Congressional Vote Nears On $463.5B FY 2007 Spending Package With Increased Funds For Some Health Programs

The House on Wednesday is scheduled to vote on a $463.5 billion fiscal year 2007 spending bill that includes additional funding for veterans' health care, NIH and community health centers, the Wall Street Journal reports (Rogers, Wall Street Journal, 1/30). The 109th Congress last year approved two of 11 FY 2007 appropriations bills and passed a continuing resolution to fund most federal agencies at FY 2006 levels until Feb. 15. Late last year, House Appropriations Committee Chair David Obey (D-Wis.) and Senate Appropriations Committee Chair Robert Byrd (D-W.Va.) said that they would complete the other FY 2007 appropriations bills through an extended continuing resolution and focus on FY 2008 appropriations bills (Kaiser Daily Health Policy Report, 1/26). Under the new CR, which would fund most government agencies until the end of FY 2007 on Sept. 30, NIH funding would be $619 million higher than FY 2006 levels (Cohn, CongressDaily, 1/30). Other increases include $4.4 billion for veterans' medical care, $2.3 billion for education and health programs, and $207 million for community health centers. Programs that fight AIDS, tuberculosis and malaria abroad also would receive additional funding (Wall Street Journal, 1/30). The Senate is expected to consider the CR as early as next week (Cohn, CongressDaily, 1/29). According to the Journal, the Bush administration apparently is "receptive to much of the package, but it would have to accept an almost $3.6 billion cut from its [FY 2007] request for military construction and base-closing funds" (Wall Street Journal, 1/30).

FY 2008 Proposal
In related news, President Bush's FY 2008 budget proposal will be released on Feb. 5, and lobbyists and analysts are predicting that Medicare is "in line for major cuts," CQ HealthBeat reports. Department of the Treasury Secretary Henry Paulson in a Wall Street Journal interview published on Friday said that the budget proposal will include "a number of changes relating to Medicare." In addition, an unnamed Journal source said the administration will propose $90 billion in Medicare cuts over five years (Reichard [1], CQ HealthBeat, 1/29). Carolyn Clancy, director of the Agency for Healthcare Research and Quality, on Friday said Bush's proposal will include new funding to create an electronic "rapid-learning" health care network, which could access individual data repositories from various health providers to allow "researchers to benefit from an extensive web of databases." Clancy said that access to the network would be possible "without needing access to individual patient information or (creating) a mega central repository." Clancy added, "In the clinic, [the information] can give providers real-time feedback to help them continually improve the effectiveness of their care. In the community, it can help bring together stakeholders to look at patient outcomes and work toward improvement. And on the broadest level, it has the potential to be a kind of information 'nervous system,' enabling us to learn directly from the health delivery system itself" (Carey, CQ HealthBeat, 1/29).

Group Says Major Reforms Needed
In other related news, the Center on Budget and Policy Priorities on Monday released a report stating that the national debt will increase from 37% of the U.S. economy today to 231% in 2050 unless major changes are made in health care spending, tax policy or both. "The three programs that will cause expenditures to grow faster than the economy over coming decades are Medicare, Social Security and Medicaid," according to the report. Medicare is "by far the largest contributor to the overall growth in expenditures through 2050 because it bears the full brunt of both demographic changes and health care cost growth," the report said, adding that the government must "pursue major reforms that eliminate inefficiencies in the health care system and restrain costs in the system to the greatest extent possible without unduly constraining medical progress." CBPP President Robert Greenstein said that the goal of covering the uninsured is not necessarily in opposition to improving the nation's fiscal outlook, because current health care spending on the uninsured is inefficient. Jim Horney, director of federal fiscal policy for CBPP, said, "The problem we face is too large to be solved solely by raising taxes or solely by reducing programs" (Reichard [2], CQ HealthBeat, 1/29). The report is available online.

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