[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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