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Congress Passes FY 2020 Spending Package With Research, Health Programs Increases

December 19, 2019

Congress Passes FY 2020 Spending Package With Research, Health Programs Increases

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Tannaz Rasouli, Sr. Director, Public Policy & Strategic Outreach
Matthew Shick, Sr. Director, Gov't Relations & Regulatory Affairs
Christa Wagner, Senior Legislative Analyst
Brett Roude, Legislative Analyst

This week, Congress passed the Further Consolidated Appropriations Act, 2020 (H.R. 1865), funding federal agencies for the remainder of fiscal year (FY) 2020 through eight of the annual spending bills, as well as extending a number of health care and tax policies (see related story). The Senate Dec. 19 voted 71-23 to send the package to the president, following House approval by a vote of 297-120 on Dec. 17. As of press time, the president is expected to sign the bill before government funding expires on Dec. 20.

The White House and Congress have been negotiating for months to determine a path forward for appropriations as they faced a government shutdown upon the Dec. 20 expiration of the continuing resolution that was keeping federal agencies operational [see Washington Highlights, Nov. 22]. Congressional and committee leaders released the final bicameral, bipartisan agreement Dec. 16, prompting AAMC President and CEO David J. Skorton, MD, to issue a statement applauding “congressional and committee leaders for working in a bipartisan, bicameral manner to fund government agencies through the end of FY 2020 and to continue important health care programs that are at risk of expiring.”

Within the Labor-HHS-Education portion (Division A) of the final bill, the agreement provides a total of $41.684 billion for National Institutes of Health (NIH) in FY 2020, including the full $492 million provided in FY 2020 through the Innovation Account established in the 21st Century Cures Act for specific initiatives (P.L. 114–255). This total funding level represents a $2.6 billion or 6.7% increase over the comparable FY 2019 funding level — the fifth consecutive increase of $2 billion or more since FY 2016 — and falls between the House-passed $41.1 billion and the Senate-proposed $42.1 billion for the agency in FY 2020.

In addition to praise from the AAMC, the Ad Hoc Group for Medical Research, convened by the AAMC, issued a Dec. 17 press statement commending lawmakers for their efforts “to expand NIH’s capacity to support foundational and life-saving research.”

The minibus retains the salary cap at Executive Level II of the federal pay scale and addresses the administration’s proposal to limit salary support on an NIH grant by stating that none of the funds appropriated “shall be used to prevent the NIH from paying up to 100 percent of the salary of an individual at this rate.”

The joint explanatory statement accompanying the package directs the NIH to submit a report to lawmakers on the use of nonhuman primates in the intramural research program and potential alternatives, using a modified version of language that was included in the House spending bill. The final measure does not include language from the House bill that would have blocked, in part, implementation of the administration’s June policy on fetal tissue research [see Washington Highlights, June 7].

The bill maintains funding for the Agency for Healthcare Research and Quality (AHRQ) at its FY 2019 level of $338 million, falling short of the House-passed level of $358.2 million but rejecting the Senate’s proposed cut to $256 million.

The minibus includes a program level of nearly $8 billion for the Centers for Disease Control and Prevention (CDC), a $636.8 million or 8.6% increase over FY 2019 enacted levels. For the first time in more than two decades, the legislation includes dedicated funding for gun violence prevention research at the CDC with $12.5 million. The bill also provides $12.5 million for gun violence prevention research at the NIH.

Lawmakers continue funding for the Hospital Preparedness Program at FY 2019 levels, adding $11 million to preserve the National Ebola Training and Education Center (NETEC) and 10 regional Ebola treatment centers for a total of $275.5 million. Funding for NETEC and the regional centers otherwise would have expired after initially being funded for five years through supplemental appropriations.

The funding allocations proposed in the legislation includes $684.5 million for the Health Resources and Services Administration (HRSA) Title VII health professions and Title VIII nursing workforce development programs, a $42.8 million (8%) increase from FY 2019 enacted levels. This amount reflects $15 million for the Health Careers Opportunity Program, an increase of $611 thousand (6%) over FY 2019 enacted levels, and $41.25 million for Area Health Education Centers, a $2 million (5%) increase over FY 2019.

The bill also provides $102 million for the Behavioral Health Workforce Education & Training program, a $27 million (36%) increase over FY 2019. The increase includes funding dedicated to the Mental and Substance Use Disorders Workforce Training Demonstration program, which was authorized under the 21st Century Cures Act (P.L. 114–255) and the Loan Repayment Program for Substance Use Disorder Treatment Work, which was authorized under the SUPPORT Act (P.L. 115-271).

Other HRSA programs receiving funding include $340 million for the Children’s Hospitals Graduate Medical Education program (a $15 million or 4.6% increase over 2019), $50 million for the Medical Student Education Program ($25 million or 100% increase above FY 2019), and $120 million for the National Health Service Corps (NHSC) discretionary appropriation (see related story). 

The Labor-HHS bill also funds programs within the Department of Education (ED). The legislation provides $1.2 billion for the Federal Work Study, a $50 million (4.2%) increase from FY 2019. The joint explanatory statement includes language that would require the department to brief Congress on how they are implementing Public Service Loan Forgiveness and Temporary Extended Public Loan Forgiveness programs. 

The minibus provides funding for the Department of Veterans Affairs (VA), including $800 million for the VA Medical and Prosthetic Research program in FY 2020, a $21 million (2.7%) increase above FY 2019.

The president is also expected to sign separate legislation (H.R. 1158) detailing funding in the other four FY 2020 spending bills, including the Commerce-Justice-Science bill that funds the National Science Foundation. The bill includes $8.28 billion for NSF an $18 million (2.2%) increase over FY 2019, with $6.74 billion (a $34 million or 5.31% increase) dedicated to research and related activities.

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