Congress appears ready to slash funding for the research and treatment of brain injuries caused by bomb blasts, an injury that military scientists describe as a signature wound of the Iraq war. House and Senate versions of the 2007 Defense appropriation bill contain $7 million for the Defense and Veterans Brain Injury Center - half of what the center received last fiscal year.

Proponents of increased funding say they are shocked to see cuts in the treatment of bomb blast injuries in the midst of a war. "I find it basically unpardonable that Congress is not going to provide funds to take care of our soldiers and sailors who put their lives on the line for their country," says Martin Foil, a member of the center's board of directors...George Zitnay, co-founder of the center, testified before a Senate subcommittee in May that body armor saves troops caught in blasts but leaves many with brain damage. "Traumatic brain injury is the signature injury of the war on terrorism," he testified.

The Brain Injury Center, devoted to treating and understanding war-related brain injuries, has received more money each year of the war - from $6.5 million in fiscal 2001 to $14 million last year. Spokespersons for the appropriations committees in both chambers say cuts were due to a tight budget this year.

"Honestly, they would have loved to have funded it, but there were just so many priorities," says Jenny Manley, spokeswoman for the Senate Appropriations Committee.

... The center has clashed with the Pentagon in recent months over a program to identify troops who have suffered mild to moderate brain injuries in Iraq from mortars, rocket-propelled grenades and roadside bombs - the most common weapons used by insurgents. Preliminary research by the center shows that about 10% of all troops in Iraq, and up to 20% of front line infantry troops, suffer concussions during combat tours....The center urged the Pentagon to screen all troops returning from Iraq in order to treat symptoms and create a database of brain injury victims. Scientists say multiple concussions can cause permanent brain damage.

The Pentagon so far has declined to do the screening and argues that more research is needed.

An influential federal panel of medical advisers has recommended that the government loosen regulations that severely limit the testing of pharmaceuticals on prison inmates, a practice that was all but stopped three decades ago after revelations of abuse.

The proposed change includes provisions intended to prevent problems that plagued earlier programs. Nevertheless, it has dredged up a painful history of medical mistreatment and incited debate among prison rights advocates and researchers about whether prisoners can truly make uncoerced decisions, given the environment they live in.

Supporters of such programs cite the possibility of benefit to prison populations, and the potential for contributing to the greater good.

Until the early 1970's, about 90 percent of all pharmaceutical products were tested on prison inmates, federal officials say. But such research diminished sharply in 1974 after revelations of abuse at prisons like Holmesburg here, where inmates were paid hundreds of dollars a month to test items as varied as dandruff treatments and dioxin, and where they were exposed to radioactive, hallucinogenic and carcinogenic chemicals.

In addition to addressing the abuses at Holmesburg, the regulations were a reaction to revelations in 1972 surrounding what the government called the Tuskegee Study of Untreated Syphilis in the Negro Male, which was begun in the 1930's and lasted 40 years. In it, several hundred mostly illiterate men with syphilis in rural Alabama were left untreated, even after a cure was discovered, so that researchers could study the disease.

"What happened at Holmesburg was just as gruesome as Tuskegee, but at Holmesburg it happened smack dab in the middle of a major city, not in some backwoods in Alabama," said Allen M. Hornblum, an urban studies professor at Temple University and the author of "Acres of Skin," a 1998 book about the Holmesburg research. "It just goes to show how prisons are truly distinct institutions where the walls don't just serve to keep inmates in, they also serve to keep public eyes out."

..."It strikes me as pretty ridiculous to start talking about prisoners getting access to cutting-edge research and medications when they can't even get penicillin and high-blood-pressure pills," said Paul Wright, editor of Prison Legal News, an independent monthly review. "I have to imagine there are larger financial motivations here."

The White House is clashing with governors of both parties over a plan to cut Medicaid payments to hospitals and nursing homes that care for millions of low-income people. The White House says the changes are needed to ensure the "fiscal integrity" of Medicaid and to curb "excessive payments" to health care providers....

More than 330 members of Congress, including 103 Republicans, have objected to the plan. A letter signed by 82 House Republicans says it "would seriously disrupt financing of Medicaid programs around the country." A bipartisan group of 50 senators recently urged President Bush to scrap the proposed rules, which were set forth in his 2007 budget and could be issued before the end of this year.

Medicaid finances health care for more than 50 million low-income people, with money provided by the federal government and the states. Under the White House plan, the federal government would reduce Medicaid payments to many public hospitals and nursing homes by redefining allowable costs. It would also limit the states' ability to finance their share of Medicaid by imposing taxes on health care providers. About two-thirds of the states have such taxes.

State and local officials, members of Congress, hospitals, nursing homes and advocates for poor people make several arguments. First, they say, Mr. Bush is doing by regulation what he unsuccessfully asked Congress to do by legislation in the last two years. Second, they say, prior administrations and the Bush administration itself approved many of the state taxes that would be deemed improper under the new rules.

Gov. Arnold Schwarzenegger of California, a Republican, said, "The administration is attempting to reverse decades of federal Medicaid policy through the regulatory process," less than a year after "Congress rejected these misguided cuts."

In Missouri, Gov. Matt Blunt, a Republican, said the change "could mean a loss of more than $84.9 million" for his state. That, he said, would "jeopardize the continuity of care for Medicaid recipients" and set back efforts to improve care in nursing homes....

The cuts contemplated by the White House would not reduce the cost of care. But state officials said the changes would put pressure on states to reduce Medicaid benefits, restrict eligibility or lower payments to health care providers...

Dr. Bruce A. Chernof, director of the Los Angeles County Department of Health Services, said the cuts would "reduce access to services in a county where 33 percent of residents are uninsured." The county's five public hospitals operate trauma centers and burn treatment units for all patients, not just Medicaid recipients, he said.

The effects are magnified by the way Medicaid is financed. For each dollar that a state loses in provider tax revenue, the federal government will reduce its contributions - by $1 in California and Connecticut, and by $3 in a poor state like Mississippi.