The House Labor-HHS-Education Appropriations Subcommittee June 17 approved by voice vote its draft fiscal year (FY) 2016 spending bill.
The subcommittee rejected along party lines a number of Democratic amendments to restore funding for many of the programs cut in the bill.
The bill includes $153 billion in discretionary spending for the programs under its jurisdiction, $3.7 billion below the FY 2015 enacted level and $14.6 billion less than the president's request.
A summary released by the committee states, "Funding within the bill is targeted to proven programs with the most national benefit, including medical research, public health, and biodefense, as well as activities to ensure Social Security, Medicare, and Medicaid services are efficient, effective, and accountable to those Americans they serve. While making these important investments, the bill reduces funding in lower-priority areas, and cuts ineffective or wasteful programs and agencies."
The bill includes several provisions to stop implementation of the Affordable Care Act (ACA), including rescinding prior year mandatory funds and prohibiting the use of new discretionary funding to implement the ACA. This includes rescinding $6.8 billion for the Center for Medicare and Medicaid Innovation (CMMI) and $100 million from the Patient-Centered Outcomes Research Trust Fund.
The bill provides a total $31.2 billion for the NIH, $1.1 billion (3.6 percent) above the FY 2015 enacted level and $100 million above the president's budget.
This funding includes $165 million to support activities for the National Children’s Study, $480.6 million for Clinical and Translational Sciences Awards, and $311.8 million for Institutional Development Awards (IDeA), an increase of $38.5 million (14.1 percent).
The bill also provides increases for several targeted research initiatives, including $886 million (a $300 million increase) for an Alzheimer’s disease research initiative; $461 million (a $100 million increase) for the antibiotic resistance initiative; $150 million (a $95 million increase) for the Brain Research through Application of Innovative Neuro-technologies (BRAIN) initiative; and the full $200 million requested by the administration for the Precision Medicine Initiative (PMI).
The bill reduces the extramural salary limit to Executive Level III ($168,700 in 2015). This represents a decrease of $14,600 (8 percent).
Within the Office of the Director, the bill also includes the following: “Provided further, That, of the funds from Institute, Center, and Office of the Director accounts within ‘Department of Health and Human Services, National Institutes of Health’ in order to strengthen privacy protections for human research participants, NIH shall require investigators receiving NIH funding for new and competing research projects designed to generate and analyze large volumes of data derived from human research participants to obtain a certificate of confidentiality.”
The bill also terminates funding and authority for the Agency for Healthcare Research and Quality (AHRQ) and includes a prohibition on patient-centered outcomes research. The spending bill permits other agencies to carry out activities currently supported by AHRQ only if the agency has such authority and the activity relates to specified priorities for each agency; for example, under the bill, NIH would only be able to assume AHRQ-supported efforts if they relate to biomedical research. The provision does not provide resources to support these activities to the other agencies.
According to a committee-prepared summary, the spending bill maintains funding for the Children’s Hospitals Graduate Medical Education (CHGME) program at the FY 2015 level of $265 million. The subcommittee has not yet released details about funding levels for other health care workforce programs at the Health Resources and Services Administration.