President Bush’s Budget Plan To Cut CDC, HHS Funding; Increase for FDA, SCHIP
President Bush's fiscal year 2006 budget proposal would eliminate or reduce funding for health care programs that target prevention, chronic diseases and obesity but increase spending for state SCHIP program enrollment efforts, community health care clinics in low-income counties and FDA, according to documents obtained by the New York Times (Pear, New York Times, 2/5). Bush is scheduled to unveil his $2.5 trillion budget on Monday (Quaid, AP/Hartford Courant, 2/5).
Among the proposals, Bush will seek $142 billion over a decade to help 12 million to 14 million uninsured residents obtain health insurance. The "centerpiece" of the plan is a proposal for $74 billion in tax credits to help some residents without employer-sponsored or government-funded health insurance pay for high-deductible health coverage and contribute to health savings accounts or obtain traditional health insurance plans, the Los Angeles Times reports.
Bush also will propose a federally funded pilot program to determine whether federal costs could be reduced by moving some nursing home residents to home- and community-based care programs (Alonso-Zaldivar, Los Angeles Times, 2/5). According to the AP/Hartford Courant, Bush's proposal to expand health coverage and improve health care over 10 years will total $140 billion in tax credits and expenditures (AP/Hartford Courant, 2/5).
According to the New York Times, documents received from budget analysts opposed to the cuts show a "wide range" of reductions to health care programs, including:
- A 9% reduction in CDC's budget to $6.9 billion;
- A 2.4% cut to HHS's discretionary spending budget to $68 billion;
- A 6.5% decrease in funding for a Public Health Service program that addresses chronic disease prevention and health promotion, including efforts to prevent and control obesity, to $841 million;
- A 12.6% spending reduction for public health emergency centers, which distribute medications and vaccines in the event of a bioterrorist attack;
- The elimination of a $131 million block grant for preventive health services that address "urgent health problems" affecting different states;
- A 64% reduction in a training program for nurses, dentists and other health care professionals to $160.5 million;
- A 33% cut to $201 million for a program that trains doctors to work at children's hospitals;
- The elimination of a $9 million program to treat patients with traumatic brain injuries; and
- The elimination of a $9.9 million program that collects umbilical cord stem cells after childbirth, which could be a source of stem cells used in research for new treatments or cures (New York Times, 2/5).
In addition, White House documents indicate that the budget proposal would reduce grants for the Healthy Communities Access Program by $94 million and phase out rural health grants (Allen/Baker, Washington Post, 2/7).
Bush on Friday said that his administration would seek to "eliminate or vastly reduce 150 programs that aren't meeting needs, aren't meeting priorities and are not getting the job done." However, administration officials on Friday also acknowledged that some health programs that "address urgent health care needs" would be cut, the New York Times reports.
Several programs would receive funding increases under Bush's FY 2006 budget proposal, according to the New York Times. The documents obtained by the New York Times show that Bush likely will propose:
- A 0.7% increase in NIH's budget to $28.7 billion. However, the Times reports that the increase is "much less than what would be needed" as the costs of biomedical research increase by more than 3.5% annually;
- Increasing FDA's budget by $81 million, or 4.5%, to $1.9 billion with the majority of the increase to be used to fund prescription drug evaluations and inspect food shipments;
- A 17.5% increase to $2 billion in spending for community health centers in low-income counties. According to budget officials, the centers would provide health care services for 16.4 million residents in 2006, compared with 14 million in 2005;
- A $718 million SCHIP enrollment initiative for children who are eligible for the program but currently not enrolled;
- Increasing funding for sexual abstinence-only programs by $38 million to $192.5 million -- an increase of more than half since 2004;
- A 4.2% increase in a CDC program for global health efforts, including HIV/AIDS; and
- A 21% increase in funding to $120 million for a program dealing with the threat of a global flu epidemic (New York Times, 2/5).
The Wall Street Journal reports that Bush's proposal also would increase funding for the National Science Foundation by 2.4% to about $5.6 billion, after its budget was reduced in FY 2005 (McKinnon/Calmes, Wall Street Journal, 2/7).
Critics of the budget proposal say the reductions to CDC bioterrorism programs, on the state and local levels, would undermine the United State's public health readiness if an attack were to occur. Although the budget proposal would seek $120 million to address a potential flu pandemic, some public health advocates say the budget provides inadequate funding for disease tracking and response.
Dr. Georges Benjamin, executive director of the American Public Health Association, said he is opposed to funding reductions for chronic disease prevention and health promotion programs. "If you want to make a dent in the leading expenditures for health, you need to support these programs," he said. Benjamin said he also was concerned about the increase in spending on abstinence-only programs.
The Atlanta Journal-Constitution reports that many public health officials support comprehensive sex education programs that discuss condom use and other birth control and disease prevention methods. Benjamin said, "We should follow the science. It says a balanced approach is the best approach."
However, Sen. Johnny Isakson (R-Ga.) said the proposed cuts are commonplace. "In this budget process for the last three or four years, the initial budget for the CDC was short -- whether it was the operating budget or the capital budget or both -- and we always came out fine in the end," Isakson said, adding, "We may have a fight ahead of us, but the CDC should come out fine in the end" (Wahlberg/McKenna, Atlanta Journal-Constitution, 2/6).
Patrick White, director of federal relations at the Association of American Universities, said, "[W]e are starting to see an erosion of the research capacity made possible by the doubling" of NIH's budget from 1998 to 2003 (Wall Street Journal, 2/7).
Vice President Dick Cheney on "Fox News Sunday" said, "We are being tight. It's not something we've done with a meat ax, nor are we suddenly turning our backs on the most needy people in our society" (DeBose, Washington Times, 2/7). Bush's budget proposal is available online.
NPR's "All Things Considered" on Saturday reported on the challenges Bush's possible health care reforms are expected to face when they reach Congress. The segment includes comments from Bush's State of the Union and NPR health policy correspondent Julie Rovner (Ludden/Rovner, "All Things Considered," NPR, 2/5). 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.