The Senate Sept. 18 failed to move forward on consideration of H.R. 2740, the House-passed fiscal year (FY) 2020 “minibus” package of four spending bills, including funding for the Departments of Labor, Health and Human Services, and Education (Labor-HHS) [see Washington Highlights, June 21]. A 60 vote threshold was needed and the motion failed 51-44, in a party line vote with the exception of Sens. Mitch McConnell (R-Ky.) and Rand Paul (R-Ky.), who voted against the measure.
The Senate had planned to replace the language of the House-passed package with Senate versions of the four bills, including a Labor-HHS spending bill with report language that was released Sept. 18 after the Senate Appropriations Committee postponed consideration of the bill the week of Sept. 9 [see Washington Highlights, Sept. 13]. Press reports indicated that, in an effort to reach consensus on the Labor-HHS bill, Senate Republicans sent a proposal to Democratic colleagues recommending appropriators tap into unobligated funding in Pell Grants as a way to increase the allocations for some programs in the original legislation.
The committee also released an accompanying press statement and summary from Subcommittee Chair Roy Blunt (R-Mo.), which noted that the spending bill combines $178.3 billion in base allocation with $9.4 billion in changes in mandatory programs (CHIMPs), a total of $2.2 billion (1%) more in discretionary spending compared to the enacted FY 2019 bill.
The draft bill provides a total of $42.1 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 would represent a $3 billion or 7.7% increase over the comparable FY 2019 funding level, adding to a $12 billion, or 40% increase, since FY 2016. This compares to the House-passed $41.1 billion (a $2 billion or 5.1% increase over FY 2019). Specifically, the proposal includes $380 million for the Institutions Development Award (IDeA) program, an increase of $19.2 million over FY 2019, as well as $589.4 million for Clinical and Translation Science Awards (CTSA), an increase of $29.7 million. The bill also maintains the HHS salary cap at Executive Level II of the federal pay scale and adds, “none of the funds appropriated in this title shall be used to prevent the NIH from paying up to 100 percent of the salary of an individual at this rate.”
The Ad Hoc Group for Medical Research, convened by the AAMC, issued a press statement commending the investment in NIH while encouraging “lawmakers in both chambers to work swiftly toward enactment of a bipartisan spending bill that avoids unnecessary delays in scientific progress.” Additionally, the bill provides $256 million for the Agency for Healthcare Research and Quality (AHRQ), an $82 million (24%) cut. The bill rejects the president’s proposal to fund AHRQ as an institute within the NIH.
The legislation provides the Centers for Disease Control and Prevention (CDC) with a program level of $7.52 billion for FY 2020, a $180 million (2.4%) increase over FY 2019 enacted levels. This compares to the House-passed funding level of $8.3 billion (a $938 million or 12.8% increase over FY 2019). However, the bill does not include the $25 million included in the House spending bill for the CDC to conduct gun violence research.
The funding allocations proposed in the legislation includes $633.5 million for the Health Resources and Services Administration (HRSA) Title VII health professions and Title VIII nursing workforce development programs, an $8.2 million (1.3%) decrease from FY 2019 enacted levels. This amount reflects the elimination of the Health Careers Opportunity Program, and flat funding for most other programs. The bill also provides an additional $5 million in new Title VII funding for Mental and Substance Use Disorders Workforce Training Demonstration program, which was authorized under the 21st Century Cures Act (P.L. 114–255).
Earlier this summer, the House of Representatives passed Labor-HHS funding legislation that would provide $680 million for Title VII and Title VIII, a $38 million (6%) increase over FY 2019 enacted levels [See Washington Highlights, May 10]. The AAMC-led Health Professions and Nursing Education Coalition (HPNEC) released a statement expressing disappointment with the Senate allocations and urging Senators and Representatives to work on a bipartisan resolution that adequately funds Titles VII and VIII for FY 2020.
The Labor-HHS legislation included funding for additional programs administered by HRSA. The Committee allocated $340 million for Children’s Hospital Graduate Medical Education, a $15 million (4.6%) increase over FY 2019 enacted levels, and $10 million less than what the House legislation provided, and flat funded the Medical Student Education Program at $25 million, $15 million less than the House bill. Finally, the legislation provided $105 million for the National Health Service Corps, which is additional funding provided to the program on top of its mandatory appropriation.
The draft legislation also provides funding for the Department of Education programs. According to the committee report, the Federal Work Study program received $1.13 billion in FY 2020 (flat-funded from FY 2019). The House-passed legislation includes $1.4 billion for FWS, a $304 million (2.8%) increase over FY 2019 enacted levels. The draft bill also includes $100 million for the Temporary Extended Public Service Loan Forgiveness program, signaling Senate support for retaining the Public Service Loan Forgiveness program.
With one week left in FY 2019, the Senate the week of Sept. 23 is expected to vote on the House-passed continuing resolution to avoid a government shutdown when the new fiscal year begins Oct. 1.