On March 10, the House Energy and Commerce Committee heard from Secretary of Health and Human Services Tommy Thompson, who detailed the administration’s FY2005 budget request for health care programs. Chair Joe Barton (R-TX) opened the hearing by noting that “health care is the cornerstone” of the committee’s work. “We’ve improved the quality of life for millions of Americans.” Saying “the new Medicare law does many good things for seniors,” Rep. Barton urged members of the committee to “focus on ways to ensure that the law, now that it is law, is fairly implemented.”
Saying he was “severely disappointed” by the FY2005 health care budget, Ranking Member John Dingell (D-MI) added that the request was “most noteworthy for what is not included, rather than what is.” He pointed to the new Medicare prescription drug benefit: “The budget includes no money to fix the gaping holes in the flawed” benefit, he said, adding, “Seniors are facing a ‘donut hole’ that just keeps getting larger.”
As he did in previous hearings, Secretary Thompson focused his oral remarks on summarizing the Medicare Prescription Drug Improvement and Modernization Act of 2003 (P.L. 108-173) (see The Source, 2/13/04). However, his written testimony highlighted a number of other budget requests and administration initiatives of particular importance to women and their families.
Noting that the Transitional Medical Assistance (TMA) program is set to expire on March 31, 2004, Secretary Thompson said that the administration proposes a five-year extension of the program. “TMA was created to provide health coverage for former welfare recipients after they entered the workforce,” he said, continuing, “TMA extends up to one year of health coverage to families who lose eligibility for Medicaid due to earnings from employment.” He also stated that the administration is committed to working with Congress to reauthorize the 1996 welfare reform law (P.L. 104-193).
The secretary reminded the committee that in his State of the Union address, President Bush announced an initiative to “educate teens and parents about the health risks associated with early sexual activity and to provide the tools needed to help teens make responsible choices.” To do this, he said, “The President proposes to double funding for abstinence education activities for a total of $273 million, including a request of $186 million, an increase of $112 million, for grants to develop and implement abstinence education programs for adolescents aged 12 through 18 in communities across the country; the reauthorization of state abstinence education grants for five years at $50 million per year as part of the welfare reform reauthorization; another $26 million for abstinence activities within the Adolescent Family Life program; and a new public awareness campaign to help parents communicate with their children about the health risks associated with early sexual activity.”
Secretary Thompson also highlighted an initiative aimed at expanding access to health care by providing a $219 million increase to $1.8 billion for community health centers. “This increase will result in increased services for an additional 1.6 million people in approximately 330 new and expanded sites,” he said, adding, “At this level, almost 15 million uninsured and underserved individuals, nearly 7 million from rural areas, will have access to comprehensive preventative and primary care services at over 3,800 health sites across the country.”
Stating that more than “1.7 million Americans die of chronic diseases–such as heart disease, cancer, and diabetes–each year,” Secretary Thompson said that the budget includes a $62 million increase to $915 million for Chronic Disease Prevention and Health Promotion. Additionally, the budget include $125 million, an $81 million increase for the Steps To A Healthier US Initiative. “This increase will fund the state and community grant program initiated this past September to reduce the prevalence of diabetes, obesity, and asthma-related complications, targeting those at high risk,” he said.
Further, the budget requests $220 million, a $10 million increase for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). “With the requested increase, the NBCCEDP will provide an additional 32,000 diagnostic and screening services to women who are hard-to-reach and have never been screened for these cancers,” stated the secretary.
Finally, Secretary Thompson noted a 31 percent increase over FY2001 for domestic and global HIV/AIDS prevention, care, treatment, and research to $15 billion in FY2005. He pointed to an increase in funding for the AIDS Drug Assistance Program (ADAP), which allows states to purchase medications for individuals living with HIV/AIDS. “Also included is $53 million for the HIV/AIDS in Minority Communities activities funded under my office, which reflects the first time the budget proposes an increase, to support innovative approaches to HIV/AIDS prevention and treatment in minority communities,” he said.
During the question and answer session, Rep. Barton told the secretary that his staff had compiled a list of 93 programs receiving line items in the HHS budget that are currently not authorized. “What do we, or you, do about those programs?” he asked.
Secretary Thompson responded that he believed the programs should be reauthorized and noted that several reauthorizations are pending before Congress, including Head Start and the Temporary Assistance for Needy Families (TANF) program. He also added that a number of programs at the Centers for Disease Control and Prevention and the National Institutes of Health need to be reauthorized as well.
Rep. Sherrod Brown (D-OH) questioned why the U.S. is not giving more to the Global Fund to Fight AIDS, Tuberculosis, and Malaria: “What, as the chairman of the Global Fund, are you telling the president?”
Responding that his hands are tied by the law, Secretary Thompson said, “The law passed by you [Congress] limits what the United States can give,” adding that the U.S is only allowed to contribute thirty-three percent of the total funding for the Global Fund. Additionally, Secretary Thompson pointed out that until other donors make contributions to the Global Fund, the U.S. cannot contribute the $200 million that was appropriated in FY2004.
Rep. Mary Bono (R-CA) expressed her concern that the Ryan White CARE Act was level-funded under the FY2005 budget request and that she hadn’t heard much from the secretary on the Women’s Health Initiative and hormone therapy. “I think it’s a topic that is very confusing to the public, and I think women are concerned,” she said.
Secretary Thompson said that the administration is “doing a lot on women’s health,” pointing to a five percent increase for women’s health programs. “Our budget includes $8 billion in discretionary funding that is targeted for women’s health,” he said.
