July 13, 2017

House spending bill would boost NIH by $1.1B—but other health agencies face steep cuts

Daily Briefing

    The House Appropriations Committee on Wednesday released its draft Labor-HHS funding bill for fiscal year (FY) 2018, which would cut HHS funding by $542 million compared with FY 2017 levels.

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    In a summary of the bill, House lawmakers note that most of the proposed cuts do not go as far as President Trump requested in his budget blueprint, and would be used to offset a $1.1 billion increase to NIH's budget.

    Proposed FY 2018 spending levels for health care  

    The draft bill includes a total of $77.6 billion for HHS, down $542 million from FY 2017 and $14.5 billion above Trump's budget request.

    Despite an overall lower HHS budget, the bill does include a funding bump for NIH, which would get a total of $35.2 billion, an increase of $1.1 billion from FY 2017 and $8.6 billion more than Trump's budget request. As part of that funding bump, several research initiatives would see higher funding levels in FY 2018, including:

    • Alzheimer's disease research, which would get a $400 million increase;
    • Precision medicine research, which would get an $80 million increase;
    • Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, which would get a $76 million increase; and
    • Regenerative medicine research, which would get an $8 million increase.

    The draft bill also includes a new provision that would require NIH to continue reimbursing grantee research institutions for facilities and administrative costs. According to CQ HealthBeat, Trump's budget proposed reducing those indirect costs by billions of dollars.

    However, other agencies would see funding cuts to help offset the increase for NIH. The draft bill would allocate:

    • $7 billion to CDC, down $198 million from FY 2017 and $1 billion above Trump's budget request;
    • $5.8 billion to the Health Resources and Services Administration (HRSA), down $398 million from FY 2017 and $277 million above Trump's budget request; and
    • $3.5 billion to CMS, down $219 million from FY 2017 and $137 million below Trump's budget request;
    • $3.5 billion to the Substance Abuse and Mental Health Administration, down $306 million from FY 2017 and $68 million above Trump's budget request; and
    • $300 million to the Agency for Healthcare Research and Quality, which Trump had proposed folding into NIH, down $24 million from FY 2017.

    The draft bill would eliminate funding for HRSA's Title X family planning program, does not include any additional funding to be used to implement the Affordable Care Act (ACA), and would bar any funding from being used to implement the ACA's navigator programs. The draft bill also would eliminate a $10 million CDC climate change program.

    Comments

    House Appropriations Chair Rodney Frelinghuysen (R-N.J.) said, "This bill reflects Republican priorities to cut spending and focus investments in programs our people need the most—public health and medical research, biodefense, fundamental education, and proven programs that increase job growth, for example," adding, "It also includes important provisions to stop government overreach."

    Rep. Rosa DeLauro (D-Conn.)—ranking member of the House Appropriations Committee's Subcommittee on Labor, HHS, Education, and Related Agencies—praised the increased funding for NIH, but criticized cuts to other health care programs. "House Republicans are set on making it more difficult for women to access health services by blocking funding for Planned Parenthood and Title X family planning," she said, adding, "They are also cutting programs for mental health and substance abuse prevention by millions, exacerbating two national issues that states across the country are facing."

    Rep. Tom Cole (R-Okla.), who chairs the Labor-HHS-Education subcommittee, said the full House Appropriations Committee is expected to take up the spending bill on July 19. However, he acknowledged that some of the policy language could change to secure some Democrats' support, which will be needed to pass the bill because the current cuts likely are not steep enough to pass the bill with full Republican support (Siddons, CQ HealthBeat, 7/12 [subscription required]; Nather, Axios, 7/12; House Committee on Appropriations release, 7/12).

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