Plans to build two veterans hospitals would be scrapped and a federal healthcare research agency would lose one-fifth of its funding under spending bills for next year that House Republicans began pushing through congressional committees last week.
But House Republicans also proposed honoring the Clinton administration's request of nearly $17 billion in healthcare spending for the Department of Veterans Affairs.
In addition, they approved spending increases for the National Institutes of Health, although many other healthcare programs HHS administers saw cuts or funding equal to the current year.
The proposed spending cuts set the stage for a showdown between President Clinton and Congress, with White House Chief of Staff Leon Panetta threatening a veto if the bills reach Clinton's desk "in their current form."
The bills passed last week by subcommittees of the House Appropriations Committee chart a specific budgetary course for programs subject to annual spending authorization and still must pass muster with the full committee this week, and the full House and Senate before going to the White House.
Spending for healthcare entitlement programs such as Medicare and Medi-caid is not included in such bills.
Planned VA hospitals in Brevard County, Fla., and at Travis Air Force Base outside San Francisco would be replaced with outpatient clinics under a spending plan passed by the Appropriations Committee's VA subcommittee. That proposal would cut the VA 1996 construction budget request by $330 million to $183.5 million. That's a cut of more than $170 million from fiscal year 1995, which ends Sept. 30.
The same subcommittee signed off on the Clinton administration request to increase VA medical care spending by $747 million from fiscal 1995, however.
But that spending increase was contingent on deriving about $400 million in savings elsewhere in the VA budget, including limiting benefits to some mentally disabled veterans and patients disabled by VA treatment. VA officials cast doubt on whether such savings were possible.
The committee's HHS subcommittee, meanwhile, approved slicing $34 million, or 21%, from the budget of HHS' Agency for Health Care Policy and Research. Its fiscal 1996 budget would total $125.5 million.
The bill also encouraged AHCPR to consider terminating clinical practice guideline development and instead use those resources to evaluate guidelines developed in the private sector.
Healthcare spending under House appropriations billsProgram 1996 1995
VA medical care $17 billion $16.2 billion
VA major construction (includes â– healthcare facility construction) $183.5 million $354.3 million
Health professions training $399.2 million $399.2 million
AIDS health services (includes healthcare facility construction) $639.9 million $656.2 million
Rural health service programs $156.3 million $175.3 million
National Institutes of Health $11.9 billion $11.3 billion
Agency for Health Care Policy â– and Research $125.5 million $159.5 million