Senate passes HHS budget bill, defies Bush spending targets

Washington -- Community health centers, medical researchers and medical students would benefit from a fiscal 2008 Dept. of Health and Human Services budget passed by the Senate. But Congress must gather enough votes to override a threatened veto.

The Senate adopted a $479 billion HHS appropriations bill 75-19 on Oct. 23, easily achieving a two-thirds, veto-proof majority with the help of 29 Republicans. The House passed a similar $472 billion HHS budget in mid-July by a vote of 276-140 -- short of a veto-proof level, despite the support of 53 Republicans.

The House and Senate were expected to release a compromise HHS bill this month.

The Senate measure generally resembles the House version. Both would boost funding to the National Institutes of Health, prevent the president's proposed virtual elimination of the Title VII medical education loan program and increase federal community health center funding.

The president's 2008 budget proposal would reduce Title VII medical student loan assistance to $10 million from $184.7 million in 2007 and would freeze funding for community health centers at $1.99 billion. It proposes reducing the National Institutes of Health budget by $310 million (2%).

The Senate budget measure would head in the other direction. It would add $5 million (2.7%) to Title VII and $250 million (12.5%) for community health centers. It would boost NIH funding by $1 billion (3.5%).

The health center increase would allow facilities to see nearly 2 million more patients, according to Dan Hawkins, senior vice president for programs and policy at the National Assn. of Community Health Centers.

"This bill will continue the vital expansion of health centers into more medically underserved communities across the country," he said.

The NIH increase would pay for an additional 400 grants, compared with fiscal 2007 and 700 more than the president's budget.

Even the Senate bill's increase wouldn't keep pace with today's biomedical inflation rate of 3.7%. The NIH needs $1.9 billion (6.7%) annual increases from 2008 to 2010 to restore it to the spending ability it had in 2002 before a series of flat budgets, said Jon Retzlaff, director of legislative relations for the Federation of American Societies for Experimental Biology.

However, it has been clear for months that the NIH wouldn't see that kind of increase this year, Retzlaff said. FASEB has been campaigning to keep NIH from suffering cuts so that more medical researchers can avoid shutting down their operations.

"[Researchers] just can't do much more other than keeping things going," Retzlaff said.

The president has threatened to veto 10 of the 12 spending bills to fund the federal government for the next fiscal year -- including the House and Senate versions of the HHS measure -- because they exceed his 2008 requested spending by a combined total of more than $20 billion.

This disagreement between Bush and the Democratic-led Congress epitomizes their increasingly frosty relationship. Bush criticized Congress for not sending a single appropriations bill to him before Oct. 26, which he said hasn't happened in 20 years.

The House adopted all 12 appropriations bills by the end of July, but the Senate has been months behind in its work.

Bush also took aim at Democrats for not working in a more bipartisan manner on the State Children's Health Insurance Program reauthorization. "Congress needs to keep their promise, to stop wasting time, and get essential work done on behalf of the American people," the president said.

Democrats, such as Rep. David Obey (D, Wis.), chair of the House Appropriations Committee, chastised Bush for requesting $200 billion for the wars in Iraq and Afghanistan while drawing a hard line on other spending. "It's amazing to me that the president expects to be taken seriously when he says we cannot afford $20 billion in investments in education, health, law enforcement and science," Obey said.

Sen. Tom Harkin (D, Iowa), chair of the Senate Appropriations subcommittee on health, noted the final Senate HHS bill didn't include a provision in the original measure supporting stem cell research that the president would have opposed.

"I remain hopeful that the president will back away from his preemptive veto threat, consider the substance of the bill and listen to the better angels of his nature," he said.

Democrats have their legislative work cut out for them as the year draws to a close.

Their resolution funding the federal government expires Nov. 16 and needs to be extended if the appropriations bills aren't finished.

While Bush criticized Congress for excessive spending, Democrats characterized the House and Senate HHS bills as an attempt to keep nearly all discretionary spending from going to the military and security programs.

Bush proposed increasing funding for defense, homeland security, international affairs, military construction and veterans affairs by $60.2 billion (11.3%) in 2008, according to the Assn. of American Medical Colleges. At the same time the president called for restricting funding of all other domestic discretionary programs.