January 2005

2005 Budget Outlook: The Facts Speak for Themselves
“We will provide every tool and resource for our military, we'll protect the homeland and we'll meet other priorities of the government. My budget will maintain strict discipline and the spending of tax dollars, and keep our commitment to cutting the deficit in half over five years.” — President George W. Bush at White House press conference, December 20, 2004.

“Our job is to work with them (Congressional appropriators), which we will, to bring some fiscal restraint -- continue to bring fiscal restraint -- after all, (growth in) non-defense discretionary spending -- non-defense, non-homeland discretionary spending has declined from 15 percent in 2001 to less than 1 percent in the appropriations bill I just signed, which is good progress. What I'm saying is we're going to submit a tough budget, and I look forward to working with Congress on the tough budget.” — President George W. Bush at White House Conference on the Economy, December 16, 2004.

Estimated FY 2004 Federal Budget Deficit: $422 billion. — Congressional Budget Office, September 2004 Baseline Budget Projections

Total discretionary spending approved by Congress for FY 2005 (excluding entitlements, such as Social Security, Medicare, Medicaid): $388.4 billion.

Total FY 2005 spending for the Punxsutawney Weather Discovery Center, home of renowned groundhog Punxsutawney Phil: $100,000 (not a budget-buster, but a splendid example of woodchuck-barrel spending).

2005 Political Outlook
The Department of Health and Human Services will have a new leader, former Utah Governor and EPA Administrator Michael Leavitt. The Congressional GOP majority will increase by four in the Senate and three in the House in 2005. Some key changes are likely to occur among leaders in health funding, but they will not be decided until Congress comes back to town in January. Senate Appropriations Committee chair Ted Stevens (R-AK) is stepping down and the new chair of this powerful committee will be Sen. Thad Cochran (R-MS). Sen. Arlen Specter (R-PA), chair of the subcommittee that funds public health programs, has signaled that he might move to another slot. Senate Health, Education, Labor and Pensions Committee chair Sen. Judd Gregg (R-NH) will be replaced in that slot by Sen. Michael Enzi (R-WY). The new leadership for appropriations and health appropriations on the House side will not be determined until January.

The 2005 outlook for federal public health funding and public health and health care programs overall appears grim, as the facts and quotes above imply. It is not possible to be more specific about the particular challenges that the public health community will face until the President delivers the State of the Union address in late January and releases his FY 2006 budget in early February.

The President’s agenda will be particularly critical at a time when Congress and White House are all in the hands of the same party, with increased Congressional majorities. However, it can also be expected that there will be much push and pull between conservative and moderate Republicans over a variety of social and fiscal issues.