U.S. Senator Richard Shelby (R-Ala.), Ranking Member of the Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (Labor/HHS) today made the following statement at a Subcommittee hearing on the Department of Health and Human Services Fiscal Year 2013 Budget Proposal:
"Thank you, Mr. Chairman. Secretary Sebelius, thank you for appearing today to discuss the Department of Health and Human Services' (HHS) Fiscal Year 2013 budget.
"We are living in difficult times. America's gross debt has increased more than $5 trillion during President Obama's first three years in office and the Fiscal Year 2013 budget request does nothing to curb spending or put our country on a fiscally sustainable path. In fact, the Administration has built the 2013 budget based on the flawed philosophy of spend now, pay later. But as the turmoil in Greece is verifying, at some point the bill must be paid.
"One of the key fiscal challenges facing the federal government is health care spending. In the last twenty years, total funding for the Department of Health and Human Services has tripled. Since 2001, the Department's discretionary appropriation has increased by 45 percent. The President's answer to control health spending, the Affordable Care Act, continues to grow our nation's deficit, and its bills are piling up.
"In Fiscal Year 2013, the budget requests a $1 billion increase in discretionary dollars for the Centers for Medicare and Medicaid Services to continue implementation of Affordable Care Act activities. This is in addition to the $15.4 billion in mandatory funding the Affordable Care Act directly appropriated since Fiscal Year 2011. By combining discretionary and mandatory funding streams, the majority of the Affordable Care Act circumvents the yearly appropriations process that is crucial to providing transparency to funding decisions.
"As we attempt to rein in federal spending, it is clear that a comprehensive view to fund health care programs is necessary. Instead of using budgetary smoke and mirrors, we should examine all sources of funding -- discretionary and mandatory -- before the Appropriations Committee determines an appropriate level of discretionary funding. Many programs advertise their baseline reduction, when, in fact, they are recipients of significant mandatory funding from the Affordable Care Act. Agencies and programs should no longer deceive the American taxpayer by arguing their spending is reduced when they also receive mandatory funding from the Affordable Care Act that supplements, and in many cases greatly increases, their spending level.
"It is also critical that our Subcommittee carefully consider the effects of the Affordable Care Act's mandatory funding on important health care programs that may not be able to continue when the Act is repealed. The Administration has used the Affordable Care Act's mandatory spending, which is not subject to a vote by Congress every year, to backfill key discretionary programs. The Administration then diverts discretionary dollars to fund new programs. When the Affordable Care Act is repealed, many important programs like Community Health Centers and the Section 317 Immunization program at the Centers for Disease Control will be in jeopardy because their base funding provided by the Labor/HHS Appropriations bill has been so significantly reduced.
"It is time to stop deceptive budgeting. We should be looking at the resources programs need for this fiscal year and not necessarily their long-enjoyed funding history. Congress should carefully review programs to ensure funding is targeted to those that are the most successful and achieve the best results.
"That is why I am disappointed that the Administration has cut funding for the National Institutes of Health (NIH). In the last 30 years, biomedical research has yielded significant scientific discoveries that have extended life, reduced illness, and cut health care costs considerably. Secretary Sebelius, your budget request abandons our nation's commitment to advancing medical research. In fact, the request does not keep pace with biomedical research inflation and as a result, in inflationary adjusted dollars, the NIH is nearly 20 percent below where they were 10 years ago.
"Our nation's leading researchers will never find a cure for the debilitating diseases that affect us without a commitment to advancing medical research. It is critical to invest in biomedical research to ensure the U.S. continues to make progress towards medical discoveries that improve lives, make treatment more effective, and lower overall health care costs.
"Mr. Chairman, I look forward to working with you this year to craft a bill that balances the needs of our health care system within our country's fiscal restraints.