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House Appropriators Approve FY 2021 Labor-HHS Bill

July 17, 2020

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Brett Roude, Legislative Analyst
Christa Wagner, Senior Legislative Analyst

The House Appropriations Committee on July 13 approved its fiscal year (FY) 2021 spending bill for the Departments of Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS, H.R. 7614) by a party-line vote of 30-22.

Following committee passage, AAMC President and CEO David J. Skorton, MD, said in a statement, “The AAMC’s member institutions continue to combat the COVID-19 pandemic and care for patients across our country, while also conducting cutting-edge research on testing, treatments, and a potential vaccine to combat the coronavirus. Simultaneously, our members continue their efforts to combat other chronic illnesses while looking ahead to prepare for future public health threats. The Committee’s bill would make a number of important investments to support this work even as the coronavirus crisis continues.”

However, Skorton urged the committee to increase funding for the Health Resources and Services Administration (HRSA) diversity pipeline programs, noting, “Increased investments in these and other similar programs will help foster a diverse and culturally competent health care workforce that will support access to health care for all, both now and in the future.”

The committee adopted two amendments to the subcommittee-passed bill [see Washington Highlights, July 10]. Among the adopted amendments was a manager’s amendment offered by Labor-HHS Appropriations Subcommittee Chair Rosa DeLauro (D-Conn.), which makes “non-controversial and bipartisan changes to the bill and report” and was approved by voice vote.

As passed by the subcommittee on July 7, the approved bill would provide a total of $47 billion for the NIH in FY 2021 — $5.275 billion more than the FY 2020 enacted level. Within the total, the bill would provide $42 billion in annual appropriations — an increase of $275 million above the FY 2020 enacted level (0.65%) and totaling $500 million in new funding due to the transfer of one-time nonrecurring expenses in FY 2020. The FY 2021 bill also provides $5 billion in emergency appropriations available through FY 2025. Of the emergency funding, which the bill allows the NIH to use to offset expenses associated with COVID-19-related disruptions to research, $2.5 billion would be distributed across the NIH proportionate to each institute and center’s FY 2020 funding level. With the additional emergency funding, the report language explains, “Each Institute and Center will receive an increase of at least 7 percent over the 2020 enacted level.”

Included in the report is language related to the timely evaluation of research proposals that directs the NIH to “ensure that any research proposal reviewed by an Ethics Advisory Board described by [the Public Health Service Act] is evaluated within the same timeframe as research proposals not subject to review by an Ethics Advisory Board.” The subcommittee also directs the NIH to submit a report on specific research projects that have been delayed. The AAMC joined nearly 100 organizations in a March letter to President Trump to lift the restrictions on NIH-funded research using human fetal tissue to allow all biomedical research tools to be available for the development of new vaccines and cures to respond to COVID-19 [see Washington Highlights, March 27]. The newly formed NIH Human Fetal Tissue Ethics Advisory Board is scheduled to hold its first meeting on July 31 (see related story).

The report language on NIH-funded animal research requests the NIH to investigate and make recommendations for more quickly transitioning to nonanimal model alternatives in research. It urges the NIH to identify alternatives to nonhuman primates in the intramural research program and encourages the NIH to require grantees to implement post-research adoption policies.

The report also encourages the NIH director to provide resources to “address the increasing underrepresentation of Black men in medical schools and in the biomedical research profession” and establish a scholarship program to support Black students in pursuing careers in medicine, science, and biomedical research.

The legislation includes $782.5 million for the HRSA Title VII health professions and Title VIII nursing workforce development programs — a $48 million (6.5%) increase over FY 2021 enacted levels. Programs receiving increased funding include Area Health Education Centers (AHEC), Public Health and Preventive Medicine, Geriatric Programs, and the Medical Student Education Program. Title VII diversity pipeline programs such as the Health Careers Opportunity Program (HCOP) and Centers of Excellence (COE) were flat-funded.

Other programs administered by HRSA, such as Children’s Hospital Graduate Medical Education, received $340 million, flat-funded from FY 2020 levels. The committee provided $66.95 million for the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health (REACH) program — a $7 million (11.5%) increase over FY 2020 enacted levels. The legislation also provided $3 million in first-time funding for the National Health Care Workforce Commission, which was authorized in the Patient Protection and Affordable Care Act (P.L. 111-148).

Within the Department of Education section of the bill text, the committee bars the department from using any funds appropriated to implement the new Title IX final rule, which will take effect on August 14 [see Washington Highlights, June 27].

The report language also “reminds colleges and universities receiving Federal funds that section 117 of the Higher Education Act requires institutions to disclose certain gifts from or contracts with foreign entities and that the Department makes such information publicly available on its website.” The language also would direct the department to work with institutions to improve the Sec. 117 reporting process [see Washington Highlights, March 13].

The Appropriations Committee has approved all 11 additional spending bills and intends to consider the committee-approved FY 2021 Labor-HHS bill on the House floor the week of July 27.

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