Thursday, May 15, 1997

Squabbles delaying more medical research funds

By Morton Kondracke

There's a movement in Congress to devote more federal money to medical research, but no decision yet on how to do it without clashes over everything from children's health insurance to tobacco taxes to education funding.

The cause - which has economics as well as humanitarianism to recommend it - is gaining a strong bipartisan following on Capitol Hill, but disagreements exist on where to get the money to pay for increases in funding for the National Institutes of Health.

The Clinton administration submitted a budget calling for a 2.5 percent increase in NIH's budget, barely enough to keep up with inflation.

The Republican Congress's two appropriations overseers of NIH, Rep. John Porter, R-Ill., and Sen. Arlen Specter, R-Pa., are vowing to increase the budget - currently $13 billion - by 6.5 percent to 7.5 percent, probably by shaving President Clinton's requests for education increases.

The Clinton budget calls for a $3.2 billion increase in education spending, mostly to extend Pell college grants, while increasing NIH funding by $300 million.

Another approach on NIH is being spearheaded by Sen. Connie Mack, R-Fla., who is working on an amendment to the 1998 budget resolution that would begin the process of doubling the NIH budget over a five-year period. Mack hasn't decided yet how big the first step might be, but the money would come from a slight reduction in various domestic discretionary programs, excluding education.

Mack's NIH goal has the endorsement of the Senate Republican leadership - it would permit Republicans to steal a march on Clinton - and recently there was discussion in the Senate Democratic Caucus on the need to spend more on medical research.

Mack is coordinating his efforts with Sen. Tom Harkin, D-Iowa, a longtime backer of higher research budgets and the author of another approach, putting a 1 percent tax on medical insurance premiums to fund a $7 billion increase for NIH to $20 billion by 2002.

In previous years, Harkin teamed up with then-Sen. Mark Hatfield, R-Ore., to try to help NIH by raising the tobacco tax. The effort got nowhere because of the power of the tobacco lobby. This year, however, tobacco is in political trouble, so conceivably the tax idea could be resuscitated, making "sin" in effect pay for "salvation."

Taxing tobacco is the approach Sens. Edward Kennedy, D-Mass., and Orrin Hatch, R-Utah, are using in their bill to provide health insurance for 7 million poor children and, as a political sweetener, help pay down the federal deficit.

But the Clinton-GOP budget deal provides both for children's health and a balanced budget, so it would seem that - if the will is there - Congress could go back to the old Harkin-Hatfield idea of taxing tobacco to fund medical research.

Each 5-cent increase in taxes on a pack of cigarettes provides $2.9 billion over five years, meaning it would take all of Kennedy's proposed 43-cent increase to raise the $30 billion needed to lift NIH funding from $13 to $26 billion.

Kennedy, even though he favors doubling NIH funding, insists tobacco money is needed for children's health insurance, despite the budget deal. The administration says the budget pact extends insurance to 5 million children, but Kennedy is not convinced. He also wants to be sure 7 million children are covered, including 2 million whose parents are too well off to qualify for Medicaid but too poor to afford insurance.

Since the budget deal will balance the budget, Kennedy conceivably could devote at least $10 billion of the $30 billion derived from the 43 cents to medical research. Some White House aides also see merit in taxing tobacco to boost NIH.

The problem is that the tobacco lobby is nowhere near dead, and many Republicans are against tobacco taxes - either because they are recipients of tobacco company campaign contributions or because they oppose all new taxes.

Porter and Mack, for instance, are both foes of smoking, but Mack opposes tax increases, and Porter thinks it's unwise for government programs to establish their own dedicated revenue sources the way highways, for instance, claim gasoline taxes.

Even though tobacco companies are in negotiations to pay out $350 billion over a 20-year period as part of a settlement of liability lawsuits, the industry now adamantly opposes any tax increase.

Currently, the average total state and federal tax on cigarettes is 57 cents a pack. Walker Merryman, vice president of the Tobacco Institute, notes with some pleasure that the Kennedy-Hatch plan to raise taxes to $1 a pack was immediately rejected by Senate Majority Leader Trent Lott and quickly lost three of its co-sponsors, Sens. Ted Stevens, R-Alaska, Ben Nighthorse Campbell, R-Colo., and Robert Bennett, R-Utah.

Many members want to increase NIH funding. And why not? Medical breakthroughs not only save lives and make citizens more productive, they also offer the promise of reduced Medicare and Medicaid costs and foreign sales of new drugs and medical equipment.

But so far, no one wants to give up some pet priority - education for Clinton, opposition to new taxes for Mack and Porter - to close a deal that would do the right thing in a big way.

Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill.

Newspaper Enterprise Assn.