Federal Budget

The combined cost of both the war in Iraq and the Hurricane relief efforts have challenged the federal government as they try to create a budget for 2006. The federal deficit is now estimated to exceed 340 billion. ( Washington Post, Dec. 29, A4) Both the House and the Senate labored over the budget, addressing both appropriations and budget cuts, until nearly Christmas. Even seasoned government watchers were confused over the final appropriations.

ANSR was very active in the fall as they lobbied to secure funding for Title VIII. Late Wednesday night, December 21, 2005, the Senate approved by voice vote the FY 2006 Labor-Health appropriations bill and the final bill was sent to the President for approval.

The final dollar amount designated for Title VIII funding is just over $151 million, a 0.4% increase. However, the budget for the Department of Defense contains an across the board 1% cut to all programs, except the Veteran Administration, resulting in a 0.6% reduction in funding.

Title VIII Funding FY 05 FY 06

Advanced Education Nursing $58, 176 $57, 061

Comprehensive Geriatric Education $3, 450 $3, 392

Loan Repayment and Scholarships $31, 484 $31, 055

Nurse Ed, Practice, Retention Grants $36, 471 $37, 291

Nursing Workforce Diversity $16, 271 $16, 107

( www.nln.org/)

Hurricane Relief

U.S. Senate Appropriations Chairman Cochran (R-MS) announced on Dec. 18, 2005 that he had secured an agreement for legislation that would provide immediate assistance to hurricane recovery efforts. The amount appropriated during negotiations is an estimated $32 billion for hurricane disaster assistance. The White House had initially requested $17 billion in aid for hurricane recovery efforts. Included in the $32 billion is $24 billion from previously appropriated FEMA spending. The additional $8 billion was created from budget cuts to discretionary spending. (www.appropriations.senate.gov)

Of the millions allocated, $11.5 billion is to be directed towards economic development grants and $10 billion to rebuild failed levees, US military instillations, bridges, and roads. $1.6 billion is to go to schools throughout the affected region and $390 million was earmarked for low-income housing for displaced victims. (Washington Post, December 23, 2005, p. A6)

Defense Spending

The Senate and House of Representatives members of the Committee on Appropriations have approved a total of $453.28 billion in defense spending. Included in this amount is $50 billion for operations related to the Global War on Terror. This spending provides $50 billion for operations in Iraq or Afganistan (Title IX) and it also fully funds military pay, benefits, and medical programs. Included in this appropriations bill (dated Dec 18, 2005) is a provision authorizing oil and gas exploration in the Arctic Coastal Plain.

For the entire list of dollar allocation, please see: www.appropriations.senate.gov

Key Features of Budget Measure ($39.7 billion five-year deficit-reduction bill)

Medicaid- increases out-of pocket costs for poor people who rely on state-federal health program, through higher co-pays and premiums
Medicare- 46.4 billion in net savings: reduces some payments to private health plans, freezes home care payments and curtails some payment rates for some imaging studies, such as MRI’s.
Welfare and child support- saves $1.6 billion in welfare, child-support enforcement, and other human services: requiring states to get half their welfare recipients working within one year or face penalties; cuts programs that attempt to collect child support from non-custodial parents; allows people getting off welfare to keep Medicaid assistance for one year.
Education- cuts $12.7 billion for education programs by fixing interest rates on student loans at 6.8 percent.
Agriculture-cuts agricultural programs by $2.7 billion
Pensions- raises $3.6 billion in government revenue over 5 years by raising premiums companies would pay to the Pension Benefit Guaranty Corp.

(Washington Post, December 22, 2005, p. A9)

Avian Flu

As per the above report, $3.8 billion was allocated for the Department of Health and Human Services (HHS) to address the potential pandemic influenza. $2.75 million is slotted for vaccines, anti-virals, and any other countermeasures that HHS determines is necessary to protect the health of Americans. An additional $350 million was directed to aid State and local public health departments plan and exercise their roles during a pandemic. $150 million is provided for international and domestic surveillance. (www.appropriations.senate.gov)

The Department of Health and Human Services (HHS) issued a recommendation in the event of a pandemic related to H5N1m the avian influenza. While there is still no vaccine available, HHS issued a checklist for citizens to use in the event of a pandemic: remain home and have a generous supply of: ready to eat foods, bottled water and cleaning supplies, over the counter medications such as Tylenol and cough and cold remedies, and fluids with electrolytes; teach children good hand washing skills; discuss with family members emergency action plans. For more details, go to www.pandemicflu.gov

Patriot Act

President Bush signed a bill that renews the Patriot Act for a few weeks into 2006 until Congress reconvenes and resume debate over the antiterrorism law. The extension of the Patriot Act is set to expire in February, 2006. The extension that President Bush signed allows the FBI to continue to investigate terrorism cases using roving wiretaps, etc. and in some of these cases, this practice is without a court order.

(Washington Post, Dec. 31, p.A2)

Antiterrorism Funds

The Department of Homeland Security announced that the federal government would give preference to high risk urban areas in handing out funds to help cities buy equipment and train emergency workers for possible terrorist attacks. There is $765 million available in local preparedness grants for 2006. While this amount is less than the $855 million available in 2005, the number of eligible cities is less, down to 35 from 50, so ample funding may still be available. (Boston Globe, January 4, 2006, p. A2)

Student Loans

In efforts to reduce the federal deficit, some lawmakers have proposed eliminating $12.7 billion in education aid. This measure would cut the amount of loan money guaranteed by the federal government, thus increasing interest rates on student loans. In addition, a 1 percent insurance fee on the student loans would be imposed. In the past, the federal government had guaranteed the student loans, thus allowing lenders to offer low interest rates. In the present bill, lenders would have to give back to the federal government a portion of the interest that they collect. There would now be a fixed interest rate of 6.8% and parents would have an interest rate of 8.5%, up from 7.9%.

(Boston Globe, December 21, 2005, p. A3)

Patient Safety Act

In November, 2005, HR 4349, the Patient Safety Act, was reintroduced in the House of Representatives by Reps Hinchey (D-NY), McCarthy (D-NY), and Capps (D-CA). “The bill would require Medicare funded health care facilities to make information publicly available about their staffing levels, patient care outcomes, and specific kinds of errors and avoidable patient care problems, such as pressure ulcers.” The bill also provides whistleblower protection to nurses who report concerns regarding unsafe patient conditions.

(AJN, January, 2006, p. 36)

Medicare Drug Plan

The Medicare Informed Choice Act of 2005 (H.R. 3861) was introduced by Rep Stark (D-CA) and Schakowsky (D-IL) to address concerns with the recent implementation of the Medicare drug plan. The bill contains 3 sections aimed at protecting senior citizens: delay late enrollment penalties, protect against bad plan choices, and protect employer-provided benefits. (AJN, December, 2005, p. 29) 21 million people will begin receiving benefits through Medicare’s prescription drug program in January. However, this number includes only 1 million that enrolled voluntarily. The rest were either enrolled automatically by the government or will receive benefits through private health plans. The government reported that they expect 28-30 million people will be signed up in the first year. (Washington Post, December 23, 2005, A7)

Pension Guaranty System

In December, the House approved a bill designed to strengthen the nation’s private pension system, a system that pays workers’ pensions when their employers cannot, for example, in cases of bankruptcy filings. Both the House and the Senate have introduced bills addressing the pension system. Both sides include language addressing how pension plans calculate liabilities and both would increase premiums that companies pay to the Pension Benefit Guaranty Corporation. Both bills require that assets in the plans equal their liabilities and would allow seven years for undefended companies to achieve this. Airlines have twenty-one years to balance in the Senate version.

(Washington Post, December 16, 2005, p. A3)