Views and Estimates on the President's Budget for Fiscal Year 2001 25 addiction. It is these latter forms of heroin abuse that have led to a significant increase of heroin abuse among American high school students. The Committee notes that a bill reported to the House by voice vote, the Drug Addiction Treatment Act of 1999 (H.R. 2634), has yet to receive material support from the Administration. The Drug Addiction Treatment Act of 1999 would free certain qualified physicians to treat their opiate-addicted patients using new schedule IV or V drugs approved for that purpose in an office-based setting. According to a July 14, 1999, letter to Ranking Minority Member John D. Dingell from Secretary of Health and Human Services Donna Shalala, buprenorphine (and buprenorphine/naloxone in combination) "increase the amount of treatment capacity available and expand the range of treatment options that can be used by physicians,” and that: buprenorphine and buprenorphine/nx products are expected to reach new The Committee intends to see H.R. 2634 enacted this year. The Committee believes that there will be less than $500,000 in annual mandatory costs, although the Congressional Budget Office estimated that this bill will cost approximately $33 million over five years due to the use of better drugs to block the effects of heroin in Medicaid-funded programs. Centers for Disease Control and Prevention Committee on Commerce is investigating the diversions of funds at the Centers for Disease Control and Prevention (“CDC”). Last year, an audit by the Office of the Inspector General of the Department of Health and Human Services found that the CDC could not account for or defied congressional intent while spending $12.9 million appropriated to study chronic fatigue syndrome. In early February 2000, it was reported that the CDC diverted much of the $7.5 million earmarked for research on the deadly hantavirus. These developments raise grave questions about the management of funds at the National Center for Infectious Diseases (NCID) and the truthfulness of CDC statements about NCID programs made to the Congress. It is unfortunate that the Clinton Administration has been unable to explain these matters in the budget submitted to Congress, which requests a six percent increase over last year's CDC budget for a total of $3.5 billion. 26 Views and Estimates on the President's Budget for Fiscal Year 2001 This year, the Committee plans to move legislation, submitted by the President in December 1999, that will require those who possess or use deadly biological agents for legitimate purposes to report such possession or use to the Department of Health and Human Services (HHS), which will now regulate such activities. Currently, HHS, and in particular, the CDC, regulates only the transfer of such agents, providing a major loophole through which illegitimate users can avoid the sanctions of current law. Based on our oversight of this matter last year, the Committee expects that such new requirements will make it necessary for Congress to provide additional resources within HHS or CDC for this function; however, the President's anti-terrorism budget proposal for HHS should be large enough to cover such increased costs. Tobacco The President's budget includes additional funds for a number of anti-tobacco efforts in a number of programs within the Committee's jurisdiction. For instance, the budget for the Centers for Disease Control and Prevention (“CDC”) includes a request for $106 million in new budget authority to fund tobacco control efforts (a tenfold increase from FY 1998 levels). Additionally, the budget also includes $39 million for FDA tobacco enforcement efforts. While the Committee supports Federal efforts to discourage youth smoking, the President's budget contains a number of requests which are cause for concern. First, the Committee notes that the FDA tobacco rule is currently before the Supreme Court, and the oral arguments did not appear to go favorably for the United States. Thus, seeking additional funds to enforce a rule which may be overturned in the near future does not appear to be in the best interests of the taxpayer. While not specifically within the Committee's jurisdiction, there are several other proposals in the President's budget which merit comment. First, the President proposes to fund Federal anti-tobacco efforts, as well as other programs, through an increase in the excise tax on tobacco products. This tax consists of both a 25¢ per pack increase in the excise tax, effective October 1, 2000, and the acceleration of an already enacted 15¢ per pack tobacco tax increase to that date. Further, beginning in 2004, the President's budget imposes a punitive tax of 50% of the lifetime profits for each underage smoker for each year that underage smoking is not reduced by 50%. The President's budget estimates that this will raise nearly $66 billion in revenues over ten years. Second, the President's budget continues to ask for funding for its legally dubious suit against the Nation's largest tobacco manufacturers for past medical costs. The Committee is concerned that the President's budget relies heavily upon a regressive tax on working Americans, a tax which was soundly defeated by the Senate February 25, 2000 Committee on Commerce Views and Estimates on the President's Budget for Fiscal Year 2001 27 in the 105th Congress and about the seemingly arbitrary decision to seek additional revenues through lawsuits against the industry. National Institutes of Health The Administration's FY 2001 budget requests $18.8 billion for the National Institutes of Health (“NIH”), an increase of $1 billion over last year's budget. The abuse of taxpayer dollars and the defiance of Congressional intent is not unique to CDC. Since January 1996, Federal law has banned Federal funding of "research in which a human embryo or human embryos are destroyed, discarded, or knowingly subjected to risk of injury or death greater than that allowed for fetuses in utero" under Federal human subjects regulations. Relying on a single deeply flawed legal analysis by the General Counsel of the Department of Health and Human Services, the NIH guidelines twist the plain meaning of the Federal law, absurdly narrowing the meaning of the phrase "research in which a human embryo or human embryos are destroyed" to refer only to that single and specific action of destroying the embryo. The Clinton Administration seeks to provide funding for research on tissue in which human embryos were destroyed in contravention of clear Congressional prohibition. Until Congress speaks clearly otherwise, the law stands, and NIH is forbidden to conduct research on embryonic stem cells. Organ Transplantation The Administration's budget requests an increase of $5 million above the $10 million appropriated by Congress when it delayed the effective date of the Administration's over-reaching organ allocation regulation. Congress increased the HHS FY 2000 appropriation from $3 million to $10 million for the purpose of increasing organ donation, but the Administration chose not the spend the organ donation money until the very end of the fiscal year. The Committee remains optimistic that funds allocated to increasing organ donation will be used wisely throughout the fiscal year, and not disbursed all at once in the final weeks of the fiscal year. The Committee believes that the Nation Organ Transplant Act must be reauthorized before any organ allocation regulations go into effect. Maternal and Child Health The Clinton Administration budget includes a request for $869 million to improve the health of mothers and children, yet the Administration has done an 28 Views and Estimates on the President's Budget for Fiscal Year 2001 inadequate job in reaching out to mothers who are in danger of insufficient pre-natal nutrition leading to birth defects. The Committee notes its disappointment that the Clinton Administration has failed to expand access to the medically underserved to ultrasound technology. Access to ultrasound technology will improve care for mothers and their unborn children. The Committee supports increasing ultrasound access to the medically underserved, and would like to see the creation of demonstration projects creating mobile health centers to provide ultrasound services and adoption counseling centered in areas of low-birthweight babies. Sometimes ultrasound technology detects pre-natal anomalies. Expanding access to pre-natal surgery for Medicaid-eligible women will help poor mothers afford health care for their babies in the womb who need special surgery to save their lives or prevent disabling birth defects. These surgeries could repair disorders like spina bifida, hydrocephaly (water on the brain), and other disorders that contribute to the population of "special needs" children waiting for adoption. Family Planning and Adoption The Administration's budget proposes to increase the title X Family Planning program to $274 million, an increase of $35 million over the FY 2000 appropriation, yet few reforms within the program are advocated. The Committee seeks increased adoption counseling training for persons who work in Federally-funded family planning clinics. These reforms, contained in the Adoption Awareness Act, will help ensure that women will be presented all relevant information, including information about adoption. Title X funding could also be targeted to establish an $85 million formula grant program to provide assistance, such as maternity homes, pregnancy centers and adoption services, to women facing unplanned pregnancies. Federal funding would be directed to States through a formula based on the number of out-of-wedlock births and abortions in a State as compared to this sum for the Nation. Upon receipt of this grant, states would privately contract out the distribution of funds directly to crisis pregnancy centers, maternity homes, and adoption services on a fee-for-service basis. Low-income women would be given priority, but the grants would not be exclusively means-tested. At a time when the Administration is proposing an 11% increase for the title X Family Planning program above last year's increases, it is disappointing to see that the Title V abstinence education grant will be held at the same $50 million level that it February 25, 2000 Committee on Commerce Views and Estimates on the President's Budget for Fiscal Year 2001 was last year. The abstinence program provides grants to 59 States and territories to provide mentoring, counseling, and student character-building to promote abstinence education and has proven to be a very successful substitute to the mixed-message programs that have been tried and failed over the last two decades. Telecommunications Federal Communications Commission FCC Salaries and Expenses. The President's budget allocates $237,188,000 for FY 2001, of which $200,146,000 is offset through section 9 (of the Communications Act, as amended) fee authority. The President's budget represents an increase of $27,188,000 over the FY 2000 appropriations. The funding increase requested in the President's budget would be allocated accordingly: (1) $12,796,000 for uncontrollable cost increases, including salaries and benefits, rental costs at the Portals facility, Federal Protection Service, and other contract services; and (2) $14,392,000 for upgrades to the FCC information technology initiatives. The President's Fiscal Year 2001 request for the FCC covers 1,975 full time employees (FTEs), which includes 1,930 FTEs and 45 FTEs to address increases for conducting spectrum auctions. The Committee notes that the recommended level of funding for the Commission relies on yet another increase in section 9 fees. In fact, the President's budget recommends that application and regulatory fees offset about 95% of the FCC's FY 2001 budget. The Committee expects that additional information will be forthcoming to justify the latest proposal to increase the section 9 fees by over $14,392,000. The Committee is troubled by the fact that for every increase in funding needed by the FCC, the application and regulatory fees are adjusted accordingly. The enactment of the regulatory and applications fees were intended to cover actual costs for those related functions and not to be used as a general revenue source to fund the agency's budget. As rulemaking and enforcement priorities have shifted for purposes of implementing the Telecommunications Act of 1996 (the “1996 Act"), the Committee believes that the FCC must reassess and reallocate personnel and resources to reflect the new priorities and the deregulatory nature of the 1996 Act. The Committee will examine these particular issues more closely as the Committee considers legislation to reauthorize the Commission later this Congress. The Committee intends to conduct |