[Congressional Record Volume 150, Number 38 (Wednesday, March 24, 2004)]
[Senate]
[Page S3094]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        CBO ESTIMATE ON S. 1172

  Mr. GREGG. Mr. President, on March 18, 2004, I filed Report 108-245 
to accompany S. 1172, a bill to establish grants to provide health 
services for improved nutrition, increased physical activity, obesity 
prevention, and for other purposes. At the time the report was filed, 
the estimates by the Congressional Budget Office were not available. I 
ask unanimous consent that a complete copy of the CBO estimate be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:
                                                    U.S. Congress,


                                  Congressional Budget Office,

                                   Washington, DC, March 23, 2004.
     Hon. Judd Gregg,
     Chairman, Committee on Health, Education, Labor, and 
         Pensions, U.S. Senate, Washington, DC.
       Dear Mr. Chairman: The Congressional Budget Office has 
     prepared the enclosed cost estimate for S. 1172, the Improved 
     Nutrition and Physical Activity Act.
       If you wish further details on this estimate, we will be 
     pleased to provide them. The CBO staff contact is Jeanne De 
     Sa, who can be reached at 226-9010.
           Sincerely,
                                              Douglas Holtz-Eakin,
                                                         Director.
       Enclosure.
     S. 1172--Improved Nutrition and Physical Activity Act 
         (IMPACT)
       Summary: S. 1172 would amend the Public Health Service Act 
     (PHSA) to reauthorize and expand a Centers for Disease 
     Control and Prevention (CDC) grant program that provides 
     funding to state and local governments to plan and implement 
     programs that would increase childhood physical activity and 
     improve nutrition. The act would authorize the appropriation 
     of $60 million in fiscal year 2004 and such sums as may be 
     necessary for fiscal years 2005 through 2008 for that 
     purpose. The act also would reauthorize a CDC training 
     program for health professionals to treat obesity and eating 
     disorders and would permit the agency to make extramural 
     training grants. The act would authorize the appropriation of 
     such sums as may be necessary for fiscal years 2006 and 2007 
     for that purpose.
       S. 1172 also would allow the Department of Health and Human 
     Services (HHS) to give special consideration to obesity-
     related conditions in an existing grant program for health 
     profession students and require the department to submit 
     reports to the Congress about children and obesity. Other 
     provisions of the act would permit CDC's National Center for 
     Health Statistics to collect and analyze data on children's 
     fitness levels and specify that allotments under CDC's 
     Preventive Health Services Block Grant may be used for 
     activities and education programs to prevent obesity and 
     eating disorders and promote healthy eating behaviors.
       CBO estimates that implementing the physical activity and 
     nutrition grant provision of S. 1172 would cost $3 million in 
     2004 and a total of $199 million from 2004 through 2009, if 
     inflation adjustments are included and assuming 
     appropriations of authorized amounts. CBO estimates that the 
     report-writing requirements would require $1 million to 
     implement in 2005, assuming appropriations of the necessary 
     amount. CBO estimates that other provision of the bill would 
     not have a significant effect on spending. Enacting S. 1172 
     would not affect direct spending or receipts.
       S. 1172 contains no intergovernmental or private-sector 
     mandates as defined in the Unfunded Mandates Reform Act 
     (UMRA). State, local, and tribal governments may benefit from 
     the grant provisions of the bill, and none of the bill's 
     provisions wold compel them to take any action.
       Estimated cost to the Federal Government: The estimated 
     cost to implement S. 1172 is shown in the following table and 
     assumes entactment of the bill by July 1, 2003. The costs of 
     this legislation fall within budget function 550 (health).

------------------------------------------------------------------------
                                By fiscal year, in millions of dollars--
                               -----------------------------------------
                                 2004   2005   2006   2007   2008   2009
------------------------------------------------------------------------
                    SPENDING SUBJECT TO APPROPRIATION
 
Spending Under Current Law;
  Estimated Authorization          45     46      0      0      0      0
   Level \1\..................
  Estimated Outlays...........     14     34     28     10      3      1
Proposed Changes for Grant
 Program:
  Estimated Authorization          15     15     62     63     64      0
   Level......................
  Estimated Outlays \2\.......      3     13     30     51     60     42
Proposed Changes for Other
 Activities:
  Estimated Authorization           0      1      0      0      0      0
   Level......................
  Estimated Outlays \2\.......      0      1      0      0      0      0
Spending Under S. 1172:
  Estimated Authorization          60     62     62     63     64      0
   Level......................
  Estimated Outlays...........     17     48     58     61     63     43
------------------------------------------------------------------------
\1\ The 2004 level is the amount appropriated for that year for Centers
  for Disease Control and Prevention for activities related to
  prevention and treatment of obesity and promotion of physical activity
  and nutrition. The 2005 amount reflects adjustments for anticipated
  inflation.
\2\ Including adjustments for anticipated inflation, the estimated
  outlay changes would total $200 million over the 2004-2008 period.
  Without such adjustmentss, the five-year totla would be $190 million.

       Basis for estimate: The PHSA currently authorizes such sums 
     as may be necessary through 2005 for CDC to administer grant 
     programs to promote childhood nutrition and physical activity 
     and to educate and train health professionals in dealing with 
     obesity or eating disorders. CDC also conducts prevention 
     research and collects data on obesity and levels of physical 
     activity. In 2004, $45 million was appropriated for those 
     activities, an increase of $11 million over the 2003 level. 
     Almost all of the funding is directed toward the childhood 
     nutrition and physical activity grant program, which 
     currently is limited to state and local governments. Under 
     current law, CBO estimates that spending from the authorized 
     funding for 2004 and 2005 for obesity-related activities at 
     CDC will be $91 million over the 2004-2009 period.
       S. 1172 would authorize the appropriation of $60 million in 
     fiscal year 2004 and such sums as may be necessary for fiscal 
     years 2005 through 2008 for CDC to administer grant programs 
     for the promotion of nutrition and fitness for children, and 
     for the expansion of the types of entities eligible to 
     receive grants. Under the act, entities such as community-
     based organizations, educational institutions, and other 
     groups deemed appropriate by the Secretary also would be 
     eligible to receive grants. As specified in the act, grant 
     funds could be used for a range of activities, such as 
     increasing opportunities for biking, promotion of healthy 
     eating in the workplace, and establishing incentives for 
     groceries to offer nutritional foods. Based on historical 
     spending patterns for similar activities at CDC and assuming 
     enactment by July 1, 2003, CBO estimates that implementing 
     the act would cost $17 million in 2004 and $290 million over 
     the 2004-2009 period, assuming appropriation of the 
     authorized amounts. The proposed changes would add $199 
     million (relative to authorized spending under current law) 
     over the 2004-2009 period.
       Requirements for HHS to submit reports to Congress would 
     require about $1 million in additional resources to implement 
     in 2005, CBO estimates.
       The act also would reauthorize a CDC training program for 
     health professionals to treat obesity and would authorize 
     such sums as may be necessary for fiscal years 2006-2007 for 
     that purpose. Based on discussions with the agency about the 
     cost of training activities in this area, CBO estimates that 
     this provision would not have a significant budgetary effect.
       The other provisions of S. 1172 would allow HHS to give 
     special consideration to obesity-related conditions in 
     certain grants and research and would not require additional 
     resources. CBO estimates that those provisions would not have 
     a budgetary effect.
       Intergovernmental and private-sector impact: S. 1172 
     contains no intergovernmental or private-sector mandates as 
     defined in UMRA. State, local, and tribal governments may 
     benefit from the grant provisions of the bill, and none of 
     the bill's provisions would compel them to take any action.
       Estimate prepared by: Federal Cost: Jeanne De Sa (226-
     9010); Impact on State and Local Governments: Leo Lex (225-
     3220); and Impact on the Private Sector: Samuel Kina (226-
     2666).
       Estimate approved by: Peter H. Fontaine, Deputy Assistant 
     Director for Budget Analysis.

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