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Energy and Commerce Oral StatementGood morning. Mr. Chairman, Mr. Dingell, Members of the Committee: thank you so very much for inviting me to testify this morning. Mr. Chairman, I want to thank you for your continued leadership on so many issues that are vitally important to the American people. I've enjoyed our previous meetings, and I know that all the members of this Committee want all Americans to be as healthy as they can be. It is good to be with this Committee again and to have the opportunity to discuss the President's fiscal year 2004 budget for the Department of Health and Human Services. In my first two years at the Department we have made tremendous progress in our efforts to improve the health, safety, and well-being of the American people. We continue to make extraordinary advances in providing health care to lower-income Americans. Through waiver and state plan amendments granted to state governments for their SCHIP and Medicaid programs, we have expanded access to health coverage for more than 2.2 million people, and have also expanded the range of benefits offered to 6.7 million other Americans through SCHIP and Medicaid. Our progress is substantial, but it is far from being finished. So this year, our work continues as we propose new and innovative programs to promote the health and well-being of our fellow citizens. The President's budget proposal contains $539 billion for HHS, an increase of $36.9 billion, or 7.3%, which will enable the Department to continue to work to help improve the health and safety of our Nation. This proposal will fund programs to increase the nation's readiness to respond to potential bioterrorist attacks, bolster disease prevention efforts, cast a wider safety net to meet the critical health care needs of the uninsured, and strengthen and improve Medicare and Medicaid. Mr. Chairman, in light of recent events I would first like to mention our efforts in this budget to fight bioterrorism. Our $3.6 billion bioterrorism budget would enhance the steps we've taken since September 11, 2001. If the request is approved, by the end of next year we will have spent $9.2 billion to research, prevent, and prepare for a potential bioterror attack. This budget repeats last year's $1.45 billion investment in State, local, and hospital preparedness. Since September 11, we have worked closely with States on comprehensive public health preparedness and response plans for chemical, biological, radiological, and nuclear attacks. And I am proud to say that as a nation, we are much better prepared for an attack of nonconventional weapons than ever before. In his address on the State of the Union, President Bush announced a new initiative, Project Bioshield, which would also help prepare the country for a bioterror attack by procuring effective countermeasures. He would spend roughly $6 billion over ten years to speed up research and approval of vaccines and treatments and ensure a guaranteed funding source for their purchase. Project Bioshield would leverage the government's intelligence, law enforcement, and public health assets to enhance our preparedness. So, while we're proud of the progress we've made over the past year, we are committed to becoming even better prepared against a larger number of potential threats in the next few years. There has been much discussion and speculation in the media in recent weeks about the Administration's plans to provide a drug benefit to Medicare beneficiaries. The Administration's proposal to strengthen and improve Medicare is still being developed, and further detail will become available in the next few weeks. But I can assure you that we are absolutely dedicated to adding a prescription drug benefit to Medicare and enacting meaningful changes to strengthen and improve the program. We have dedicated $400 billion over the next decade to achieve this ambitious goal, and we look forward to working closely with this Committee to develop and pass a responsible and effective Medicare bill this year. Passing Medicare legislation will be a huge task, and improving Medicaid is also urgent. In fact, Medicaid is growing even more rapidly than Medicare-the federal portion is $285 billion, and the program grows at about 9-10% a year. Like Medicare, Medicaid is vital to making sure all Americans have access to health care. But state Medicaid programs are under tremendous financial pressure, and beneficiaries risk losing coverage. 2/3 of States have already made reductions or have reductions pending. Under current law, states are eliminating coverage of optional populations and dropping optional benefits. In the past year, 38 states have reduced services or eligibility and most states are currently considering other benefit or eligibility cutbacks. We want to give states another option. It is our responsibility to work together so that States get the help they need in managing their health care budgets, while preventing further service and benefit cuts and expanding coverage for low income Americans. Simply pouring more money into an outdated system will not bring that system up to date or repair its structural flaws. Failure to act would put the health insurance of thousands of Americans at risk because states can no longer afford to maintain their current programs. The President has proposed a plan to preserve coverage, make Medicaid more efficient, and provide better health care delivery. If Congress adopts this plan, states will be able to build on the successes of the State Children's Health Insurance Program. Let me be very clear about two things. First, state participation in the new program would be optional. Second, mandatory populations will continue to receive all of their mandatory benefits. The Medicaid entitlement will be unchanged. States will have more flexibility in covering optional populations, which account for a large part of Medicaid spending. They will gain the ability to target special needs populations, such as those suffering from mental illness and AIDS and those who prefer home and community based care. We must begin by addressing the immediate fiscal needs of the states. President Bush's plan would meet the 9% base growth in the program and then forward funding by $3.25 billion for 2004 and $12.7 billion over seven years. If we do not improve Medicaid, a million Americans could lose coverage this year, and millions more next year. I look forward to working with you, Mr. Chairman, to make sure they keep it. Another issue of keen personal interest to me is the drastic toll chronic diseases take on our society. Consider the following facts:
Our health care system waits for people to get sick and then spends billions of dollars to make them well. We want to do things differently. That's why our budget proposes a coordinated, Department-wide effort to promote a healthier lifestyle by emphasizing the prevention of obesity, diabetes, asthma and risky youth behavior. The HHS budget also includes an investment of $125 million--$100 in new money-for targeted disease prevention. We continue to implement our commitment to increase access to health care for Americans who have no health insurance. We are committed to providing new and expanded health centers in 1200 communities, doubling the number of people served. The FY 2004 budget expands the number of health centers by 120 to 3,698 centers, expands services in 110 existing sites, and would serve an additional 1.2 million people. Last year, we completed a 5-year doubling of the budget of the National Institutes of Health. This year, we continue that commitment with a budget of $27.9 billion, a net increase of $549 million over last year. As a result of one-time projects being funded in FY 2003, and not needing to be re-financed, actual NIH research investment will rise by $1.9 billion, or 7.5 percent. The Bush Administration is also dedicated to combating the spread of HIV and AIDS across the globe. The HHS budget contains $294 million in global AIDS prevention funding, including $150 million to prevent mother to child transmission, a 50% increase over our last request. The idea for this project arose after my visit to Africa last year. Additionally, in fiscal years 03 and 04, HHS and USAID will fulfill the President's commitment of $500 million to support the Global Fund to combat HIV/AIDS, tuberculosis, and malaria world-wide. HHS, in collaboration with DOD and USAID, has established maternal and child health clinics and teaching centers in Afghanistan, which will allow physicians, nurses, and midwives to be trained in an appropriate clinical environment. I've been to Afghanistan, and I am convinced the clinic will be an important element in our government's contribution to fulfilling the health care infrastructure of that country. Here at home, access to good health care is often threatened by the huge cost of medical liability insurance, which is driving doctors in some states out of state or out of business. We can take a major step toward controlling these costs and keeping these doctors where they are needed by putting reasonable limits on non-economic damages. I look forward to working with you on that effort. Additionally, I understand that later this afternoon this Committee will mark up a patient safety bill that would enhance our understanding of adverse events in medical settings and improve patient safety. I want to thank you for your efforts last year to pass this bill, and urge to you move it through Congress and onto the President's desk. Mr. Chairman, the budget the President has proposed for HHS funds a wide variety of programs, with a combined single purpose: to improve the lives of the American people. All of our proposals, from building on the successes of welfare reform to protecting the nation against bioterrorism; from increasing access to health care to strengthening and enhancing Medicare-all these proposals are put forward with the goal of ensuring a safe and healthy America. Americans have made many great discoveries over the years, and the discoveries that will endure the longest have expanded our understanding of nutrition and exercise, birth and aging, and how to prevent, treat, and cure disease, disability, and suffering. Our doctors have better knowledge and technology at their disposal than ever before, and the rest of us also have access to a treasury of good advice about getting and staying healthy and energetic. We have much more to discover, Mr. Chairman, and at the same time we also have the opportunity to put our recent discoveries into practice-to make sure America's federal and state health programs, and the entire medical industry, reflect the best work of our researchers and the kindest impulses of our hearts. By working together, we have made great progress toward that goal, and as the major proposals in the President's budget show, there is much more we can do. The President has made improving our nation's health and health care one of his biggest priorities for the year, and by working together, we can make it one of our proudest achievements. I look forward to all the work, and I know our discussion this morning will get things rolling. Thank you, Mr. Chairman. Last Revised: March 3, 2003 |
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