). Overall, the Department of Health and Human Services would see its budget rise "from $359 billion in FY 1998 to $381 billion" in FY 1999, "a six percent increase" (Vobejda, Washington Post,, 2/3)
Giving Research A Boost
A separate article in the New York Times reports that "the Clinton administration [yesterday] proposed a large increase in research spending, including substantial increases for medical and university studies." Among the budget plan's "chief beneficiaries" is the National Institutes of Health, which would receive a $1.15 billion increase in the coming year, bringing its budget to $14.8 billion with a pledge from the administration "to increase its financing to $20 billion in five years" (Leary, 2/3). The Washington Post reports that this additional NIH funding would be "the largest dollar increase in its history," helping "to accommodate new initiatives in cancer, diabetes, brain disorders and genetic medicine." The White House is calling its increased federal funding for science the "'Research Fund for America,' which is basically a new name for collective federal spending on civilian research." Vice President Al Gore yesterday called it "the largest commitment to key civilian research in the history of the United States of America" (Suplee, 2/3). At yesterday's unveiling at the White House, President Clinton said the increased research spending will provide "future generations the gift of scientific and medical advances. The 21st Century Research Fund, the largest funding increases ever for the National Institutes of Health ... will speed the progress of biomedical breakthroughs in the fight against many of our deadliest diseases" (transcript, 2/2).
H.D. Palmer, Gov. Pete Wilson's deputy finance director, "criticized Clinton for refusing to reimburse California fully for the costs of educating, jailing and providing emergency health care to thousands of illegal immigrants." Ernest Hopkins, the director of federal affairs for the San Francisco AIDS Foundation, praised the budget for increasing funding for AIDS programs, including housing for people with AIDS, NIH-funded AIDS research and the AIDS Drug Assistance Program ( San Francisco Chronicle, 2/3).
One Wrinkle To Smooth
On yesterday's CBS "Evening News," Scott Pelley noted that Clinton's proposed "billions of dollars in popular new programs" relies on a "catch:" passage of the "'controversial' tobacco settlement" (2/2). The Washington Post notes that "[b]y including the anticipated funds in the budget, the White House is betting that it will increase pressure on the Republican-controlled Congress to approve tobacco legislation or face political heat for failing to do so" (Torry, 2/3). Sen. Phil Gramm (R-TX) said, "If we have a tobacco settlement, the money ought to go to save Medicare. It ought not to go to fund general government." Senate Budget Committee Chair Pete Domenici (R-NM), on the tobacco settlement: "I may favor the settlement, but the truth of the matter is it's a very big concern that we'll ever pass that. And, if we do, we have to take that from the states and say we're going to use it. So chances of ever getting that money are pretty slim." Office of Management and Budget Director Franklin Raines disagreed with Domenici's assessment of the settlement's chances, noting that support for the deal is "growing for a simple reason. There's nothing else we can do that will have an impact on the public health more dramatic[ally] than increasing the cost of cigarettes" ("NewsHour," PBS, 2/2). Today's Los Angeles Times looks at how the settlement money would be divided among the states and federal government (Rubin, 2/3).
GOP Tax Cut Strategy
While Clinton has proposed a $1.50 per pack increase in the federal tobacco tax to fund new health and social programs, the Washington Times reports that Republicans are preparing a counter idea that centers on tax cuts. Republicans "are considering increasing" the tobacco tax by a similar amount "and using the bulk of the money to deliver tax cuts to other constituencies, such as married couples." A spokesperson for House Speaker Newt Gingrich (R-GA) said, "Speaker Gingrich repeated in the presence of GOP leadership that any tax increase ... must be offset by a tax cut" (Roman, 2/3).
Responses To The Plan
The National Family Planning and Reproductive Health Association yesterday praised Clinton's proposed $15 million, or 7.4% increase for the federal Title X family planning program. "We salute the Clinton Administration for supporting increased funding for family planning, ... [which] reduces the number of unintended pregnancies, allows women to plan and space their births, resulting in healthier mothers and babies, and lessens the need for abortion," said the group's president and CEO, Judith DeSarno (release, 2/2). The Health Insurance Association of America said of the proposed Medicare expansion, "[N]ow is not the time to consider expanding Medicare" (HIAA release, 2/2).