Additional Half Billion Dollars for World Trade Center Health Program
Congressman Dan Goldman (right) led the successful push to add $676 million to the budget of the World Trade Center Health Program in the closing days of the year that just ended. The Health Program, which provides medical treatment to people affected by the terrorist attacks of September 11, 2001, had been facing an impending budget shortfall that, if left unaddressed, could have cause it to scale back services starting in less than a year.
By sponsoring an amendment to the National Defense Authorization Act for fiscal year 2024 (NDAA), a budget measure focused primarily on military and intelligence spending, Mr. Goldman (along with a coalition of Congress members from the New York area) was able to earmark more than half a billion dollars for the Health Program. This allocation is divided between the Health Program’s primary budget (which gets an infusion of $444 million), and special provisions to ensure that people made sick by exposure to toxins during the simultaneous attacks at the Pentagon and Shanksville, Pennsylvania, are also covered.
“Today the House of Representatives renewed its commitment to the first responders and survivors whose lives were upended that day,” Mr. Goldman said when the lower house of the federal legislature approved the measure, on December 14. “This funding will go a long way to ensuring that we provide them with the coverage and care they deserve.” The new allocation is intended to fund the Health Program through 2029. President Biden signed it into law in December 22.
Such eleventh-hour windfalls are becoming an annual ritual for the Health Program. Two days before Christmas, 2022, at the last possible moment, the U.S. Senate ratified a similar bill that partially funded the Health Program, with an allocation of $1 billion.
Created in 2011 and reauthorized by Congress in 2015, the Health Program is budgeted for preset amounts of funding, based on anticipated enrollment. But these projections turned out to underestimate the number of people in need of such services. Some 9,000 first responders and 5,000 survivors (the label denoting residents, students, and workers near the location of the attacks) signed on during the Health Program’s first five years, while an additional 16,000 responders and 20,500 survivors joined in the five years up to 2021. As of the end of September, 2023 according to the Health Program, there are than 127,0426 people enrolled, divided between approximately 40,945 survivors and 86,481 responders.
In 2019, Congress partially addressed this influx, raising the numerical limitations on Health Program enrollment by an additional 50,000 responders and 50,000 survivors. The increased headcount, however, didn’t come with any additional money. Instead, Congress allowed the Health Program to use funds going forward that had been allocated to prior years, and mandated that New York City take responsibility for ten percent of the overall costs. These expedients bridged the funding gap on an interim basis, but were projected to run out by the end of this year. At that point, the Health Program would have faced expenditures greater than the amount of money it had on hand, which would have meant curtailing the services it offers to sick patients.
The funding formulas contained in the statutes that created and renewed the Health Program have failed to keep pace with the anticipated costs of providing the program’s services because of the evolving nature of the health problems it is being called upon to treat. As the Centers for Disease Control (which oversees the Health Program) explains in a statement, “the Program has seen an increase in the number of cancer cases. The complexity of treating cancer, especially with other co-morbidities, and an aging membership in general, has increased the Program’s healthcare costs beyond what was previously estimated.”