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  • Washington Highlights

    Senate Democrats Unveil FY 2022 Spending Bills, Including Health Program Proposals


    Brett Roude, Legislative Analyst
    Christa Wagner, Manager, Government Relations

    Senate Appropriations Committee Democrats released drafts of the committee’s remaining nine fiscal year (FY) 2022 spending bills on Oct. 18, including funding for the departments of Labor, Health and Human Services, and Education (Labor-HHS-Education), and the National Science Foundation (NSF). The Senate Appropriations Committee previously approved three of the chamber’s FY 2022 bills, including funding for the Department of Veterans Affairs, while the House of Representatives passed nine of its 12 bills earlier this summer [refer to Washington Highlights, July 30, Aug. 6].

    Upon release of the Democratic draft bills, Senate Appropriations Chair Patrick Leahy (D-Vt.) noted, “I have previously called for bipartisan, bicameral, negotiations on topline spending for Fiscal Year 2022, and I renew that call today so we can enact all 12 appropriations bills by December 3rd, when the current Continuing Resolution expires. ...The alternative to completing the appropriations process is a full-year continuing resolution, which does not serve the American people and locks in outdated spending priorities.”

    In response, Vice Chair Richard Shelby (R-Ala.) stated, “Chairman Leahy’s decision to unilaterally unveil partisan spending bills is a significant step in the wrong direction. … We need a topline agreement that does not shortchange our nation’s defense and a willingness to set aside partisan politics. Only then will we be able to produce full year bills for the American people.”

    The AAMC and the Ad Hoc Group for Medical Research, which AAMC convenes, joined over 200 organizations in an Oct. 21 letter to House and Senate leadership outlining the detrimental effects of continuing resolutions to medical research and urging swift completion of the FY 2022 appropriations process.

    In response to release of the draft Labor-HHS-Education spending bill, AAMC President and CEO David J. Skorton, MD, and Chief Public Policy Officer Karen Fisher, JD, issued a press statement expressing gratitude to Chairman Leahy and Subcommittee Chair Patty Murray (D-Wash.) for “producing a draft FY 2022 spending bill that would provide crucial support for programs to promote the health of patients, communities, and the nation.” They added encouragement for passage of the higher funding levels in the House bill and added, ”We urge Congress to work quickly to ensure that the final version of the FY 2022 Labor-HHS-Education appropriations bill prioritizes spending that will improve the health of all.”

    According to the committee's explanatory statement, the draft Labor-HHS-Education bill would provide the HHS with $117.6 billion in base discretionary funding for FY 2022 — an increase of $20.9 billion (21.6%) over the comparable FY 2021 funding level. By comparison, the House-passed bill would provide the HHS with $119.8 billion [refer to Washington Highlights, July 16]. The draft bill includes proposed investments for agencies and programs important to academic medicine that are highlighted below.

    National Institutes of Health (NIH)

    The draft bill would provide $45.5 billion for existing institutes and centers within the NIH, a $2.6 billion (6%) increase, compared to the House-passed bill which would provide $46.4 billion for the NIH’s base. The Senate draft also includes $2.4 billion in new funding for the president’s proposed Advanced Research Projects Agency for Health (ARPA-H), compared to the president’s requested $6.5 billion and the House-passed $3 billion investment. The explanatory statement notes the committee “remains open” to establishing ARPA-H as a free-standing agency outside of the NIH. A standalone authorizing proposal to establish ARPA-H outside of the NIH was recently introduced in the House [refer to related story]. Combined, the Senate draft includes a proposed $47.9 billion for the NIH in FY 2022.

    The explanatory statement also acknowledges the especially burdensome impact of COVID-19 on the research workforce and encourages the NIH to develop a standardized approach to support affected researchers across institutes and centers.

    Like the House bill, the Senate draft includes a provision requiring institutions that receive NIH funding in FY 2022 and beyond to notify the NIH if key personnel or a principal investigator in an NIH notice of award is removed due to concerns about harassment, and the legislation permits the NIH to issue regulations to implement the new requirement.

    The Senate draft also directs the HHS and the NIH to convene the National Science Advisory Board for Biosecurity to review the intended purpose and scope of the HHS Framework for Guiding Funding Decisions about Proposed Research Involving Enhanced Potential Pandemic Pathogen Care and Oversight to review safe research practices for potential pandemic pathogens.

    The Ad Hoc Group for Medical Research issued an Oct. 19 press statement in response to the Senate draft bill expressing appreciation for the proposed increase in the NIH’s base budget with a supplemental investment for ARPA-H, reiterating the historic bipartisan support for the agency, and urging Congress to quickly enact the House-passed FY 2022 funding level for the NIH.

    Agency for Healthcare Research and Quality (AHRQ)

    The draft bill would match the $380 million passed by the House and proposed by the president for AHRQ, representing an increase of $42 million (12%) over the comparable FY 2021 funding level.

    Centers for Disease Control and Prevention (CDC)

    The draft bill would provide a total of $9.7 billion in program level funding for the CDC, an increase of $1.9 billion (24%) above the FY 2021 enacted level, compared to the House-passed increase of $2.7 billion. Within the CDC total, the bill includes $600 million in new funding to support annual investments in general and core public health infrastructure and capacity nationwide, compared to $1 billion approved by the House.

    The draft would provide $40 million, a $10 million (33%) increase over both FY 2021 and the president’s request, and $5 million more than the House, for the Advanced Molecular Detection program to continue advancing genomic sequencing and surveillance capabilities.

    The bill also matches the House-passed bill and president’s request for $115 million for a new evidence-based community violence intervention program to fund a broad range of programs to prevent intentional violence and $153 million for the Social Determinants of Health program.

    Health Resources and Services Administration (HRSA)

    The draft Labor-HHS-Education bill includes $884.6 million for HRSA Title VII health professions and Title VIII nursing workforce development programs in FY 2022, a $130.75 million (17%) increase above FY 2021 comparable levels. By comparison, the House-passed bill would provide $980 million for the Title VII and Title VIII programs, a $226 million (30%) increase over FY 2021 enacted levels.

    The FY 2022 Senate proposal contains increases to the Title VII workforce diversity programs including a $3.5 million increase for the Health Careers Opportunity Program, a $3 million increase for Centers of Excellence, and a $1 million increase for Scholarships for Disadvantaged Students.

    The legislation includes funding for additional programs administered by HRSA, including $375 million for the Children’s Hospitals Graduate Medical Education program, a $25 million (7%) increase over FY 2021 enacted levels. The legislation also proposes $150 million for the National Health Service Corps (NHSC) for its discretionary funding mechanism, a $30 million (25%) increase over FY 2021 enacted levels. The NHSC also receives $310 million in mandatory funding per year and received $800 million in emergency supplemental funding in the American Rescue Plan.

    Within the HRSA Office of Rural Health Policy, the draft legislation provides $12.7 million for the Rural Residency Program, a $2.2 million (21%) increase over FY 2021 values, and $39 million for telehealth programs, a $5 million (15%) increase over FY 2021 enacted levels.


    The spending bill would provide $296.7 million for the Hospital Preparedness Program (HPP) within the Office of the Assistant Secretary for Preparedness and Response, a $16.2 million (6%) increase over FY 2021. The House-passed bill included a total of $320 million, while the president proposed $293 million. In addition to funding for the core HPP cooperative agreements, like the House-passed bill, the Senate draft includes increases for the National Emerging Special Pathogen Training and Education Center (NETEC) and for Regional Ebola and other Special Pathogen Treatment Centers (RESPTC). The draft bill also would boost other preparedness programs, including the CDC’s Public Health Emergency Preparedness program, the Biomedical Advanced Research and Development Authority, the Strategic National Stockpile, and pandemic flu efforts.

    Department of Education

    The Labor-HHS-Education bill, which also funds the Department of Education, includes $1.2 billion for Federal Work-Study, a $40 million (3%) increase over FY 2021 levels and the president’s budget request. Additionally, the bill would provide $100.5 million for the Strengthening Historically Black Graduate Institutions Program, a $13.3 million (15%) increase over FY 2021 values and $1.7 million under the president’s budget request and House-passed levels.

    National Science Foundation (NSF)

    The Senate Appropriations Committee also unveiled the draft Commerce, Justice, Science, and Related Agencies spending bill, which would provide the NSF with $9.5 billion in FY 2022, representing an increase of $1 billion (12%) over the comparable FY 2021 funding level. In comparison, the House Appropriations Committee-passed legislation included $9.6 billion for the NSF, while the president requested $10.2 billion for FY 2022. Of that total, the Senate draft bill would provide $7.7 billion for research and related activities, an increase of 11% over FY 2021 and the same level included in the House-passed bill. Additional details are provided in the explanatory statement.

    Reports indicate that the Senate Appropriations Committee will skip the markup process for the remaining bills to proceed directly to conference with House appropriators before the current continuing resolution is set to expire on Dec. 3 [refer to Washington Highlights, Oct. 1].