Secretary of Health and Human Services (HHS) Michael Leavitt detailed the HHS FY2006 budget before several committees this week. On February 16, he appeared before the Senate Finance Committee. Chair Charles Grassley (R-IA) opened the hearing praising the administration for its efforts to improve access to health care for the uninsured. “They [the uninsured] need relief from rising health costs.” Speaking to controversy about the newly enacted Medicare prescription drug benefit, Sen. Grassley stated, “This chairman won’t support reopening the prescription drug benefit for changes that will undermine the program… Surely they [seniors] have waited long enough for us to provide prescription drug coverage.”
Ranking Member Max Baucus (D-MT) expressed his concern about the administration’s proposal to cut $60 billion from Medicaid: “We all want to make Medicaid more efficient. And we all want to root out fraud and abuse in Medicaid. I am willing to consider improvements to Medicaid. I am open to talking about the need for more state flexibility. And I am open to talking about better accountability. But I don’t believe it’s wise to cut Medicaid for the sake of meeting an arbitrary budget number…Medicaid is too important to too many people. And program cuts or funding caps will have a real impact on real people.”
Secretary Leavitt detailed President Bush’s health agenda, saying that it “leads us towards a nation of healthier Americans, where health insurance is within the reach of every American, where American workers have a comparative advantage in the global economy because they are healthy and productive, and where health technology allows for a better health care system that produces fewer mistakes and better outcomes at lower costs.” To that end, the budget proposes a 10 percent increase in funding to $642 billion in FY2006.
Highlighting budget proposals aimed at providing affordable health care, Secretary Leavitt pointed to the administration’s proposal to provide a $304 million increase to $2 billion for community health centers. Noting that 40 percent of community health center patients have no health insurance and 64 percent are racial or ethnic minorities, Secretary Leavitt said that the increase would complete “the President’s commitment to create 1,200 new or expanded sites to serve an additional 6.1 million people by 2006.”
House Ways and Means Committee
Secretary Leavitt appeared before the House Ways and Means Committee on February 17. Expanding on his previous testimony, he highlighted the administration’s proposal to reauthorize the 1996 welfare reform law (P.L. 104-193). “President Bush laid out a clear path for the next phase of welfare reform. The proposal is guided by four critical goals that will transform the lives of low-income families: strengthen work, promote healthy families, give States greater flexibility, and demonstrate compassion to those in need.” He explained that the proposal would replace the current caseload reduction credit with an employment credit, establish demonstration projects to integrate welfare and workforce assistance programs, and reform child support enforcement programs so that more money is collected and directed to needy families. With regard to child care assistance, Secretary Leavitt stated, “Our proposal supports maintaining the historically high level of funding for child care, including $2.1 billion for the Child Care and Development Block Grant and $2.7 billion for Child Care Entitlement a total of $4.8 billion for what is referred to as the Child Care and Development Fund or CCDF. In addition, States continue to have the flexibility to use TANF [Temporary Assistance for Needy Families] funds for child care both by transferring up to 30 percent of TANF funds to CCDF, and by spending additional TANF money directly for child care.”
Highlighting new initiatives in the budget, Secretary Leavitt said that the administration proposed $200 million to “support the formation and stability of healthy marriage through demonstrations, research and a matching grant program.” In addition, $40 million would be provided for the promotion and support of responsible fatherhood. Finally, Secretary Leavitt explained that the proposal would reauthorize the State Abstinence Education Program, adding, “The FY2006 budget expands activities to educate adolescents and parents about the health risks associated with early sexual activity and provide them with the tools needed to help adolescents make healthy choices. The programs focus on educating adolescents ages 12 through 18, and create a positive environment within communities to support adolescents’ decisions to postpone sexual activity. A total of $206 million, an increase of $39 million, is requested for these activities.”
During the question and answer session, members on both sides of the aisle focused their comments on the child care assistance. Rep. Jim McCrery (R-LA) asked whether the $2.1 billion provided for the Child Care Development Block Grant would be adequate, pointing out that the Republican welfare reauthorization bill (H.R. 240) would increase funding each year up to $3.1 billion in FY2010. Secretary Leavitt explained that the administration’s budget “provides sufficient funds” because welfare caseloads have been reduced and fewer people are eligible for the child care assistance. Reps. Sander Levin (D-MI) and Ben Cardin (D-MD) disagreed. They pointed to information provided by HHS concluding that 300,000 families would no longer be eligible for child care assistance if the funding remained level over time. Secretary Leavitt reiterated that the number of caseloads had been cut in half, adding that the $2.1 billion represents a 27 percent increase since FY2001 if one divides that amount by the number of qualifying families.
Rep. Nancy Johnson (R-CT) voiced her concern regarding the number of children who have suffered abuse in foster care, stating that is “irresponsible for the committee to not reform the foster care system.” She also expressed her desire to work with Secretary Leavitt to address the needs of mental health patients who are dual-eligible for Medicaid and Medicare.
House Energy and Commerce Committee
Members of the House Energy and Commerce Committee focused the majority of their questions on the administration’s proposed Medicaid cuts when Secretary Leavitt testified before their committee on February 17. Several Members focused specifically on HHS programs affecting women. Rep. Mary Bono (R-CA) asked the Secretary to work to further studies under the auspices of the Women’s Health Initiative (WHI). Stating that “women are still clamoring for answers” regarding hormone therapy, Rep. Bono requested that the Secretary examine why bioidentical hormones were not included in WHI studies. Additionally, Rep. Bono asked for continued support for programs to combat childhood and adult obesity. Secretary Leavitt agreed that obesity is a “substantial part of the health dilemma” and said that it is “a matter of educating people to change their behavior.”
Citing several studies that found that abstinence-only education programs are not effective, Rep. Lois Capps (D-CA) asked why the administration was proposing a funding increase. “Abstinence is 100 percent effective,” responded Secretary Leavitt.
