After a brief markup, the Senate Appropriations Committee Sept. 7 approved, 29-2, its Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) fiscal year (FY) 2018 spending bill. One day prior, senators from the Labor-HHS Subcommittee approved the bill by a motion to report, offered by Ranking Member Patty Murray (D-Wash.) without objection.
The Senate bill is a result of a bipartisan compromise, negotiated by Subcommittee Chair Roy Blunt (R-Mo.) and Ranking Member Murray. In his opening statement, Chairman Blunt highlighted the subcommittee’s bipartisan efforts, “For the second year in a row, this subcommittee has come together to craft a bipartisan bill that prioritizes resources for programs that will have the most benefit for the most Americans.” Ranking Member Murray added that she is “especially pleased that this bill doesn't include a single new damaging policy rider,” but said this bill “underscores the need” for lawmakers to strike a broader bipartisan budget deal.
According to the summary provided by the majority, the Senate Labor-HHS bill provides $79.4 billion of discretionary funding for the Department of Health and Human Services (HHS), $1.7 billion more than the previous fiscal year. As of press time the committee had not yet released official bill language and committee report, but preliminary analysis of programs of interest to academic medicine are summarized below:
Within the bill, the committee showed strong support for the National Institute of Health (NIH), providing $35.6 billion in base NIH funding, a $1.9 billion (5.5 percent) increase over the comparable FY 2017 funding level. Additionally, the bill fully utilizes the $496 million provided through the NIH Innovation Account established in the 21st Century Cures Act (P.L. 114-255), bringing the total funding level for NIH to $36.1 billion, or $2 billion more than the previous year.
The chairman expressed his support for biomedical research saying the he was “proud” to have “another $2 billion increase for the National Institutes of Health, which will provide doctors and researchers additional resources to help them treat and cure our most deadly and costliest diseases.”
Like the bill approved by the House Appropriations Committee in July [see Washington Highlights, July 21], the Senate spending bill maintains the HHS salary cap at Executive Level II of the federal pay scale and includes language prohibiting HHS from reducing NIH support for facilities and administrative (F&A) expenses. The AAMC joined 110 other organizations representing patients, scientists, clinicians, and research institutions, on an Aug. 21 letter urging HHS to reconsider the president’s proposal to drastically reduce NIH’s F&A support.
In a statement released after Senate action on the Labor-HHS bill, AAMC President and CEO Darrell G. Kirch, MD, commended the committee for its efforts on NIH, noting, “Together with their House counterparts, the Committee’s leadership has been key in ensuring that sustained growth in the NIH budget remains a national priority, and these efforts not only offer a lifeline to patients, across the country, but also strengthen local economies and our global competitiveness.”
The bill also maintains funding for the Agency for Healthcare Research and Quality (AHRQ) at its FY 2017 funding level of $324 million, and boosts funding for the Children’s Hospitals Graduate Medical Education (CHGME) program, by $5 million (1.6 percent) increase from its FY 2017 enacted level.
Draft language of the spending bill and committee report further indicate that the committee provides Title VII health professions programs with $311.7 million, a $2.5 million (0.8 percent) increase above the FY 2017 level. The spending bill provides FY 2017 enacted level funding to two programs that the House spending bill (H.R. 3358) proposes to eliminate: the Health Careers Opportunity Program (HCOP), with $14.3 million, and the Public Health and Preventive Medicine program, with $17 million. The Centers of Excellence programs (COE), which the House appropriations bill cuts by 55 percent, also receives flat funding of $21.7 million in the Senate bill. For the Area Health Education Centers (AHECs), the bill provides a $2.5 million (8.3 percent) increase in funding over its FY 2017 enacted level, with an allocation of $32.8 million in funding. The draft bill language and committee report also indicate that the remaining Title VII programs received flat funding at their FY 2017 levels.
According to draft bill and committee report language, the Title VIII nursing workforce programs receive $234.5 million from the Senate, a $5 million (2.2 percent) increase above the FY 2017 level. Within that funding, $69.5 million was allocated to the Advanced Education Nursing programs, of which, the Senate directed $5 million to be used for “…grants for the clinical training of sexual assault nurse examiners to administer medical forensic examinations and treatments to victims of sexual assault in hospitals, health centers, and other emergency health care service provider settings…”
The committee’s adoption of the spending bill clears it for consideration by the full Senate, though floor consideration has not yet been scheduled.