The good news: The Academy helped convince Congress to maintain most of the federal funding for family medicine training for fiscal year 2004, and President Bush signed the bill into law in late January.
The bad news: The administration's proposed budget zeroes out the funds for fiscal year 2005.
Also, while Bush's 2005 proposal increases HHS spending overall, spending for items other than Medicare and Medicaid would be decreased $1.1 billion, or 1.6 percent, compared with 2004.
Title VII's status
The omnibus appropriations measure for 2004 includes Section 747 under Title VII of the Public Health Service Act, the section that supports training in family medicine, other primary care specialties and dentistry. The new law provides $82.2 million for Section 747 -- a decrease of $10.2 million from the 2003 funding.
Congress may again this year block Bush's proposal to eliminate the Section 747 grants for 2005, said Bill Hoagland, director of budget and appropriations for Senate Majority Leader Bill Frist, R-Tenn. Hoagland said this Feb. 3 during kaisernetwork.org's "Ask the Experts" discussion, CongressDaily reported.
Academy leaders are asking appropriations committee leaders to permit the AAFP to testify about Title VII in hopes of conveying messages Capitol Hill staff and legislators will find compelling.
2005 budget highlights
Medicare spending would increase to $290 billion in the Bush budget for 2005, up from $266 billion in the 2004 funding. Some new costs pertain to the Medicare Prescription Drug, Improvement and Modernization Act. The funding also includes coverage of a physical exam for new Medicare enrollees and coverage of cardiovascular screening, blood tests and diabetes screening for all beneficiaries.
For physicians, particularly those in rural areas, the new Medicare act increases reimbursement, a fact that is reflected in the 2005 funding proposal. Bush's proposed budget would also fund reforms to make the Medicare appeals process more efficient.
The Bush budget for 2005 would provide the Agency for Healthcare Research and Quality with $304 million, the same level as for 2004. Priorities of the agency include a continued focus on patient safety and medical errors. Of the total $84 million requested for patient safety programs, $50 million is targeted to "health system-based information technology."
Vigilance, advocacy
The AAFP anticipated the administration's 2005 budget would reflect mounting pressure on health expenditures because of declining tax revenues and rising costs of international and homeland security, says Kevin Burke, director of the AAFP Government Relations Division.
The Academy is particularly disappointed about the zeroing-out of Section 747, Burke says. "The Academy will be fully engaged in contacts with Congress this year. It will require vigilance and advocacy by AAFP members to promote bills important to the specialty as Congress begins to deal with the proposed budget as well as with health legislation."
To reach writer J. Michael Brodie, e-mail mbrodie@aafp.org.
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