The House Labor-HHS-Education Appropriations Subcommittee July 13 voted, 9-6, to approve its draft fiscal year (FY) 2018 spending bill, teeing up full committee consideration as soon as the week of July 17. The spending package rejects many of the president’s FY 2018 budget provisions, including proposals to dramatically reduce funding for the National Institutes of Health (NIH) and to cut NIH support for facilities and administrative (F&A) expenses.
According to a committee-prepared summary, the bill includes $156 billion overall for programs at the Departments of Labor, Health and Human Services (HHS), and Education, $5 billion (3.1 percent) less than FY 2017.
Within that total, the measure provides $34.7 billion in base funding for NIH, a $943.4 million (2.8 percent) increase over the comparable FY 2017 funding level, which Subcommittee Chair Tom Cole (R-Okla.) described “as a floor, not as a ceiling for biomedical research funding” in his opening remarks. The bill also fully utilizes the $496 million designated for specific NIH initiatives in the Innovation Account established in the 21st Century Cures Act (P.L. 114-255), bringing the bill’s total NIH funding level to $35.2 billion in FY 18. The president’s FY 2018 budget request proposed cutting NIH funding to $26.9 billion [see Washington Highlights, May 26].
In addition to the funding increase for NIH, the bill includes a provision blocking the president’s proposal to drastically reduce NIH support for F&A expenses. Numerous research stakeholder organizations, including AAMC, have been warning of the consequences the administration’s F&A proposal would impose on the research enterprise and, by extension, patients, researchers, and communities [see Washington Highlights, June 23].
Shortly after the subcommittee released bill text, AAMC President and CEO Darrell G. Kirch, M.D., issued a July 12 statement lauding the measure’s provision to preserve “NIH’s support for facilities and administrative infrastructure that makes research possible at medical schools and teaching hospitals nationwide.”
The bill also maintains the HHS salary cap at Executive Level II of the federal pay scale, rather than Executive Level V as the president had proposed, and continues funding for the NIH’s Fogarty International Center, which the administration proposed eliminating. The subcommittee also opted to maintain the Agency for Healthcare Research and Quality (AHRQ) as an independent agency, rather than a new NIH institute as proposed in the budget request. The bill does, however, cut $24 million (7.4 percent) from AHRQ’s budget, providing $300 million for the agency in FY 2018.
Additionally, the bill provides $5.8 billion for the Health Resources and Services Administration (HRSA), nearly $400 million less than the FY 2017 enacted level for the agency. While the bill language does not provide specific dollar allocations for each of HRSA’s workforce programs, the committee’s summary reveals that the bill maintains funding for the Children’s Hospitals Graduate Medical Education (CHGME) program at the FY 2017 level of $300 million, and eliminates the $14 million Health Careers Opportunity Program (HCOP), as proposed in the president’s request. The Health Professions and Nursing Education Coalition (HPNEC), an AAMC-led group of over 60 organizations who advocate on behalf of Title VII and Title VIII programs, sent a July 12 letter to members of the subcommittee recommending $580 million for the workforce programs.
In his statement, Dr. Kirch indicated that the association is “encouraged by the nearly $1 billion increase for the NIH budget overall,” but also urges lawmakers to craft a bipartisan budget agreement that enables appropriators “to invest fully in the broad spectrum of federal agencies that support our national health security,” including growth above inflation for NIH and investment in other health priorities.
The statement also expresses concern over a provision in the bill that would prohibit federal funding “to conduct or support research using human fetal tissue if it is obtained pursuant to an induced abortion,” which Dr. Kirch characterized as “undermining the nation’s well-established review system to evaluate the scientific merit and validity of research proposals.”