A Budget That Would Undermine and Reverse Progress on Health Care | Commentary
Anyone who looked closely at the fiscal 2016 Labor-HHS-Education budget that sailed through the House Appropriations Committee recently was in for a jolt. It may be impossible to overstate the many ways this legislation would take the country backward.
First, look what it does to women’s health. Perhaps the most shocking line item in the House proposal is the decision to zero out the nation’s family planning program, Title X, which has had bipartisan support for decades because it helps women avoid unintended pregnancy and improve their health. The Title X program provides birth control, screenings for cancer and sexually transmitted infections, and other preventive health services to low-income women who would otherwise go without health care. If the House budget prevails and this program is defunded, nearly 4.6 million people would lose health care. Rural and low-income women would suffer the most.
The Senate budget proposal would cut Title X by 10 percent. In no way is that acceptable, especially when you consider that this program is badly underfunded, tremendously cost-effective and does as much as any government program to improve women’s health.
Both the House and Senate proposals would devastate the budget for comprehensive, medically accurate sex education programs, which have been proven to work — while at the same time increasing support for programs that promote abstinence-only-until-marriage which, multiple studies have shown, do not.
And while both chambers would reduce effective sex education programs and deny low-income women birth control, they would continue the Hyde Amendment, which withholds abortion coverage from women enrolled in Medicaid.
The House budget includes a sweeping exemption that lets any individual, employer or health plan refuse to purchase or provide insurance coverage for any item or service to which they object on moral or religious grounds. Just as we are making progress in coverage for preventive services, this budget would turn back the clock.
It’s not just women’s health that is targeted. Consider the effect of these budget proposals on efforts to improve the quality and value of health care. The Senate budget would complicate and confound efficient implementation of the Affordable Care Act — an effort clearly designed to undermine the law.
The House would cut $6.8 billion from the appropriation to the Center for Medicare and Medicaid Innovation, which is at the forefront of developing and testing new models of health care payment and delivery. CMMI advances best practices and engages stakeholders in developing promising new models of care, which move us closer to a transformed health care delivery system. Right now, CMMI is testing patient-centered medical homes and accountable care organizations, among other models. Its work spans Medicare, Medicaid and the Children’s Health Insurance Program, reaching millions of consumers.
The House would also end funding for the Agency for Healthcare Research and Quality, while the Senate would devastate AHRQ’s budget by cutting $100 million from it. Neither option is responsible, acceptable or good for the public health. AHRQ is conducting essential research on how to measure and improve quality in health care. The agency is responsible for establishing the National Quality Strategy framework, which supports a more patient- and family-centered health care system that can help reduce the cost of quality health care. AHRQ also conducts essential research into how to reduce health disparities — a hugely important priority for our country.
If we want to deliver high-value, quality care to patients and families, we need to invest in better ways to deliver care — not undermine agencies like CMMI and AHRQ that are improving our health care system.
Both the House and Senate would freeze funding for the Office of the National Coordinator for Health Information Technology, rejecting the increase this agency needs to make new health technologies interoperable so they can connect with each other effectively. The country has invested billions of dollars in health information technology; it would be counterproductive not to finish the job so these technologies will achieve their promise to support higher quality, better coordinated care, including interoperability with the patients and family caregivers who are at the center of care.
The budgets the House and Senate are advancing put anti-choice, anti-Obama ideology ahead of a health care system that delivers higher quality, higher value care. That’s wrong for the country. We can — and must — do better.
Debra L. Ness is president of the National Partnership for Women & Families.