WASHINGTON, Feb. 4 (UPI) -- The domestic component of President Bush's $2.12 trillion budget proposal released Monday is full of plans for reforming and reshaping federal programs.
Among other key components, it proposes $190 billion over 10 years for Medicare reform, extends prenatal benefits to women through the Children's Health Insurance Program and boosts funding for special education students.
"It is a bold plan -- and it is matched by a bold agenda for government reform," Bush wrote Congress. "From the beginning of my administration, I have called for better management of the federal government. Now, with all the new demands on our resources, better management is needed more sorely than ever.
"Just as the No Child Left Behind Act of 2001 asks each local school to measure the education of our children, we must measure performance and demand results in federal government programs," he said.
Bush undertook an ambitious domestic agenda early last year that was stalled after the Sept. 11 terror attacks on Washington and New York. Among those initiatives was his goal to provide prescription drug coverage for seniors, and to expand access for religious organization to federal taxpayer dollars to provide social service programs -- the so-called faith-based initiative.
Office of Management and Budget Director Mitch Daniels said Monday the proposal reflects a "small deficit" of $80 billion for 2003 followed by a $14 billion deficit in 2004. Surpluses are not expected to return before 2005.
Democrats on Capitol Hill have criticized the president's 10-year, $1.35 trillion tax relief package for causing the four-year run of federal budget surpluses. Republicans, on the other hand, point to the war effort for what they consider a short-term depletion of federal treasury coffers.
Under his federal budget request, Bush seeks $190 billion over 10 years for targeted improvements to the Medicare system. The administration estimated 77 million Americans would be in Medicare by 2030.
"Medicare is broken. And in many ways it endangers patients. And it needs to be fixed. Now, prescription drug coverage is one of its biggest, perhaps its biggest, defect, but it's only one of many," Daniels said. "We can do a very thorough and major improvement of Medicare for about $190 billion, and we hope the Congress will seriously engage with us soon, stop just throwing around kind of round numbers that sound good that don't have an ounce of real policy behind them."
The administration proposes phasing in the Medicare Low-Income Drug Assistance program for those who earn up to 150 percent of the poverty level, or $17,000 for a family of two. The federal government would pay 90 percent of the costs of the plan, and states would be responsible for the remaining 10 percent.
Currently, the system provides health care insurance but no prescription drug coverage for the nation's 39 million elderly and the disabled. A second initiative, the Pharmacy Plus Program, would allow states to use their Medicaid programs, which serve the indigent, to provide drug-only coverage for low-income seniors.
The budget also estimates the fund for hospital insurance -- the Part A Trust Fund -- will face cash-flow deficits beginning in 2016. It anticipates Medicare's fund for its other benefits under Part B, which includes doctor visits and other non-hospital health care costs, likely would require a doubling of its premiums to remain solvent over the next 10 years.
An analysis of the Medicare trust fund finds the program will suffer a $553 billion shortfall over the next decade.
Bush's budget request would extend the availability of $3.2 billion in unused funds for CHIP due to expire in fiscal years 2002 and 2003. The states will have access to those funds through 2006. With those funds, Bush intends to expand medical coverage under CHIP to include services for pregnant women.
The proposal, set to be published in the Federal Register in the next few weeks, would "clarify" the definition of child under CHIP, the U.S. Department of Health and Human Services said on Friday. That set off controversy because it declares a fetus to be a child for purposes of the program. Abortion-rights proponents saw that as a backdoor attempt to de-legitimize abortion, while opponents of abortion hailed it as a strong first step toward outlawing abortion.
The new regulation would allow states to include coverage for children from conception to age 19. It also means women would be able to receive prenatal and delivery care under the program.
HHS estimates that 10.9 million women of child-bearing age, from 18 to 44, do not have health insurance, and approximately 2.3 million children were enrolled in CHIPs in 2000.
The Association of Reproductive Health Professionals called the proposal a "serious threat to women's health" hidden in the regulation. The group said Monday that Bush's proposal redefines a human child to include children from conception to age 19 though CHIP and Medicaid already provides prenatal care to women.
"This is a transparent attempt by an anti-choice administration to convey personhood to fetuses," said Felicia Stewart, ARHP board chairwoman.
Bush's Office of Faith-Based and Community Initiatives would provide its Compassion Capital Fund $100 million to help small charities deliver services, $25 million to fund a program providing mentors for children of inmates, $20 million in grants to promote responsible fatherhood and $10 million for maternity group homes. The program would also expand tax benefits for taxpayers who do not itemize charitable donations.
The administration is seeking $56.5 billion in funding for the U.S. Department of Education, up 18.6 percent. Daniels pointed out that the Education Department funding rose 37 percent two years ago, 24 percent last year.
"At that growth rate, it will eat the entire budget by 2010, so a deceleration is in order. Secretary [Rod] Paige very much accepts, and has stated the view again this week, he's awash in money, it's results he doesn't have. And $50 billion is by far, of course, the largest request ever for the Department of Education," Daniels said.
With the success of his overall education reform package, Bush said he plans to focus on retooling special education in the nation's public schools. Funding for Title I would be increased to $11.35 billion, up from $10.35 billion in fiscal year 2002.
Title I of the Elementary and Secondary Education Act of 1965 addresses the educational challenges facing high-poverty communities by targeting extra resources to schools and school districts with the highest concentrations of poverty. Title I provides more than $8 billion annually to more than 90 percent of school districts nationwide to improve education for more than 11 million at-risk children, according to the National PTA.
Rep. John Boehner, R-Ohio, praised Bush's plan to expand the education tax credit that would give $,2500 a year to parents with children in failing schools.
"Regardless of income and other factors, parents with children in chronically failing schools should be able to choose the best school possible for their children," said Boehner, chairman of the House Education and Workforce Committee.
The National Education Association sharply criticized the Bush education plan, saying it "proposes a tax scheme that undermines the strict accountability measures outlined in the new education law, delivering taxpayer dollars to private and religious schools that do not follow the new law's testing and accountability provisions. "
"Let's work together to meet the goal of high standards. Using taxpayer money to fund schools that are not held to high standards and are not held accountable to meeting strict achievement and quality mandates undermines accountability," said NEA President Bob Chase.
And the NEA said funding for education in the budget is far below the amount set in the new education law. Title I funding for the neediest students will be $5 billion below the levels allowed in the education bill for 2003.
In forwarding his current education reforms, Bush's proposal provides $1 billion for the Reading First Program, a $100 million increase over 2002. It also includes $75 million for Early Reading First, the same level as 2002.
The budget proposes $387 million for the second year of states' development of annual reading and math assessments for grades 3 through 8. It provides $2.9 billion for Teacher Quality State Grants to recruit, train and retain qualified teachers, and ensures the quality of new teachers in schools receiving Title I funds.
