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Budget sequester: Cuts would hit vaccination, elderly meals, childcare

The budget sequester due to take effect on Friday would hit virtually every health program, from childhood vaccinations to Meals on Wheels, according to the Obama administration.
/ Source: NBC News

Four thousand children in Georgia who won’t get free vaccines. More than 2,000 food safety inspections cancelled. Four million meals that won’t go to homebound seniors.

The Obama administration is scrambling in the last few days to gin up pressure on Republican members of Congress who increasingly look like they will willingly let what was supposed to have been unthinkable – a budget sequester – happen by Friday.

The budget sequester was designed to be a consequence so dreadful that members of Congress would come up with more sensible budget cuts instead. Now it’s been delayed so long that if and when it does hit, it will mean a 5 percent across-the-board cut for government agencies, squeezed into the seven months left in the fiscal year.

“It will affect all disease areas, all research areas,” says Bill Hall, a spokesman for the Health and Human Services department. “Because it is across the board and deep down in every single institute, it would affect virtually everything. It is a five percent cut on everything.”

It's not so much the amount of the cuts -- $85 billion across the whole government. It's the wholesale nature of the cuts the sequester requires, without the ability to pick and choose agencies to spare, that worries government officials.

The only exemptions are so-called mandatory programs, such as Medicaid, the Children’s Health Insurance Program and Social Security. Everything else that HHS oversees, from the Centers for Disease Control and Prevention, to the National Institutes of Health and the Food and Drug Administration, will be forced to make the sudden 5 percent across-the-board cuts.

“An agency can’t make the cuts in just one area to reduce the impact,” Hall said in a telephone interview. “This goes down to a very granular level.”

The White House sought to make it real over the weekend in a series of interviews by officials and fact sheets.

”If a sequester takes effect, up to 2,100 fewer food inspections could occur, putting families at risk and costing billions in lost food production,” it says. “If a sequester takes effect, up to 373,000 seriously mentally ill adults and seriously emotionally disturbed children could go untreated. This would likely lead to increased hospitalizations, involvement in the criminal justice system, and homelessness for these individuals.”

Meals on Wheels would have to cut 4 million meals, the White House said. “The meals can account for 50 percent or more of daily food for the majority of home delivered participants,” it said.

“In Georgia, around 4,180 fewer children will receive vaccines for diseases such as measles, mumps, rubella, tetanus, whooping cough, influenza and hepatitis B due to reduced funding for vaccinations of about $286,000.”

Many Republican politicians were unimpressed.

South Carolina governor Nikki Haley asked why the federal government couldn't just make the cuts. "How many more times are the governors going to have to pick up the mess of Washington, D.C.?" she asked after a meeting at the White House on Monday.

“We are talking about less than 3 percent of the annual federal budget,” Louisiana governor Bobby Jindal said Monday after the same briefing. “For them to suggest that this will result in a hollowing out of the military, interruptions of food inspections, and it’ll result in folks not getting critical healthcare services is, again, preposterous.”

The American Heart Association disagrees. “If Congress doesn’t act to turn off the sequester by March, the NIH will be hit with an across the board budget cut of 5.1 percent. This dramatic decrease could trigger a loss of more than 20,500 jobs across the United States and reduce new economic activity by $3 billion,” the group says on its website. It refers to studies showing that National Institutes of Health research grants generate more jobs and economic activity in the communities to the tune of $2.11 for every $1 spent.

"If this $1.5 billion cut hits us on March 1, that translates into hundreds of grants that will simply not get paid," NIH Director Dr. Francis Collins told reporters last week.

The group United For Medical Research has a state-by-state map showing that Jindal’s state, Louisiana, stands to lose lose 220 jobs and $8.36 million, just from National Institutes of Health support alone. NIH supported 4,319 jobs in Louisiana at a cost of $163.9 million, United for Medical Research says.

International efforts to fight malaria, tuberculosis and AIDS could be permanently damaged, said Kaitlin Christenson, director of the Global Health Technologies Coalition, which groups about two dozen non-profit organizations.

“When it comes to research, many biomedical studies cannot survive cuts in funding I the middle of their work,” Christenson said in a telephone interview. “Some may be irreversible.”


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