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September 21, 2014

Posts in "Budget/Appropriations"

September 19, 2014

Pentagon Transfers $1 Billion to Ebola Relief Effort

Prior to leaving for a seven-week recess break, the Senate on Thursday completed action on a stopgap spending bill funding federal health agencies until Dec. 11. Included in the bill is additional Health and Human Services agency funding and transfers to respond to the Ebola crisis in West Africa.

However, the $88 million in revised funding pales in comparison to escalating levels of Pentagon funding transfers for Ebola relief efforts. On Monday, the Department of Defense announced a transfer request for $500 million to support the introduction of U.S. troops into region to assist in logistical operations and training of health care workers. The additional funding coincides with President Barack Obama’s revised U.S. Ebola response plan. On Wednesday, the Pentagon upped its funding request to $1 billion.

Funding transfers within Pentagon spending accounts are not uncommon but they require the approval of the leaders of congressional defense committees. Here are the first and second reprogramming requests submitted to congressional committees for Ebola response activity funding.


September 17, 2014

Democrats Offer an Alternative Health Spending Bill

The House today is poised to pass a stopgap spending bill that funds the federal government – including health agencies and programs – through Dec. 11. The short-term measure is necessary because congressional appropriators this year have yet to gain an agreement on the regular annual spending bills. The annual measure funding the bulk of health agencies – the Labor-HHS-Education bill – is the most contentious bill due to conflicting views on funding the health care overhaul law plus a range of spending restrictions and the prospect of added controversial amendments.

House Democratic appropriators this week decided to unveil their own Labor-HHS-Education spending bill, even though it has no chance of garnering a House vote. The effort offers a glimpse into Democratic spending priorities. The draft measure offers a slight increase in funding for the National Institutes of Health and the Centers for Disease Control and Prevention. However, CQ HealthBeat’s (@CQHealthTweet) Kerry Young noted some differences between the House Democrats’ draft and a languishing separate measure spearheaded by Senate Democratic appropriators. The two bills diverge slightly on funding for the Substance Abuse and Mental Health Services Administration and specific funding for HIV/AIDS programs and cancer research.




September 10, 2014

Mapping the Impact of NIH Funding

The largest discretionary spending component of the budget of the Department of Health and Human Services funds the National Institutes of Health, the primary federal medical research agency. The sprawling NIH campus in Bethesda, Md., belies the fact that 85 percent of the agency’s $31 billion annual budget goes to fund medical research off campus in all 50 states.

A medical research advocacy group, United for Medical Research, this week updated its state-by-state map of NIH research funding flowing to each state and supporting an estimated 400,000 jobs. California and Massachusetts lead in receipt of NIH research grants and the larger states dwarf the totals for Idaho, Wyoming and Alaska. NIH has established an award program that seeks to ship research dollars to 23 states with a poor track record of competing for NIH grant money. However, parsing out medical research outside of the NIH also amplifies the nationwide impact of any reductions in the NIH budget.





Congress Offers Ebola Response Funding; Health Care Volunteers Are Needed in Africa

House appropriators on Tuesday evening unveiled details of a fiscal 2015 continuing resolution to fund the government into the new fiscal year. The measure stretches funding through Dec. 11 and provides an extra $88 million to fight the Ebola outbreak in West Africa. The added funding matches the administration’s request to support medical specialists on the ground in Africa and speed the development and manufacturing of Ebola drugs.

Congress’ role in addressing the threat of the Ebola virus focuses on providing funding for medical supplies and drug and vaccine research. However, halting the spread of the disease will hinge on finding enough health professionals willing to volunteer. HealthBeat’s (@CQHealthTweet) Rebecca Adams (@RebeccaAdamsDC) reported Tuesday on the profound challenge of enticing health professionals to volunteer to go to Africa to directly assist in efforts to combat the spread of the virus.

The World Health Organization estimates that 760 foreign volunteers will be needed at any one time over the next six months to monitor infected people, test lab samples, run logistical offices and disinfect thousands of corpses. The global WHO appeal so far has generated only a handful of responses and the agency estimates that as many as three health care workers are needed for each patient. The gruesome impact of the virus on the human body and the paucity of proven drugs and a viable vaccine hinders the task of recruiting volunteer health workers.


September 8, 2014

Spotlight: White House Suggests Additional Ebola Response Funding

Congress returns this week with the primary objective of forging a stopgap spending bill extending existing federal spending in order to avoid a federal agency shutdown at the end of the month. On Friday, the administration added additional Ebola response funding to a list of requested immediate spending adjustments and transfers — called “anomalies,” to address additional critical funding requirements. CQ HealthBeat reported that the administration’s spending adjustment request includes the transfer $10 million from existing accounts into a new fund to respond to the crisis and $58 million in new funding for Department of Health and Human Services drug research to accelerate the development of Ebola drugs and vaccines. Separately, the U.S. Agency for International development has allocated $75 million from current funds to respond to the outbreak.

White House budget planners want congressional appropriators to add the additional funding to a continuing resolution, which would fund the federal government beyond the Oct. 1 start of the new federal fiscal year. The continuing resolution is expected to provide stopgap funding from October until mid-December. Separately, a group of House Democrats last week pressed Republican leaders to schedule a hearing prior to the end of the month on U.S. efforts to fight the spread of the Ebola virus in West Africa.

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September 4, 2014

Waiting for Ebola Response Funding

The Ebola crisis in West Africa might complicate congressional action on a stopgap spending bill to keep the government operating beyond the Oct. 1 start of the new fiscal year.

Several lawmakers at a hearing on the Ebola crisis during last month’s recess urged Centers for Disease Control and Prevention Director Thomas Frieden to request more money. However, in an interview with CQ HealthBeat on Wednesday, Frieden noted that spending is already authorized for global disease detection and response, and he avoided detailing additional funding needs specifically in response to the Ebola crisis. The administration’s proposed budget submitted before the virus outbreak requested $42.5 million in added spending for global health programs.

The continuing resolution might include additional money to support the international medical response to Ebola, but CQ Roll Call’s Tamar Hallerman reported today that congressional Republican leaders are seeking to avoid too many new spending provisions in a stopgap bill, which would extend current spending levels and policy directives through Dec. 11 or 12.


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August 20, 2014

IRS Struggles to Collect the Medical Device Excise Tax

Funding for the 2010 Affordable Care Act hinges, in part, on a 2.3 percent excise tax on medical device sales. The tax applies to cardiac defibrillators, imaging equipment and a variety of other equipment sold to hospitals, doctors and other providers. Congressional efforts to eliminate the tax enjoy significant bipartisan support in Congress from Republicans and Democrats, particularly from states that are home to a concentration of medical device manufacturers.

Internal Revenue Service collection of the tax began in 2013. A Treasury Department’s Inspector General report released on Tuesday indicates that taxpayer reporting on the IRS excise tax form does not account for all applicable medical device sales. Also, the tax agency is struggling to reconcile data provided by taxpayers and cannot accurately identify all of the medical device makers that are required to file the form and pay the tax. Through the first half of 2013, Treasury auditors estimate that the tax levy should have collected $1.2 billion in excise taxes, but the IRS has received $913 million.

August 8, 2014

Ebola Crisis Prompts CDC Funding Questions (Video)

A House Foreign Affairs subcommittee hearing Thursday on the Ebola outbreak in West Africa prompted a discussion on Department of Health and Human Services (HHS) funding levels. The lead agency responding to the Ebola crisis is the Centers for Disease Control and Prevention (CDC), which is funded through the HHS budget. The chairman of the House panel questioned whether enough money was available for CDC programs designed to prepare for a pandemic health crisis. CQ HealthBeat’s Kerry Young reported that a senior GOP appropriator, also attending the hearing, inquired about the need to shift current HHS funding toward toward addressing the CDC response to the Ebola crisis.

However, the HHS budget is already subject to separate transfers to cover new expenses from an influx of migrant children at the border with Mexico. A HHS agency, the Administration for Children and Families, is responsible for housing and care for the migrant children. The administration requested emergency program funding for HHS border relief efforts, but Congress was unable to reach an agreement on supplemental spending prior to the August congressional recess.

Neither the House nor Senate has passed a fiscal 2015 spending bill for HHS, whose appropriations are frequently stymied by disputes over additional spending for the implementation of the 2010 health care law. When Congress returns in September, appropriators could offer additional HHS pandemic response funding in separate planned action on a stopgap continuing spending resolution which would extend funding for all federal agencies past the Oct. 1 start of the new federal fiscal year.


August 1, 2014

Drug Coverage Premiums and Spending Forecast Remain Low

The Department of Health and Human Services  has announced a slight increase in the Medicare Part D program’s premiums for next year. The prescription drug benefit, first implemented in 2006, now offers drug coverage to 39 million people.

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$1.1 Trillion Axed From Long-Term Estimates on Federal Health Care Spending

In July, two pivotal scorekeepers on federal spending issued annual reports on the long-term outlook for federal health care spending. Full story

Next Year’s Battle: CHIP Funding

At this time next year, a major battle will be brewing in Congress over the renewal of funding for the State Children’s Health Insurance Program.

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July 31, 2014

Veterans’ Health Bill Sails Toward Passage

The Senate today is expected to overwhelmingly approve a compromise veterans’ health bill, clearing it for President Barack Obama’s signature. The measure would provide $10 billion for non-Veterans Affairs health care services to veterans’ who cannot schedule appointments at a veterans’ medical center and offers $5 billion to the VA to hire additional staff and upgrade facilities to meet demands for health care.

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July 29, 2014

Medicare Trustees Report Extends Trust Fund Solvency

The trustees of the Social Security and Medicare trust funds on Monday released their annual report. The trustees projected that due to lower health care spending the Medicare hospital inpatient trust fund will be depleted in 2030, four years later than estimated last year.

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July 28, 2014

Retiring Appropriator Seeks to Steady Medical Research Funding

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Harkin. (Bill Clark/CQ Roll Call)

Sen. Tom Harkin, the chairman of the Senate Labor-HHS-Education spending subcommittee and the Health, Education, Labor and Pensions Committee, is retiring at the end of the year. Ahead of his departure, the Iowa Democrat has introduced a bill that seeks to steady medical research funding for the National Institutes of Health.

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Veterans’ Health Bill Compromise Set After Weekend Talks

A compromise struck by House and Senate negotiators on Sunday on veterans’ medical care legislation would provide $15 billion in up-front emergency funds to help ease lengthy wait times at VA medical facilities, according to plan summary obtained by CQ Roll Call.

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