April 9, 2001 (Washington) -- Taking a key early step in the annual Washington budget negotiations dance, the administration Monday officially delivered to Congress hundreds of pages of documents containing its proposals for national spending for 2002.
In late February, Bush released initial budget numbers, but this submission fills in the details of his plan. Overall, President Bush is asking for $55.5 billion for discretionary programs under the Department of Health and Human Services (HHS), a 5.1% increase over last year.
Nearly all of the health spending increase goes to the National Institutes of Health, which is getting a 13.5%, or $2.8 billion, boost for its biomedical research activities. Another big winner is the FDA, which is netting a nearly 10% boost, with large increases in food safety initiatives, including a mad cow disease prevention effort and tougher rules for imported food and healthcare products.
At the same time, the budget cuts funds by 3% at the CDC, as well as money for various public health programs, including a hemophilia relief program, "community access" grants to coordinate the delivery of safety-net healthcare, and other initiatives.
"There's some grumbling," HHS Secretary Tommy Thompson acknowledged, regarding those agencies that received cuts. But he contended that many of the cutbacks were "one-time" set-aside projects done for specific members of Congress.
Thompson said, "The American people don't expect annual budgets to be growing by double digits, for their family budgets certainly don't grow at that pace."
The proposal would also slash spending on grants for the training of doctors. And to speed conversion to electronic billing, the plan would also charge doctors and other providers a $1.50 fee for submitting paper-based reimbursement claims to Medicare.
But Thompson touted a $123 million increase in spending on safety-net community health centers and a 7.2% increase for government efforts in AIDS/HIV research, treatment, and prevention. Thompson repeatedly spoke of the hope of finding an AIDS vaccine.
The Bush budget also increases funding for women's health programs.
The health budget has traditionally been released at HHS headquarters near Capitol Hill, but Thompson unveiled the blueprint Monday at an inner-city youth center.
Thompson said the move was to highlight the Bush administration's belief in "grassroots" rather than government solutions.
The budget documents are a formal starting point for congressional budget deliberations, but lawmakers have already made some important departures. Congress returns to business on April 24 after returning from its two-week Easter recess.
There is little enthusiasm, for example, for Bush's Medicare "Immediate Helping Hand" program of state-based prescription drug assistance for low-income seniors.
Instead, lawmakers are talking about a more comprehensive drug program, along with structural reforms to the underlying Medicare program.
For Medicare reforms and drug coverage initiatives, Bush had proposed spending $156 billion over the next 10 years, but the Senate last week voted for as much as $300 billion.
Bush would also provide tax credits to encourage the purchase of private health insurance, but the Senate last week voted its support for $28 billion in additional spending for the uninsured.
And there is likely to be congressional pressure to increase spending elsewhere; last week, the Senate voted to allow greater increases in spending in a variety of domestic programs.
Meanwhile, Thompson Monday addressed two nonbudgetary health matters that have been of keen national interest.
- He termed it "doubtful" that he will reverse the Clinton administration's decision not to permit reimportation of pharmaceuticals. Legislation was enacted last year permitting exported drugs to be brought back into the country, but HHS would have to certify that the reimportation program was safe for Americans before it could begin. Former HHS secretary Donna Shalala blocked this measure on the grounds that the government could not guarantee the drugs' safety or cost.
- He said a "short delay" is likely a decision on how to proceed on medical privacy rules. April 14 is supposed to be the implementation deadline for first-ever national standards to assure the confidentiality of individual health records. But Thompson said that he has been flooded by public comments and would need additional time to digest the information. The Clinton administration originally issued the rules, but Thompson is expected to loosen them to be less burdensome on the healthcare industry.