Association Applauds $2.75 Billion Increase for NIH

Washington, D.C., April 10, 2001--The Association of American Medical Colleges (AAMC) applauds the Bush administration's support for the National Institutes of Health (NIH) but signals serious concerns about the impact of the proposed budget on health professions programs, coordinated efforts to provide care for uninsured, and for the Centers for Disease Control and Prevention (CDC).

Regarding the health professions, the AAMC is appreciative of the administration's recognition of those programs that further diversity and strengthen the nursing workforce. However, the Bush budget's drastic 61 percent cut in overall funding for the health professions programs will result in the deterioration, if not elimination, of programs such as area health education centers, geriatric health education centers, and primary care training grants. The $3 million cut in funds to the National Health Service Corps (NHSC) is also worrisome as it is the core program providing scholarships and loan repayments to encourage health professionals to pursue primary care careers in underserved areas. The overall goals of these federally funded health professions education programs are to increase the number of primary care providers, address geographic maldistribution, provide care in medically underserved areas, and maintain diversity in the health care workforce.

"Given the Bush administration's strong words of support for helping the uninsured through tax credit proposals and strengthening health care services at the community level, the treatment of the health professions programs is deeply disappointing," said AAMC President Jordan J. Cohen, M.D. "The budget numbers conflict with the rhetoric."

While the Bush administration does increase funding for community health centers by $124 million (10.6 percent), inevitably some, if not all of these centers, will be severely understaffed. Moreover, it eliminates $125 million for the Community Access Program, which seeks to strengthen the effectiveness, efficiency, and coordination of services for the uninsured and underinsured. Overall, the budget for the Health Resources and Services Administration (HRSA), which administers the health professions programs and a variety of programs to provide access to care for special populations, will be reduced by $557 million, from $5.58 billion to $5.01 billion. The AAMC is also deeply concerned about the $109 million (2.6 percent) proposed cut for the CDC, the nation's lead public health agency for promoting health and quality of life by preventing and controlling disease, injury and disability.

Research
The Bush budget request of $23.1 billion for the NIH reflects a presidential commitment to double NIH's FY 1998 funding level by FY 2003, with FY 2002 representing the fourth installment of this five-year plan. The proposed $2.75 billion increase for FY 2002 would be the largest year-to-year dollar increase ever for NIH, and reflects nearly a 70 percent increase over FY 1998. The AAMC is pleased to hear that NIH's focus will be on genetic medicine, clinical research, interdisciplinary research, and health disparities.

However, the AAMC is greatly concerned that other programs vital to the nation's scientific enterprise are not receiving adequate support. In particular, the National Science Foundation (NSF) budget was given $4.47 billion, an increase of only $56 million (1.3 percent) over last year.

More positively, the budget includes $360 million for the VA research program, an increase of $10 million (2.9 percent), and $306 million for the Agency for Healthcare Research and Quality (AHRQ), an increase of $36 million (13.3 percent). While the AAMC is encouraged by these requests as good first steps, the association will continue to strongly advocate Congress and the administration to increase funding for the full complement of federal research programs-NIH, NSF, VA, and AHRQ.

Medicare
The AAMC is also encouraged that President Bush's budget does not propose any reductions to Medicare provider payments and appreciates the fact that the "Immediate Helping Hand" prescription drug proposal should not be financed through the Part A trust fund.

As further reforms to the Medicare program are an administration priority, the Association will be analyzing carefully how the administration's reform plan affects special payments to teaching hospitals-especially payments such as Indirect Medical Education (IME) that are scheduled for reduction after FY 2002.

The AAMC looks forward to working with President Bush to improve HCFA administration and reduce regulatory burdens on providers. The AAMC, however, does not support the budget's proposed provider user fees.

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The Association of American Medical Colleges represents the 125 accredited U.S. medical schools; the 16 accredited Canadian medical schools; some 400 major teaching hospitals, including 74 Veterans Administration medical centers; 91 academic and professional societies representing over 100,000 faculty members; and the nation's 67,000 medical students and 102,000 residents.

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