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Spending bill shortchanges rural health, critics charge

A controversial provision to move up the ban on Medicare coverage for erectile dysfunction drugs is dropped from the legislation.

By David Glendinning, amednews staff. Jan. 16, 2006.

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Washington -- Congress late last month approved a bill to fund health programs under the Dept. of Health and Human Services after agreeing to spend more money on training rural physicians. But rural health advocates argue that overall spending still comes up too short.

The first version of the fiscal year 2006 spending bill unexpectedly failed to pass the House in November after some lawmakers complained that not enough money would go toward rural health programs. After directing roughly $90 million into this area from other parts of the budget, both chambers approved the legislation and sent it to President Bush, who signed it into law Dec. 30.

The $600 billion measure provides mandatory funds to pay for such health programs as Medicare and Medicaid, as well as labor and education priorities. Roughly $140 billion will pay for discretionary programs while about $460 billion will fund the mandatory programs.

Out of the $90 million redirected in the final version to rural health, about $27 million will fund area health education centers, which train physicians and other health professionals in community settings while encouraging them to work in underserved areas. Another $25 million will go toward a separate training program in primary care and dentistry, scholarships for disadvantaged medical students and loan forgiveness for rural doctors.

The initial defeat of the HHS spending bill was largely due to the roughly half-dozen Republican lawmakers in the House who crossed party lines to vote against the bill while citing their constituents' concerns about such funding priorities, said Alan Morgan, CEO of the National Rural Health Assn. But even after putting more money back in, Congress still approved hundreds of millions in cuts to other programs operating in medically underserved areas.