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  • Washington Highlights

    House Appropriators Approve Spending Bill With NIH Increase, Cuts to Health Professions

    Tannaz Rasouli, Sr. Director, Public Policy & Strategic Outreach
    Matthew Shick, Sr. Director, Gov't Relations & Regulatory Affairs

    After a marathon markup stretching into the evening, the House Appropriations Committee July 19 approved, 28-22, its draft FY 2018 Labor-HHS-Education spending bill and accompanying report, providing a nearly $1 billion increase for the National Institutes of Health (NIH) and blocking the administration’s proposal to reduce NIH support for facilities and administrative (F&A) expenses. Though Democrats offered dozens of amendments to the text, the committee left most of the bill unchanged, adopting only three amendments to the bill, including a manager’s amendment of technical and “non-controversial” revisions.

    The subcommittee had approved the spending bill one week earlier [see Washington Highlights, July 14], providing $34.7 billion in base funding for NIH, a $943.4 million (2.8 percent) increase over the comparable FY 2017 funding level. The bill also fully utilizes $496 million from the NIH Innovation Account established by the 21st Century Cures Act (P.L. 114-255), bringing the FY 2018 total for NIH to $35.2 billion, $1.1 billion more than FY 2017.

    Other accounts in the spending bill, however, face cuts, which Democrats sought to restore. The panel rejected an amendment from Rep. Lucille Roybal-Allard (D-Calif.) to restore a $24 million (7.4 percent) cut to the Agency for Healthcare Research and Quality (AHRQ).

    The committee also considered an amendment from Rep. Roybal-Allard to restore funding for the Health Resources and Services Administration (HRSA)’s Title VII health professions and Title VIII nursing workforce programs to their FY 2017 enacted funding levels. The committee’s bill would provide $448 million for Title VII and Title VIII, a $91 million (16.8 percent) cut.

    For Title VII, the measure includes $237 million, a 72.2 million (23.3 percent) cut below FY 2017, achieved through elimination of the Health Careers Opportunity Program (HCOP) and the Public Health and Preventive Medicine Program, and substantial reductions for Centers of Excellence, Behavioral Health Workforce Education, and Geriatrics programs. The bill includes $211.2 million for Title VIII nursing programs, an $18.3 million (8 percent) cut overall, maintaining the Nurse Corps program at its FY 17 funding level of $83 million, and consolidating remaining Title VIII programs in a new $128 million line item called “Nursing Workforce Development.”

    In her remarks supporting restored funding for the programs, Rep. Roybal-Allard emphasized the importance of these programs to “protect and promote the health professions workforce for the 21st Century.” She continued, “At a time when the demand for health care continues to rise, cuts and consolidations to Title VII and VIII are counter to the goal of increased access.”

    Subcommittee Ranking Member Rosa DeLauro (D-Conn.) spoke in support of Rep. Roybal-Allard’s amendment, echoing the importance of these workforce program and characterizing them as “a pathway to the middle class.”

    Subcommittee Chair Tom Cole (R-Okla.) commented on the amendment as well, recognizing the importance of the programs, but ultimately opposing it due to subcommittee’s limited budget allocation. However, Chairman Cole mentioned that if there were to be a budget agreement that increases the subcommittee’s allocation, he may support provisions in the amendment. Ultimately, the amendment failed with a 22-30 party line vote.

    During the markup, Rep. Mark Pocan (D-Wis.) offered an amendment to strike the bill’s prohibition on research with fetal tissue derived from “induced abortions.” The committee rejected the amendment by voice vote. The AAMC joined a July 18 letter  with 23 other organizations asking House appropriators to oppose the restriction on fetal tissue research.

    The committee’s adoption of the spending bill clears it for consideration by the full House, though floor consideration has not yet been scheduled. Senate action on its version of the spending bill is not expected until the fall.