Cutting the $553 billion base Defense Department budget is made that much harder when House members continue their long-standing habit of slipping into it “little” multimillion-dollar items that once were called earmarks.

In the House version fiscal 2012 Defense Authorization Bill they became en banc amendments approved without public discussion in committee (Armed Services) and on the House floor, and financed from a $650 million Mission Force Enhancement Transfer Fund, which was created by reducing other programs.

The House Appropriations Committee has taken a more subtle approach. Instead of its old habit of soliciting earmarks, it now asks members to provide “programmatic requests” ahead of subcommittee markups.

In a May 3 “Dear Colleague” letter, Rep. Denny Rehberg (R-Mont.), chairman of the Appropriations Subcommittee on Labor, Health and Human Services, set out guidelines for House members making programmatic requests. He suggested that since earmarks will not be considered, members should consult prior earmark disclosure statements to “assist in making a determination as to whether the subcommittee has considered a particular item an earmark.”

First introduced as an earmark and continued as such year after year, it is now considered a program — even though the administration does not request it. Therefore, any congressional request that it be continued is a programmatic request. Get it?

You see the effect best in the House Appropriations Committee report on the fiscal 2012 Defense Appropriations Bill released last week. The panel added $523.5 million in medical research and development money for 22 programs in addition to the $663.7 million for medical research through the Defense Department that the Obama administration had requested.

One of those added programs was $3.2 million for Bone Marrow Failure Disease research. Last month, Rep. Doris Matsui (D-Calif.) sent a letter to colleagues seeking support for the program that had first been earmarked in 2008. In boldface type it said: “The Bone Marrow Failure Disease Program is not an earmark. This request will be considered programmatic.”

She also noted that “recent anecdotal data indicate that members of the armed services who were deployed to Iraq or Afghanistan may have been exposed to environmental factors associated with these fatal diseases.”

Another program on the committee-approved list is $5.1 million for Tuberous Sclerosis Complex Research. On May 2, Rep. Loretta Sanchez (D-Calif.) sent an electronic message to her House colleagues. Labeled “This is a Programmatic Request,” it asked members to support “a continuation of funding” for the research in the fiscal 2012 defense budget, saying that since 2002, about $35.9 million had been spent through this program. No connection to the military was mentioned.

As I wrote in March, Congress for almost 20 years has put these medical research funds in the Defense Department budget that have never been requested in a presidential budget. Although generally meritorious, many earmarked programs for research fall outside the Pentagon’s traditional mission of battlefield medicine and research.

Begun as a $25 million earmark in 1992 for research on breast cancer, the requests have grown over the years, requiring the Pentagon to set up a Congressionally Directed Medical Research Programs office managed primarily through contractors. The office advertises and awards grants and oversees their completion.

This year, the committee-listed programs ranged from $3.2 million for Duchenne muscular dystrophy research to $64 million for prostate cancer research to $120 million for breast cancer research. Many of these subjects are covered by National Institutes of Health individual research grants, which in 2006 totaled about $15.2 billion, according to a Rand study.

To fund these additions, the House committee “found” $400 million made up primarily of $330 million, which it said would be “underexecuted” money in the TRICARE health program for active and retired Pentagon personnel. In the recent fiscal 2011 continuing resolution, the committee projected TRICARE would not use $236 million of its appropriated funds. An additional $109 million would come from unused money allocated for other health-care programs.

Of the overall list, the committee provided detailed justification for two programs. One was $10.2 million for lung cancer research. The committee linked this to its concern with “the high rate of lung cancer among military personnel and veterans.” It said that military personnel have increased exposure to lung cancer carcinogens and are more susceptible to lung cancer than the general population.

The other set aside $12.8 million to research cancers not specified in the itemized list.

Last week, at the Senate Appropriations Defense subcommittee hearing on the fiscal 2012 budget, an unusual event occurred during Defense Secretary Robert M. Gates’s testimony. Sen. Daniel Coats (R-Ind.) raised a question about “where possibly we can get some savings,” pointing out “research on a number of health issues” put in the bill approved by the House Appropriations panel.

He singled out $30 million for orthopedic research, asserting that his state is a leader in such research and asking, “Are there savings possible in that category where there is duplicative research paid for by government or conducted by private industry which addresses the very same issues?”

He made clear that he knew “it’s the holy grail not to touch anything having to do with health of service members.” But, he added, “I’m not suggesting that. I’m simply saying there may be some duplications there that we ought to be looking at.”

He is right.