What do the balanced budget, Medicare, tax cuts, and healthcare reform all have in common? During the 104th Congress, each has been addressed under the proposed omnibus budget reconciliation legislation.
Many readers may be lost when it comes to understanding the workings of the arcane federal budget process. Trying to untangle the web to ascertain how much money has been allocated the National Institutes of Health (NIH) can be deeply confusing. The following may be useful as preparation for the fiscal year 1997 process.
The Budget and the Budget Reconciliation Process
Early each year, the President submits a budget to Congress, basically an outline of the administration’s fiscal policy. The Congress then authors a budget resolution containing targets for the deficit, revenues, and spending totals for 20 government functions for a 5-year period.
In addition, the Federal Budget Act provides for a process called budget reconciliation under which Congress conforms tax and spending legislation to the levels set forth in the budget resolution. Changes recommended by committees pursuant to reconciliation instructions are incorporated into a reconciliation bill or resolution. In recent years, the reconciliation measure also has served as a vehicle for attaching authorizing legislation.
Congressional Quarterly refers to the reconciliation process as one “in which tax laws and entitlement programs are changed, or reconciled to achieve deficit-reduction targets set in the congressional budget resolution.”
Prior to 1995, passage of the most recent budget reconciliation bill was in 1993. It contained a controversial mix of tax increases and spending cuts, totaling $433 billion over 5 years.
In late 1995, House and Senate leaders pushed for a constitutional balanced budget amendment. Although the proposal passed the House, it narrowly failed in the Senate. The budget reconciliation bill then became the vehicle for balancing the budget over a proposed 7-year period. The foundation of the legislation was a package of measures that included a proposed $245 billion in tax cuts, balanced by $270 billion in Medicare savings and $182 billion in Medicaid savings, representing half of the proposed $894 billion, 7-year proposed balanced-budget plan.
The Appropriations Process
Budget reconciliation should not be confused with the appropriations process, in which 13 annual appropriations bills fund programs within limits established by authorizations. The legislation gives legal authority to spend or obligate money from the Treasury. Of particular importance to the American Heart Association is the Labor, Health and Human Services (HHS), and Education Appropriations Bill, containing over a quarter-trillion dollars for programs that include funding for the Department of Health and Human Services, including the NIH, and the Department of Education.
Last year, the Congress even approved a set of recisions, cuts in spending from the previous fiscal year. Over $10 billion in recisions were signed into law, including $79 million in funding for the NIH.
The Continuing Resolution
Much attention has focused during the 104th Congress on the threat of “government shutdown” necessitated by a failure of Congress to approve all 13 regular appropriations measures on time. Six of 13 appropriations bills had not been signed into law by December 15, two and one-half months after the statutory deadline for passage of appropriations measures. A 3-week shutdown of departments lacking new appropriations then ensued, followed by the passage of a number of continuing resolutions, which were, in effect, temporary emergency funding for affected federal agencies. In 1995, rather than the continuing resolution simply serving as a temporary funding measure, the leadership in the Congress held the continuing resolution hostage on a number of occasions in order to convince the President to approve a balanced budget plan. As is already the case with budget reconciliation and appropriations, the continuing resolution is clearly now a political tool as well.
What Does This Mean to Cardiovascular and Stroke Funding?
Caught in this tangled governmental web is funding for biomedical research. Last year, the process began with the introduction of the President’s fiscal year 1996 budget for the NIH, which included a 4% increase in funding. Later that year, despite the threat of massive cuts to the Labor/HHS Appropriations Bill, the House approved a 5.7% increase for NIH and the Senate a 2.7% increase. Unfortunately, not only did the full Congress fail to secure passage of a final Labor/HHS bill, but the legislation was not even brought to the Senate floor for a vote.
Subsequently, each of the Continuing Resolutions passed by the Congress and signed into law by the President contained funding at the lesser of the House and Senate proposed levels, in no case less than 75% of fiscal year 1995 funding levels. Finally, in January, the Congress passed year-long Continuing Resolutions for certain agreed-upon critical departments and programs, including the NIH, which will be funded at the House-passed level for fiscal year 1996, $11.939 billion or 5.7% above fiscal year 1995.
What to Expect in 1996
The budget and appropriations process has left a bad taste in the mouths of American taxpayers. We can only hope that during this election year the process will run far more smoothly. As reported in Circulation (March 1, 1996), the AHA is strongly weighing in on Capitol Hill with a new research funding initiative that includes the formation of a National Coalition for Heart and Stroke Research, collection of survey data on public attitudes about federal heart and stroke research, and expansion of its grassroots network. For more information, contact the AHA Office of Public Affairs at (202) 822-9380.
- Copyright © 1996 by American Heart Association