How Health Care Fares In Obama's Budget Freeze

President Obama's proposed three-year freeze on most non-defense programs in the budget has spared most of the popular health programs at the Department of Health and Human Services. But with the huge health overhaul still on hold and a deadline at the end of February to fix Medicare payments for doctors, Congress can't afford to ignore health for very long.

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President Obamas health overhaul plan for this country is stalled in Congress, but health care was a major priority in the budget the president sent to lawmakers yesterday. While other kinds of programs are scheduled for cuts or having their funding frozen, health care did well by comparison. Still, as NPRs Julie Rovner reports, more health funding challenges lie ahead.

JULIE ROVNER: Speaking to reporters, Health and Human Services Secretary Kathleen Sebelius defended the fact that the programs under her purview did, well, pretty well.

Secretary KATHLEEN SEBELIUS (Department of Health and Human Services): We target relief directly to working Americans who need them most and make long overdue investments to strengthen our health care and public health systems, keeping all of us healthy and more secure.

ROVNER: The department's two biggest programs, Medicare and Medicaid, were never going to be part of the administration's proposed three-year spending freeze. But it turns out that a lot of programs that want exceptions to the freeze are also part of HHS. The National Institutes of Health, for example, would get a billion dollar increase next year. Community health centers, which are also popular with Democrats and Republicans, would get a $290 million boost.

Those increases didnt go unnoticed by people like New Hampshire Senator Judd Gregg, the senior Republican on the Budget Committee. Here's how he put it on Fox News.

Representative JUDD GREGG (Republican, New Hampshire): I think it was Einstein who said that insanity is doing the wrong thing over and over and expecting change. Well this is fiscal insanity to continue to grow the government the way we're growing it, continuing to spend the way we're spending, continue to raise the debt the way we're raising it. We're going to pass on to our kids a country that basically is insolvent.

ROVNER: Groups that lobby for money for public health programs though, feel like they dodged a bullet.

Mr. JULIO ABREU (Lobbyist, Mental Health America): It means that these programs, these public health agencies are an important part of the administration's vision looking forward.

ROVNER: Julio Abreu is a lobbyist with the health group Mental Health America and the president of the Coalition for Health Funding, which represents dozens of organizations. He says many of the groups that are part of his coalition are also working for the health overhaul, but while they wait, he says the programs they support in the budget can fill important holes.

Mr. ABREU: These programs tend to be of a prevention nature. They tend to help develop workforce. They are early intervention with programs like Head Start, programs like Suicide Prevention.

ROVNER: Indeed, Secretary Sebelius said some of the proposed budget increases are already aimed at laying the groundwork for a health care overhaul -whenever that happens. That includes things like digitizing medical records and studying which kinds of medical procedures work better than others.

Ms. SEBELIUS: There is a new platform health care built in this country.

ROVNER: But she also pointed out that there are a lot of things that just boosting budget lines can't do.

Ms. SEBELIUS: It doesnt change, dramatically, the cost trajectory or certainly fill the coverage gap or provide security to lots of Americans who have coverage right now but are really at the mercy of health insurers who make rules day in and day out that lock people out of the market, kick people out of the market, limit coverage.

ROVNER: Meanwhile, even before Congress gets back to health overhaul or digs into the budget, it has an even more immediate health issue to address: If it doesnt act by the end of February, doctors face a 21 percent cut in their Medicare payments. That would anger both doctors and patients noted Rodger Wetzel of AARP in a recent Webcast.

Mr. RODGER WETZEL (AARP Executive Council): If the scheduled cut goes into effect, we can certainly expect to see more physicians no longer accepting Medicare patients.

ROVNER: The budget assumes that Congress will fix the Medicare doctor pay problem but that doesnt mean it will be easy - nothing to do with health ever is.

Julie Rovner, NPR News, Washington.

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