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Hearing of the Health Subcommittee of the House Energy and Commerce Committee - "Setting Fiscal Priorities in Health Care Funding"


Location: Washington, DC

The Subcommittee will come to order.

The Chair will recognize himself for an opening statement.

The title of this hearing is "Setting Fiscal Priorities in Health Care Funding."
And that is exactly what we must do: assess and prioritize all of the things that we need to do and would like to do and then make difficult funding decisions with limited amounts of money.

Today, we will address five areas of the health reform law -- and determine if these funding streams are needed, if these programs are funded at the most responsible levels, and if they should be mandatory or discretionary.

Sec. 4002 of PPACA establishes a Prevention and Public Health Fund "to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs."

The section authorizes the appropriation of, and appropriates to the fund from the Treasury, the following amounts: $500 million for FY2010; $750 million for FY2011; $1.00 billion for FY2012; $1.25 billion for FY2013; $1.50 billion for FY2014; and for FY2015 and every fiscal year thereafter $2.00 billion.

The Secretary has the full authority to use this account to fund any programs or activities under the Public Health Service Act that she chooses, without Congressional oversight.

On June 18, 2010, HHS announced $250 million in Prevention and Public Health Fund dollars would go "to support prevention activities and develop the nation's public health infrastructure."

On September 27, 2010, HHS announced another $320 million in grants from the Fund to "expand the primary care workforce."

And on February 9, 2011, HHS announced an additional $750 million from the Fund for various prevention activities, including preventing tobacco use, obesity, heart disease, stroke, and other diseases, and increasing immunizations.

The goals of these three disbursements from the Fund are laudable, and there is no doubt that we must focus on preventing disease.

But, we must remember that this funding is over and above the amount that Congress has decided should go to these activities and the amount that Congress has already appropriated for these activities. It is also disbursed at the sole discretion of the Secretary.

Last Thursday I asked Secretary Sebelius whether she needed further Congressional approval to spend the money from the 4002 fund, and she answered no.

I then asked her if she could fund activities above and beyond the level Congress appropriated, and she stated yes.

This should concern every Member that we have a created a slush fund that the Secretary can spend from without any Congressional oversight or approval.

By eliminating this fund, we are not cutting any specific program or activity. We are reclaiming our oversight role of how federal taxpayer dollars should be used.

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