The House Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations Subcommittee Feb. 25 held the first hearing of the year to discuss the president’s fiscal year (FY) 2016 budget request for the Department of Health and Human Services (HHS). HHS Secretary Sylvia M. Burwell testified.
While there was bipartisan support for many priorities in the budget request, including the proposed increase for the National Institutes of Health (NIH), Subcommittee Chair Tom Cole (R-Okla.) noted the subcommittee will have limited resources due to the return of sequestration in FY 2016 and the Budget Control Act caps set in law.
Given this context, he asked Secretary Burwell how she would prioritize the budget request. Burwell said the budget is a reflection of tough choices, but also described the fiscal climate of FY 2013 when government agencies were operating at sequester levels. During that time, she noted, NIH had the lowest number of research project grants in a decade. She also highlighted several recent public health challenges, including the Ebola outbreak, the influx of unaccompanied minors across the border, and the measles outbreak.
In light of these challenges, House Appropriations Committee Chair Hal Rogers (R-Ky.) also expressed concern about the budget context, adding, “we're facing a budget crunch that requires tough decisions in order to maintain continued investment in life-saving and breakthrough medical research, as well as prevention and treatment initiatives.”
House Appropriations Committee Ranking Member Nita Lowey (D-N.Y.) praised the budget’s investments in medical research at NIH, and for replacing sequestration. However, she cautioned that in the absence of a larger budget agreement and robust allocation for the subcommittee, the appropriations process would be “deeply imperiled.”
Subcommittee Ranking Member Rosa DeLauro (D-Conn.) echoed Lowey’s concerns, highlighting that after adjusting for inflation, the Labor-HHS budget has lost nearly $20 billion since 2010, translating to “less money for medical research, less money for public health, and less money for other critical priorities across the Labor-HHS bill.”
Rep. DeLauro added, “We must do better. We need to eliminate the sequester caps once and for all, and return to adequate levels of funding to support our nation’s health…We must invest in the NIH to accelerate breakthroughs against diseases like cancer… We must invest in public health, to strengthen our country in the fight against measles, meningitis, Ebola, and the obesity epidemic.”
Representative Lucille Roybal-Allard (D-Calif.) commended the administration for supporting the Health Resources and Services Administration (HRSA)’s Title VII health professions programs and for the newly proposed Title VII Health Workforce Diversity Program [see Washington Highlights, Feb. 6]. She said, “In today’s increasingly diverse population, HRSA’s Title VII health professions training programs have really been an invaluable tool in creating a pipeline of minority primary care professionals who overwhelmingly return to practice in diverse underserved areas.”
However, Rep. Roybal-Allard expressed concern that the new Health Workforce Diversity Program may not address the pre-high school pipeline as the Title VII Health Careers Opportunity Program (HCOP) does, and also had concerns about the administration’s proposal to eliminate the Title VII Area Health Education Centers (AHEC) program, despite proven success.
Other discussion topics included the nation’s prescription drug abuse epidemic and the impact of the new electronic billing system beginning in October 2015, known as ICD-10, on small physician practices.