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Panel Blocks Some Proposed Cuts in Health Programs, Adopts Others

JUNE 8, 2006 -- A House appropriations panel Wednesday rejected fiscal 2007 cuts proposed by the Bush administration in doctor and nurse training programs for rural areas and in funding for children's hospitals. But the panel went along with White House plans for flat funding for the National Institutes of Health, which scientists say, because of inflation in research costs, will lead to the funding of fewer research grants—just as promising research leads proliferate because of a wealth of new knowledge about the human genome.

Similarly, the panel, the House Labor-HHS Appropriations Subcommittee, went along with proposed cuts at the Centers for Disease Control and Prevention, although the reductions it approved were smaller than those favored by the White House.

But the panel increased funding for community health centers by $206 million, an amount it said would fund the creation or expansion of 300 medical facilities across the U.S. to treat people, many of them low-income or uninsured, in areas lacking in health care services, such as inner cities and rural areas. And it boosted a CDC program for immunizing children by $70 million over last year's spending levels.

The panel shielded several programs targeted by a "hit list" developed earlier this year by the White House Office of Management and Budget (OMB) to cut spending on health care programs.

For example, the Bush administration had proposed to trim almost $200 million from a $300 million a year program to fund graduate medical education (GME) programs at children's hospitals. The panel voted to keep funding essentially flat.

Peters D. Willson, vice president of public policy for the National Association of Children's Hospitals, said the proposed cut in GME funding would damage children's hospitals, which he called "the backbone of pediatric medical care and research," and which train 30 percent of the nation's pediatricians and the majority of physicians who work in pediatric subspecialties such as pediatric pulmonologists and neurologists.

The OMB had said that children's hospitals were more likely to be profitable than other hospitals and that it would "redirect" funding to the facilities with the greatest need and the largest number of uninsured children.

The panel also protected another program targeted by the OMB budget "hit list," the health professions training program at the Health Resources and Services Administration. The Labor-HHS Subcommittee said those proposed cuts would have been "devastating" to "critical programs that improve the availability of well-trained health care professionals to underserved areas."

The panel voted to provide $313 million for those programs, $18 million more than last year. The administration proposed $159 million in funding.

The panel also voted to continue or slightly increase funding for programs to foster the spread of centers to treat traumatic brain injury and to screen newborns for hearing difficulties.

The panel voted to approve $6.17 billion in funding for CDC, compared with the $6.09 billion proposed by the administration. But that's below this year's funding level of $6.37 billion. While the agency's budget overall would be trimmed under the budget approved by the panel, spending for programs to control infectious diseases would increase $148 million. The increase voted for CDC programs to immunize children would help those from low-income families or with limited insurance coverage to gain access to the growing number of vaccines now recommended for the young, including to prevent meningitis.

The budget approved for NIH—$28.26 billion—actually cuts funding for most of the individual institutes at the agency while increasing funding for the office of the director by $140 million.

The panel also voted to fund Ryan White AIDS programs at $2.13 billion, an increase of $70 million over last year. However, federal spending for AIDS Drug Assistance Programs (ADAPs) would remain flat at $789 million under the funding level approved by the subcommittee. That means low-income AIDS patients who can't afford AIDS drugs will have to be placed on waiting lists for ADAP programs, say those who favor an increase in their funding.

The subcommittee also approved $318.7 million in funding for the Agency for Healthcare Research and Quality, the same amount as this year.

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