Speaking of Medicare+ Choice, HCFA issued an operational policy letter explaining how some reimbursement models will adapt to the new structure. The Balanced Budget Act eliminated prepayment plans, which provide only Part B benefits, and medicare risk contracts after this year, and cost contracts by 2002. Current cost contractors that also have a prepayment agreement may move members into cost contracts with HCFA approval.... President Clinton's proposed 1999 Veterans Affairs budget includes a $17 billion cut in health care spending. In past years, the VA health care budget has increased $1 billion annually. The Clinton administration does not want to spend money on vets who claim their illnesses resulted from smoking.... Even with Medicare, senior citizens spend almost one-fifth of their incomes on health care. According to a report by the American Association of Retired Persons, Medicare recipients shelled out an average of 19 percent of their incomes, or $2,149, for health care in 1997.... The Department of Health and Human Services has kicked 1,400 health care professionals out of Medicare and Medicaid for defaulting on federal health education loans. A list of those disqualified is posted on the Internet at http:// www.defaulteddocs.dhhs.gov and is updated regularly.