Bush Budget Proposal Would Eliminate Six HHS Programs
The fiscal year 2007 budget proposal that President Bush announced last week would eliminate six HHS programs, for a savings of $866 million, and reduce spending by about $1 billion for five additional programs, CQ HealthBeat reports. The proposal would save $630 million though the elimination of the community services block grant, which funds "Community Action Agencies" that offer employment, housing, nutrition and health care for low-income individuals. In addition, the proposal would eliminate the CDC Preventive Health and Human Services Block Grant -- which funds chronic disease prevention, immunization, injury reduction programs and sex-offense prevention programs -- for a savings of $99 million.
The proposal would save $39 million through the elimination of certain categories of funding under the $693 million Maternal and Child Health Small Categorical Grant program. According to the Office of Management and Budget, the programs that the proposal would eliminate have not established long-term goals or indicated improvement.
The proposal also would eliminate the Urban Indian Health Program, which funds primary, preventive and behavioral health care for the 60% of American Indians and Alaska Natives that reside in urban areas, for a savings of $33 million. OMB said that health care providers who receive funds through the program receive 60% of their operating funds from other sources, adding that many individuals served by the providers can obtain care at community health centers.
In addition, the proposal would save $25 million through the elimination of Real Choice System Change Grants. HHS said the grants are no longer necessary because of funding to move individuals with disabilities into home and community-based care programs. The proposal also would reduce spending for:
- The Children's Hospital Graduate Medical Education Payment Program, which subsidizes children's hospitals, from $297 million to $99 million;
Health Resources and Services Administration Health Professions Programs, which direct health care professionals to underserved communities, from $295 million to $159 million;
- HRSA Rural Health Programs -- which fund rural health care facilities, state offices of rural health and the establishment of rural provider networks -- to $27 million, for a savings of $133 million; and
- Poison control centers, from $23 million to $13 million, (Reichard, CQ HealthBeat, 2/10).
Stephen McConnell, vice president for public policy at the Alzheimer's Association, criticized the budget proposal, which he said would eliminate $12 million in state grants for community-based Alzheimer's care, in addition to a $1.6 million "Maintain Your Brain" campaign. He said, "It costs Medicare three times as much to take care of somebody with Alzheimer's disease than not," adding, "If we could even just slow the progression of this disease, we could reduce the cost substantially."
HHS CFO Charles Johnson defended the spending reductions included in the budget proposal and said that the proposal has "a very substantial amount of funding going into Alzheimer's."
Sen. Edward Kennedy (D-Mass.) said the Bush administration included "tax cuts for the wealthy and giveaways for the drug industry" in the proposal.
Vinay Nadkarni, a spokesperson for the American Heart Association, criticized a provision in the proposal that would eliminate a $1.5 million program that provides defibrillators to rural communities and trains local personnel to use them. He said, "Coronary heart disease is the No. 1 killer in the United States. This is actually something we can arm ourselves with" (Connolly, Washington Post, 2/14).
The budget proposal also includes the first spending reductions for cancer research in 10 years. The proposal would reduce spending for the National Cancer Institute by 0.8%, or $39.4 million, to $4.75 billion. In addition, the proposal would reduce spending for the CDC cancer prevention programs by 1% to $304.7 million.
The proposal also would reduce spending for the National Breast and Cervical Cancer Early Detection Program for low-income women by $1.4 million and reduce spending for the CDC Office of Smoking and Health by $2.1 million.
Sen. Tom Harkin (D-Iowa), ranking member of the Senate Appropriations Subcommittee on Labor, HHS, Education and Related Agencies, said, "Instead of funding a war on cancer, the president' budget is funding a retreat."
Rep. Clay Shaw (R-Fla.) said, "When you are so close you don't jog, you sprint" (Cohn, CongressDaily, 2/14).
The budget proposal also would require veterans younger than age 65 to pay more for TRICARE, the military health care program, the San Diego Union-Tribune reports. The proposed fee increases would affect about 3.1 million military retirees and their families nationwide.
Annual enrollment fees for TRICARE Prime, the managed care program, currently are $230 for an enlisted retiree or retired officer and $460 for a family. Under the proposal, the fees would increase to $325 for a junior enlisted retiree and $650 for a family; $475 for a senior enlisted retiree and $950 for a family; and $700 for a retired officer and $1,400 for a family. The fees are based on retirement income levels (Fitzsimons, San Diego Union-Tribune, 2/14).
In addition, under the proposal, copayments in the TRICARE retail pharmacy network would increase to $5 from $3 for generic medication and to $15 from $9 for brand-name treatments (Tacoma News Tribune, 2/11).
Defense Department analysts have estimated that, without increased fees, TRICARE expenses could reach $64 billion, or 12% of the estimated department budget, by 2015. Under the proposal, the fee increases would "be phased in over two years beginning in October 2007," the Union-Tribune reports (San Diego Union-Tribune, 2/14).
WAMU's "The Diane Rehm Show": The NPR-syndicated program on Monday included a discussion with Senate Finance Committee Chair Chuck Grassley (R-Iowa) about provisions in the budget proposal related to Medicare and Medicaid (Rehm, "The Diane Rehm Show," WAMU, 2/13). The complete segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.