Window to Washington

An inside-the-beltway look at the legislative and regulatory process.

Senator fights to keep an ounce of prevention free from pounds of budget cuts


Sen. Tom Harkin (D-Iowa), chairman of the Health, Education, Labor and Pensions Committee, had some harsh words this week for House Republicans, who have included cuts to a prevention fund he championed as a way to pay for an extension of current Medicare's physician reimbursement rates.

“They don't believe in prevention; they don't believe in public health; they believe just go ahead and get sick and then somehow magically somebody is going to take care of you,” he told reporters Tuesday when asked about the proposed cuts to the Prevention and Public Health Fund.

The $15 billion fund, a longtime priority for Harkin, was included in the Patient Protection and Affordable Care Act to pay for 10 years worth of state and local initiatives to prevent illness and promote health.

Supporters of the fund's potential cite a report from Trust for America's Health—a health policy group—entitled Prevention for a Healthier America. The report concluded that investing $10 per person per year in proven community-based programs that increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within 5 years.

Critics counter that the federal government such activities far exceed the authority of the federal government and such funding will simply go to costly local amenities—such as bike trails—that it is dubious to claim most unhealthy people would ever even use.

Harkin said he didn't know if he and his Senate allies would be able to head off the $8 billion cut to the fund that House Republicans included in their bill.

“I'm gonna fight like the dickens to keep the Prevention and Public Health Fund in there,” He said.

The fate of the fund has grown increasingly uncertain since not only Republicans but also the Obama administration have targeted it for cuts to provide the monies for other priorities.

Asked if the administration's willingness to cut the fund in the past undermined its chances in the current spending fight, Harkin ruefully shook his head.

“I wasn't too happy with that,” he said.

You can follow Rich Daly on Twitter @MHRDaly.


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