The House Appropriations Committee approved its fiscal year (FY) 2022 spending bill for the Departments of Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) on July 15 by a vote of 33-25. This follows the subcommittee passage by voice vote on July 12.
The committee-approved bill would provide $119.8 billion for the Department of Health and Human Services (HHS), a historic increase of $22.9 billion (24%) over FY 2021 enacted funding and $129 million below the president’s FY 2022 budget request [refer to Washington Highlights, June 4].
Following committee passage, AAMC President and CEO David J. Skorton, MD, and AAMC Chief Public Policy Officer Karen Fisher, JD, said in a statement, “For more than a year and a half during the COVID-19 pandemic, we have witnessed firsthand the critical role of the NIH, CDC, and other federal health and research agencies that work with medical schools and teaching hospitals to keep the population healthy. The increased funding passed by the House Appropriations Committee today is essential to strengthen the nation’s health and research infrastructure, to improve the health of people everywhere, and to best prepare for future public health threats.”
The committee adopted two amendments to the draft bill passed by the subcommittee, including a manager’s amendment offered by committee Chair Rosa DeLauro (D-Conn.), which was approved by voice vote. The bill would provide funding for research, public health, and health care agencies, and programs that impact academic medicine.
The Appropriations Committee has approved nine additional FY 2022 spending bills [refer to Washington Highlights, July 1]. House Majority Leader Steny Hoyer (D-Md.) issued a Dear Colleague letter on July 15 to the Democratic Caucus indicating that a legislative package containing seven FY 2022 spending bills, including Labor-HHS, is expected to be considered on the House floor during the week of July 26.
National Institutes of Health and Other Research-related Provisions
The draft bill would provide a total of $49.4 billion for the NIH in FY 2022, representing a $3.5 billion (8.2%) increase in existing NIH institutes and centers, compared to the president’s proposed $2.5 billion increase, as well as $3 billion in new funding available for the president’s proposed Advanced Research Projects Agency for Health (ARPA-H). The bill makes ARPA-H funding available through Sept. 30, 2024, as proposed by the president, but provides $3 billion less than the president’s proposed $6.5 billion investment for the new entity. The accompanying report notes that “the Committee believes the ARPA-H must be a distinct Institute within the NIH, with a unique culture and organization that should focus on time-limited projects with goals, benchmarks, and accountability.”
With respect to the NIH overall, the committee report acknowledges the particularly burdensome impacts of COVID-19 on early career investigators and allows NIH to continue to make funding for certain multi-year research grants available through FY 2022 if they were subject to COVID-19 related disruptions.
The committee directs the NIH to submit a report regarding a new Center for Alternatives to Animals in Research and Testing within the NIH, as well as language to increase public reporting of the use of animals in research.
The bill also includes a new provision requiring institutions that receive NIH funding in FY 2022 and beyond to notify the NIH if a principal investigator or key personnel in an NIH notice of award is removed due to concerns about harassment, and the legislation permits the NIH to issue regulations to implement the new requirement.
The manager’s amendment added language to the bill prohibiting funding to the Wuhan Institute of Virology and for certain gain of function research. The AAMC joined more than 30 stakeholders in a July 14 letter to House Appropriations Committee leaders urging Congress to ensure any investigation of the COVID-19 pandemic origins is evidence-based and informed by scientists.
Agency for Healthcare Research and Quality (AHRQ)
For AHRQ, the bill would provide the president’s proposed $380 million, an increase of $42 million (12%) over the comparable FY 2021 funding level, including $5 million to establish the Center for Primary Care Research.
Centers for Disease Control and Prevention (CDC)
The bill would provide a total of $10.6 billion in program level funding for the CDC, an increase of $2.7 billion (35%) above the FY 2021 enacted level and $1 billion above the president’s request. Within the CDC total, the bill includes $1 billion in new funding for the CDC to support annual investments in general, core public health infrastructure and capacity nationwide.
The committee directs the CDC and the NIH to work with HHS agencies to continue expanding genomic sequencing and surveillance program for SARS-CoV-2 and the existing network and provides $35 million, a $5 million (16.7%) increase over both FY 2021 and the president’s request, for the Advanced Molecular Detection program.
The bill also matches the president’s request for $100 million in new funding for a new evidence-based community violence intervention program to fund a broad range of programs to prevent intentional violence and$153 million for the Social Determinants of Health (SDOH) program within the CDC, matching the president's request. The AAMC-endorsed Social Determinants Accelerator Act (H.R. 4026), which would authorize similar programming, was approved by the House Energy and Commerce Health Subcommittee on July 15 [see related story]. The spending bill also includes $119 million, a total increase of $56 million (88.9%) over FY 2021 and $49 million over the president’s budget request, for Safe Motherhood and Infant Health programs at the CDC.
Health Resources and Services Administration (HRSA)
The bill would provide $980 million for the HRSA Bureau of Health Workforce (BHW) Title VII health professions and Title VIII nursing workforce development and diversity pathway programs, a $225.9 million (30%) increase over FY 2021 enacted levels, and a $135 million (16%) increase over the president’s request. This includes historic proposed increases in the Centers of Excellence, Health Careers Opportunity Program, Minority Faculty Loan Repayment Program, Scholarship for Disadvantaged Students program, and Medical Student Education Program.
The bill would also provide $185 million in discretionary funding for the National Health Service Corps (NHSC), matching the president’s budget request and a $65 million (54%) increase over FY 2021 appropriated levels. Additionally, the bill includes $400 million for the Children’s Hospitals Graduate Medical Education Program, a $50 million (14%) increase over the president’s budget request and FY 2021 enacted levels.
Under the HRSA Office of Rural Health, the bill would match the president’s $12.7 million request for the Rural Residency Planning and Development program, a $2.2 million (21%) increase over FY 2021 levels.
The bill also includes several new investments in a number of HRSA programs focused on maternal health, including boosts for:
- Continued implementation of Alliance for Maternal Health Safety Bundles, which are evidence-based practices designed to improve patient outcomes and reduce maternal mortality;
- A Pregnancy Medical Home Demonstration to incentivize maternal health care providers to reduce maternal deaths and adverse maternal outcomes; and
- State Maternal Health Innovation Grants for demonstration projects to improve maternity care and reduce maternal mortality.
The spending bill would provide $320 million for the Hospital Preparedness Program (HPP) within the office of the Assistant Secretary for Preparedness and Response (ASPR), exceeding the $292.8 million total proposed by the president. Within the total, the bill includes increases for the core HPP cooperative agreements, the National Emerging Special Pathogens Training and Education Center (NETEC), and to expand the number of Regional Ebola and Other Special Pathogen Treatment Centers (RESPTC).
The spending bill would also increase funding for other preparedness programs, including the CDC’s Public Health Emergency Preparedness program, the Biomedical Advanced Research and Development Authority, the Strategic National Stockpile, and pandemic flu efforts.