Yesterday’s Student Loan Interest Rate Legislation — GOP Labels The Prevention and Public Health Fund A “Slush Fund” And Kills It
Yesterday, the majority House GOP caused Democrats to trade off repealing the portion of Affordable Health Care Act that created the Department of Health & Human Service (HHS) Prevention and Public Health Fund (PPHF) in order to avoid college Stafford Loan interest rates on new loans to double to 6.8% as of July 1, 2012. [HR 4628] Not only did they end PPHF, they also rescinded the unobligated balances in the fund.
During the debate on the House floor, Speaker of the House John Boehner, shaking with misplaced anger, had this to say about the GOP proposal:
“You may have already forgotten that several months ago you all [forgetful Democrats] voted to cut $4 billion out of this slush fund when we passed the payroll tax credit bill.”
“Slush fund” = the HHS Prevention and Public Health Fund.
They really will say anything.
First, Boehner’s assertion that Democrats “voted to cut $4 billion out of this slush fund when we passed the payroll tax credit bill” is massively misleading. Recall that the payroll tax holiday blockade was engineered last December by House Tea Party Congressloons. As this battle continued into February an agreementof adhesion that Democrats had to accept began to emerge.
Though it’s hard to untie the Gordian knot of the payroll tax holiday negotiations, among the reasons for GOP intransigence was the so-called “doc fix.” Briefly, a 27% cut in Medicare payments to doctors was scheduled to occur on March 1, 2012. 27%! This would have decimated the Medicare doctor pool. So, among other things, the GOP went after cuts in – what else? – “Obamacare” to pay for the doc fix. Very interested, then, in paying for things . . .
Yet, the agreement was still in jeopardy in mid-February. What was among the final disagreements?
One of the issues holding up the agreement late Wednesday was Republicans’ insistence on a provision allowing Medicare to pay for services at newly built doctor-owned hospitals. Under the nation’s new healthcare law, such hospitals would no longer be reimbursed because their services were deemed too costly. LA Times
Not precisely a principled objection, simply more of the same GOP self-dealing to protect laissez faire for-profit hospitals. Ironically, it raided Medicare, the program the GOP insists must reduce its spending.
One of the cuts to “Obamacare” insisted upon by the GOP in order for the payroll tax/doc fix legislation to move forward was to the Prevention and Public Health Fund. Four billion dollars from a 15 billion dollar fund. And that’s much of the background to Boehner’s disinformation quoted at the outset.
Second, Boehner continues the GOP war cry, “slush fund,” that has dogged the PPHF to this day. To make a long story short, below are the PPHF’s funding activities; below is the GOP’s idea of a “slush fund.”
From HHS’s website:
The following table reflects the planned use of Prevention and Public Health Fund resources in fiscal year 2012. The table includes the name of the agency receiving funds, the activity to be supported, and the program or activity funding level. The effective transfer date of funds will be posted once the process of transferring of funds to the various agencies is completed.
Department of Health & Human Services
FY 2012 Prevention and Public Health Fund
Slush Fund?
| Agency | Activity/Program | Allocation | |
|---|---|---|---|
| AoA | Chronic Disease Self-Management Program | $10 Billion | To provide older adults with the education and tools they need to help them cope with chronic conditions through completion of an evidence-based chronic disease self -management program. |
| AoA | Alzheimer’s Disease Prevention Education and Outreach | $4 Billion | To design and carry out a public awareness campaign focused on Alzheimer’s disease |
| AHRQ | Clinical Preventive Services Research | $5 Billion | To continue support for Centers for Excellence in Clinical Preventive Services which support the HHS National Prevention Strategy by developing evidence around the most efficient and effective ways primary care health systems can deliver clinical preventive services. |
| AHRQ | Clinical Preventive Services Task Force | $7 Billion | To maximize the quality and effectiveness of the U.S. Preventive Services Task Force by providing scientific, technical and administrative support. |
| CDC | Community Guide / Community Preventive Services Task Force | $10 Billion | To provide evidence-based findings and recommendations about effective public health interventions and policies to improve health and promote safety |
| CDC | Prevention Research Centers | $10 Billion | The purpose of the centers is to help alter the individual behaviors and community environmental factors that put people at risk for the leading causes of death and disability—chronic diseases, such as cancer, heart disease, and diabetes. |
| CDC | Nutrition, Physical Activity, and Obesity Activities | $10 Billion | To improve healthful eating and physical activity to prevent and control obesity and other chronic diseases by helping build and sustain statewide capacity to implement population-based strategies and interventions. |
| CDC | Chronic Disease Innovation Grants (Diabetes Prevention Program) | $10 Billion | To expand CDC’s National Diabetes Prevention Program to support the establishment of evidence-based lifestyle change programs in underserved communities to prevent type 2 diabetes in people with prediabetes. |
| CDC | Infectious Disease Screening Activities (Viral Hepatitis) | $10 Billion | To expand identification of those chronically infected persons who do not know their status and their referral to medical care, particularly focusing on groups disproportionately affected by chronic hepatitis B and hepatitis C; and to identify and disseminate best practices for screening and the prompt linkage to needed medical management and treatment. |
| CDC | Public Health Workforce | $25 Billion | To help to ensure a prepared, diverse, sustainable public health workforce by increasing the number of State and local public health professionals (e.g., epidemiologists, public health managers, informaticians) who are trained through CDC-sponsored fellowships and other training activities targeted at the existing workforce. |
| CDC | Nat’l Public Health Improvement Initiative (Public Health Infrastructure) | $40.2 Billion | To systematically increase the capacity of public health departments to detect and respond to public health events requiring highly coordinated interventions to improve and/or sustain the performance (efficiency/effectiveness) of public health organizations, systems, practices, and essential services. |
| CDC | Healthcare-Associated Infections | $11.75 Billion | To fund health departments in healthcare-associated infection (HAI) prevention efforts within their States by expanding State prevention activities and accelerating electronic reporting to detect HAIs at the State level. |
| CDC | Epidemiology and Laboratory Capacity Grants | $40 Billion | To enhance the ability of State, local, and territorial Epidemiology and Laboratory Capacity and Emerging Infections Program grantees to strengthen and integrate capacity for detecting and responding to infectious diseases and other public health threats. |
| CDC | Promoting Breastfeeding | $7.05 Billion | This program will fund community initiatives to support breastfeeding mothers and support hospitals in promoting breastfeeding. |
| CDC | Let’s Move Activities | $5 Billion | This is a collaborative effort to promote children’s health by encouraging and supporting healthier physical activity and nutrition practices. |
| CDC | Community Transformation Grant Program | $226 Billion | This program will support community-level efforts to reduce chronic diseases such as heart disease, cancer, stroke, and diabetes. |
| CDC | Section 317 Immunization Program | $190 Billion | The objective of this program is to modernize the public health immunization infrastructure to increase vaccination coverage among children, adolescents, and adults. |
| CDC | Racial & Ethnic Approaches to Community Health (REACH) | $40 Billion | To support community coalitions that design, implement, evaluate, and disseminate community-driven strategies to eliminate health disparities in key health areas. |
| CDC | Tobacco Prevention (Media and Quitlines) | $83 Billion | To raise awareness and shift key attitudes and beliefs about the harms of tobacco use and exposure to secondhand smoke in areas of the country with some of the highest rates of tobacco use prevalence. |
| CDC | CDC Healthcare Surveillance and Statistics | $35 Billion | To expand the availability of data for tracking the provision, use, effectiveness, and impact of primary and secondary preventive healthcare services and to expand the capacity of CDC and its health department partners to use these data for such tracking. |
| CDC | Environmental Public Health Tracking | $35 Billion | The purpose of the program is to establish and maintain a nationwide tracking network to collect, integrate, analyze and translate health and environmental data for use in public health practice. |
| CDCWorkplace Wellness$10 Billion To engage and recruit employers and lead them through the process of building a core workplace health programHRSAPublic Health Workforce Development$25 Billion To support Public Health Training Centers which will continue to collaborate with partners to assess health workforce development needs and provide graduate or specialized training in public health in the areas of preventive medicine, health promotion and disease prevention, including continuing education sessions designed to meet the public health workforce development needs. The initiative on integrative medicine residency (IMR) will incorporate competency-based integrative medicine curricula in graduate medical education and establish a national coordinating center.HRSAMental Health Training$10 Billion To support grants to health professions programs for the recruitment and training of individuals in behavioral health professions, including social work and psychology.HRSAAlzheimer’s Disease Prevention Education and Outreach$2 Billion To support outreach and education to enhance healthcare providers’ knowledge of the disease, improve detection and early intervention, and improve care for people with the disease and their caregivers.SAMHSAPrimary & Behavioral Health Integration$35 Billion To establish projects for the provision of coordinated and integrated services to special populations through the co-location of primary and specialty care services in community-based mental and behavioral health settings.SAMHSASuicide Prevention – Garrett Lee Smith$10 Billion To support the Garrett Lee Smith (GLS) State/Tribal grants, GLS-Campus grant programs, National Suicide Prevention Lifeline program, and the Suicide Prevention Resource Center grant.SAMHSAScreening, Brief Intervention and Referral to Treatment$25 Billion To integrate screening, brief intervention, referral, and treatment services within general medical and primary care settings.SAMHSASAMHSA Healthcare Surveillance$18 Billion To support critical behavioral health data systems, national surveys, and surveillance activities.ASPA Prevention Education and Outreach$20 Billion
To generate broad awareness of preventive benefits and encourage people to utilize them for better health.ASPA Tobacco Media Activities$10 Billion To prevent and reduce tobacco use and to ensure program integrity and responsible stewardship of Federal funds. |
Is that a self-respecting slush fund? A slush fund is like sending billions of dollars, much of it in cash, to Iraq and Afghanistan often with no auditing or accountability. Isn’t it?
So how should we pay for the rate cap extension?