March 2, 2001
Bush Proposes $2.8 Billion Increase for NIH, Cut in Health Professions Education
President Bush Feb. 28 released the first look at his FY 2002 budget following a speech to a joint session of Congress the night before. Entitled "A Blueprint for New Beginnings: A Responsible Budget for America's Priorities," the document highlights a number of White House priorities in rather limited detail, but provides few or no specifics on the rest of the budget. Those details will be filled in by a larger budget submission, expected in early April.
What is outlined in the document provides good and bad news for medical schools and teaching hospitals. On the plus side, the budget proposes a $2.8 billion increase for NIH, bringing the total budget to $23.1 billion in FY 2002, as part of the effort to double the NIH budget by 2003. Reaction from the medical research community has been positive, although advocates, including the AAMC as a member of the Ad Hoc Group for Medical Research Funding, have been urging a $3.4 billion increase.
The budget document also states, "NIH is in the process of identifying strategies and policies that could be implemented in 2002 and 2003 and beyond to maximize budgetary and management flexibility in the future. Such strategies could include funding the total costs of an increasing number of new grants in the grant's first year and supporting some one-time activities such as high-priority construction and renovation projects."
The administration also proposes a $124 million increase for Community Health Centers "to strengthen the health care safety net for those most in need." The document notes this increase is "the first installment for a multi-year initiative to increase the number of community health center sites by 1,200." On the negative side, the budget assumes only a $2.1 billion (5.4 percent) overall increase in discretionary health spending. If the increases for NIH and other programs are factored out, it appears the administration is proposing to freeze or cut other health programs. However, the budget provides few specifics on what would be cut.
One area where the administration appears to propose a significant cut is health professions education. The budget document notes the programs "were created almost forty years ago when a physician shortage was looming. Today a physician shortage no longer exists. Moreover, the Federal role is questionable in this area given that these professions are well-paid and that market forces are much more influential in determining supply." The administration proposes "focusing resources on the Health Professions' grants that address current health workforce supply challenges, such as the impending nursing shortage and improving diversity in the health professions."
In some areas, it is unclear how much money is being proposed. For the National Health Service Corps, the budget document states, "Through a targeted management reform initiative, the NHSC will be better able to address the neediest communities. The NHSC management reform will examine the rate of scholarships to loan repayments, as well as other set-asides, to ensure maximum flexibility in placing NHSC providers." The administration proposes "to amend the Health Professional Shortage Area definition to reflect other non-physician providers practicing in communities, which will enable the NHSC to more accurately define shortage areas and target placements better." The budget states, "The NHSC initiative will also encourage more health care professionals to participate in the NHSC by making scholarship funds tax free." The document also notes HHS "enhance its coordination with immigration programs, including the J-1 and H-1C visa program, which review applications for health care providers practicing in underserved communities."
For the National Science Foundation, the administration proposes a $56 million (1.2 percent) increase.
Information: Dave Moore, AAMC Office of Governmental Relations, 202-828-0525.
