The House July 25 approved, 284-149, a budget agreement (H.R. 3877) that would suspend the debt ceiling through July 31, 2021, would revise discretionary spending caps in fiscal years (FYs) 2020 and 2021, and would allow Congress to move forward with the appropriations process, which had stalled while congressional and administration negotiators deliberated a budget deal.
In advance of the vote, the AAMC issued a July 23 statement praising the legislation as “a critical first step toward funding federal agencies and programs vital to patients across the country and to our nation’s health security.”
Under the agreement, lawmakers would be able to spend $621.5 billion overall in FY 2020 on non-defense discretionary (NDD) programs across the federal government, such as the National Institutes of Health (NIH), workforce programs at the Health Resources and Services Administration, and other public health, education, and science agencies and programs.
If enacted, the revised spending cap would avert $55 billion in cuts to NDD spending that would occur under the statutory Budget Control Act cap for FY 2020; by contrast, the revised cap would represent a $24.5 billion (4.1%) increase over the comparable funding level in the FY 2019 spending bills. An additional $2.5 billion would be available to lawmakers for one-time costs associated with the decennial Census, and $8 billion from the Overseas Contingency Operations fund would support non-defense security spending.
While the agreement would establish the topline spending limits, it does not specify funding levels for individual programs and agencies, which will need to be determined through the 12 annual spending bills.
The FY 2020 spending packages approved by the House to date, including the bill (H.R. 2740) that would boost NIH funding by $2 billion and increase investments in other health agencies [see Washington Highlights, June 21], were drafted after the House “deemed” an overall cap that assumed $631 billion in funding for NDD programs in FY 2020, $9.5 billion less than the funding level negotiated by congressional leaders and the administration [see Washington Highlights, April 12]. The Senate has been awaiting a final agreement before drafting its FY 2020 appropriations bills.
The Ad Hoc Group for Medical Research, which the AAMC convenes, sent a July 24 letter urging all House offices to support the budget agreement to allow the appropriations process to move forward, noting, “To keep pace with scientific opportunity, we must ensure an investment in [the NIH] in FY 2020, that, at minimum, matches the funding level approved by the House, and your support for H.R. 3877 would mark a necessary first step in advancing this life-saving research and other discretionary spending priorities in FY 2020 and beyond.”
In addition to revising the NDD spending cap for FY 2020, the agreement also establishes a new spending cap of $626.5 billion for NDD in FY 2021 and increases the spending caps for defense spending in FY 2020 to $666.5 billion and in FY 2021 to $671.5 billion.
Lawmakers partially offset the cost of the package with $77.4 billion in savings generated by extending the sequester on Medicare and other mandatory programs for two additional years through FY 2029 and customs user fees. The deal also outlines an agreement among congressional leaders and the administration that there will be “no poison pills [or] additional new riders” relative to the FY 2019 spending bills.
The package now awaits consideration by the Senate, which is expected to vote on the agreement the week of July 29 before senators leave Washington for the August work period. President Trump has indicated his support for the agreement through a series of tweets acknowledging the legislation’s benefits for military spending.