House and Senate negotiators Sept. 13 adopted a compromise agreement on the fiscal year (FY) 2019 Labor-HHS-Education and Defense spending bills (H.R. 6157) that next will go to each chamber for final approval before being sent to the president. The measure also includes a continuing resolution through Dec. 7 for any of the 12 annual spending bills that have not been finalized by the start of the new fiscal year Oct. 1.
The conference agreement, which spends $178 billion on the Labor-HHS-Education portion of the bill in Division B, adopts the Senate-passed $39.1 billion funding level for the National Institutes of Health (NIH) [see Washington Highlights, Aug. 24], representing a $2 billion (5.4%) increase including funding provided through the 21st Century Cures Act.
Within the NIH total, conferees provide $361.6 million for the Institutional Development Awards (IDeA), an $11.0 million (3.1%) increase over FY 2018, and $559.7 million for the Clinical and Translational Science Awards, a $17.0 million (3.1%) increase. The package also boosts funding for Alzheimer’s disease research, the Brain Research through Advancing Innovative Neurotechnologies Initiative, the Cancer Moonshot initiative, and research on a universal flu vaccine, among other items.
Like both the House committee and Senate bills, the conference agreement maintains the salary cap at Executive Level II of the federal pay scale and continues a prohibition on changes to NIH support for facilities and administrative expenses. The conferees did not adopt a provision in the House committee-passed bill [see Washington Highlights, July 13] that effectively would have prohibited fetal tissue research.
Negotiators also include in the package a provision from the Senate-passed bill transferring $5 million from the NIH Office of the Director (OD) to the Department of Health and Human Services Office of the Inspector General (OIG), “to examine NIH’s oversight of its grantees’ compliance with NIH policies, including NIH efforts to ensure the integrity of its grant application and selection processes.” The package’s joint explanatory statement directs OIG to “examine the effectiveness of NIH’s and grantee institutions’ efforts to protect intellectual property derived from NIH-supported research.”
Separately, the package also carries over language in the Senate spending bill allocating $50 million within the NIH OD for grants or contracts to public and nonprofit private entities for modernization and construction of biomedical and behavioral research facilities.
Among other highlights, the package provides $338 million for the Agency for Healthcare Research and Quality, $4 million (1.2%) more than FY 2018 and both the House committee- and Senate-passed FY 2019 bills.
The agreement includes $25 million for a new Health Resources and Services Administration primary care Graduate Medical Education (GME) program, originally proposed at $200 million by the House earlier this year [see Washington Highlights, June 29].
As proposed in both the House committee and Senate, the final package includes $325 million for Children’s Hospital GME, a $10 million (3%) increase over FY 2018; as well as $105 million for the National Health Service Corps, matching the FY 2018 omnibus and bringing total funding for the program to $415 million for FY 2019. The agreement also includes $10 million for the HRSA Rural Residency program established in the FY 2018 omnibus, a $5 million (33.3%) decrease below the original level.
Rejecting significant cuts proposed by the president and the House committee, the HRSA Title VII and Title VIII workforce development and diversity pipeline programs — including the Health Careers Opportunity Program — are flat-funded, with the exception of $39.3 million for Area Health Education Centers, a $1 million (0.3%) increase over FY 2018.
Conferees also establish a new $50 million “Infectious Diseases Rapid Response Reserve Fund” within the Centers for Disease Control and Prevention (CDC) to be available indefinitely for the CDC Director to use to prevent or respond to a major infectious disease emergency declared by the Health and Human Services Secretary.
The agreement excludes, reportedly at the request of House Republicans, a provision championed in the Senate spending bill by Senators Dick Durbin (D-Ill.) and Chuck Grassley (R-Iowa) that would provide up to $1 million within HHS to require direct-to-consumer drug advertisements to disclose pricing information.
The Senate is expected to vote on the package the week of Sept. 17, with a House vote the following week, before sending to the president. If it is enacted before Oct. 1, it will be the first time since 1996 that the Labor-HHS bill has been completed before the start of the new fiscal year.