Earlier today, several federal health directors testified before the US House of Representatives. Many questions focused on sequestration’s possible impact on our federal prevention, research and health care agencies. The graph below may help to inform this continued discussion.
A video of today’s hearing begins at minute mark 0:22:55 here.
Because of sequestration and cuts in prior years, the CDC’s budget authority is $724 million less today than it was in FY 2005.
The agency’s total budget of $6.5 billion, which includes transfers and the Prevention and Public Health Fund, has grown by only $190 million over that same time.*
These numbers do not tell the full story.
These cuts come at a time when surveys are finding a 21% reduction in the nation’s total state and local health department workforce.
* Total FY13 budget numbers assume the Prevention and Public Health Fund allocations to the CDC will be lower due to the sequester, but similar to levels provided in 2012. Exact PPHF allocations for FY13 are yet to be determined.
July 25, 2012
Because congressional leaders failed to reach a bipartisan compromise on deficit reduction, the legislative equivalent of a deficit-reducing guillotine now hangs by a tripwire over federal spending. If the guillotine falls on January 2, 2013, every “discretionary” federal program - or 40% of federal spending - will face cuts of 8 percent or more.
To date, the media (and most politicians) have focused on the possible defense industry job losses that could result. High powered dignitaries are parading through the streets of Washington preaching defense job losses and stories of doom and gloom for defense contractors. Little has been written about the impact such cuts would have on non-defense areas of the budget.
Today, Senator Tom Harkin released a new report, Under Threat - Sequestration’s Impact on Nondefense Jobs and Services. Long a proponent of prevention, Senator Harkin’s report takes a look at what would happen in other areas of federal spending if these cuts take place. The numbers are troubling. Here are just a few:
Most agree that nothing will happen before November, but if Congress sits on its hands for the few legislative days between the November elections and the fall of the guillotine in January, social service and health programs will take a devastating hit.
One odd fact about guillotines - it seems the head is about 8% of the entire mass of the body. And cutting off your brain as a means to lose weight is about as smart as using a 8% sequester to fix a deficit. Congress must find a meaningful compromise so these grim scenarios don’t come to pass.
December 23, 2011
Last Saturday, Congress sent the president an Omnibus Spending bill giving the Obama Administration more than $1 trillion to spend between now and the end of September, 2012. Several federal departments annual budgets were wrapped up in the massive bill which passed Congress three months behind schedule.
In normal times, media coverage of an annual trillion-dollar spending measure is decent. Reporters dig into the bill for a week or more and write about who won and who lost – but these are not normal times and coverage was sparse. A close friend of mine, an avid newspaper reader who once worked for an appropriations committee chairman, didn’t know the bill had passed Congress and was off to the president for his signature.
It seems an agreement on the spending bill, which ended the excitement of a possible government shutdown, meant the story was over. Reporting quickly re-focused on the new partisan fight between the House and Senate over extended unemployment benefits, a popular middle class tax break and a looming pay cut for doctors who serve Medicare beneficiaries.
But the Omnibus is worth a closer look.
Because our work highlights public health programs, we track the Centers for Disease Control and Prevention’s budget closely. This week we dug into the bill and checked to see how the CDC fared. The resulting graph below plots CDC’s funding trends through FY 2012. The table this is drawn from can be found on our website. [Be sure to scroll to page 2 of that PDF]
THE NUMBERS: An Explanation
This year’s FY 2012 Omnibus bill provides the CDC’s programs with a $76 million more than last year. Only $9 million of this $76 million increase comes from new budget authority.
To put this funding level in perspective, consider that if the agency had simply kept pace with the rising cost of goods and services since 2005, inflation would have driven the CDC’s core discretionary budget up to $7.322 billion in FY 2011. Instead, CDC’s core discretionary programs were funded at $1.67 billion below that mark in 2011. Mandatory funding from the Prevention and Public Health Fund in 2011, along with more than half a billion in department-wide transfers and fees, raised CDC’s program funding to $6.837 billion – still $485 million behind inflation.
The CDC’s budget authority (in blue above) is clearly trending downward as the ever-more important Prevention and Public Health Fund (shown in purple) grows each year. But more on that later.
MORE THAN LEVEL-FUNDING – A WIN!
With the national dialogue focused on deficits and budget cutting, most advocates in Washington are not asking for increased spending. Take, for example, this post from the Policy Watch Blog of the Association for Career and Technical Education after the Omnibus bill passed:
On December 17, Congress finalized a funding package that contains the remaining nine appropriations bills for Fiscal Year (FY) 2012, including the Labor, Health and Human Services, and Education Appropriations bill. The legislation passed the House and Senate with bipartisan support. In this bill, [our key program] is level-funded! This is fantastic news!
These days, advocacy groups in Washington are generally pleased when they avoid evisceration. And the failure of the Supercommittee hints at even more pressure to cut is in the future. The fact that the CDC’s budget was not cut, but actually did slightly better than level funding is a testament to all who advocated on behalf of the public health this year.
THE PREVENTION FUND
The original intent of the Prevention and Public Health Fund was to do more to combat the rising number of patients entering hospitals with preventable chronic diseases. A well written New York Times opinion piece from April 2011 summarized the value of the fund using the words, “boost,” “build” and “bolster” to describe how the Prevention Fund would improve health and save money down the road.
Unfortunately, this block of funding has become the finger in the dike for our nation’s disease control and prevention efforts. So far, the fund has not helped prevention-focused agencies “build” or “bolster” much of anything new. Instead, the Prevention Fund has kept the CDC from being cut to the bone.
If partisan bickering were ever to do away with the prevention fund at this point – as some in Congress have called for - the CDC would suffer a 12% cut to its budget overnight.