Senate Appropriations Committee Republicans released all 12 of their draft fiscal year (FY) 2021 spending bills on Nov 10, including funding levels for the departments of Health and Human Services (HHS), Education, and Veterans Affairs (VA), as well as the National Science Foundation (NSF).
The committee also announced it would skip the markup process and begin conferencing with the House of Representatives, who passed most of their bills earlier this summer, before government funding expires on Dec. 11 [see Washington Highlights, Oct. 2].
Upon release of the draft bills, Senate Appropriations Chair Richard Shelby (R-Ala.) noted, “By and large, these bills are the product of bipartisan cooperation among members of the committee. As negotiations with the House begin in earnest, I look forward to working with Chairwoman Lowey, Vice Chairman Leahy, and Ranking Member Granger to resolve our differences in a bipartisan manner.”
Chairman Shelby had canceled earlier consideration of the FY 2021 bills by individual subcommittees over the summer after Republicans and Democrats were unable to come to agreement about including provisions related to COVID-19 and social justice as part of the annual spending bills.
“I am very disappointed that the majority chose to cancel Committee mark ups of the FY 2021 bills and that the bills were not considered by the full Senate, eliminating the ability of members to offer amendments. However, our goal is to work with the House to conference all twelve appropriations bills and avert a government shutdown,” responded Ranking Member Patrick Leahy (D-Vt.).
According to the Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS-Education) explanatory statement, the draft legislation would provide the HHS with $96.3 billion in base discretionary funding for FY 2021 — an increase of $1.9 billion (2%) over the comparable FY 2020 funding level. By comparison, the House-passed bill would provide the HHS with $96.4 billion [see Washington Highlights, Aug. 7].
Based on a preliminary review of the bill text, the draft bill provides a total of $43.7 billion for the National Institutes of Health (NIH) in FY 2021 — an increase of $2 billion (4.8%) above the FY 2020 enacted level. The NIH funding level includes the full $404 million provided in FY 2021 through the Innovation Account established in the 21st Century Cures Act for specific initiatives. The Senate bill does not provide any emergency supplemental funding in the FY 2021 spending bill, unlike the House-passed bill which included $42 billion in regular appropriations (a $500 million, or 1.2%, increase) and $5 billion in emergency supplemental funding. Senate Republican leaders proposed separate legislation in July to provide COVID-19-related emergency funding for the NIH and other agencies.
The Senate’s committee-prepared summary highlights a sixth straight year of increased investments in the NIH, totaling an increase of $13.6 billion (45%) starting in FY 2016. The summary also highlights investments in Alzheimer’s disease and related dementias research ($354 million), the president’s premature birth initiative ($50 million), and cancer research investigator grants ($87.5 million).
The Ad Hoc Group for Medical Research, convened by the AAMC, issued a press statement in response to the release of the Senate bill expressing appreciation for the proposed increase in the NIH’s base budget, praising the bipartisan support for the NIH, and urging Congress to quickly enact both FY 2021 spending and emergency supplemental funding to combat COVID-19.
The legislation provides the Centers for Disease Control and Prevention (CDC) with a program level of $7.8 billion for FY 2021 — a $130 million (1.7%) increase over FY 2020 enacted levels. This compares to the House-passed funding level of $8 billion (a $232 million, or 3%, increase over FY 2020). However, the bill does not include the $25 million included in the House spending bill for the CDC to conduct gun violence research.
The draft Labor-HHS-Education bill includes $750.67 million for the Health Resources and Services Administration (HRSA) Title VII health professions and Title VIII nursing workforce development programs in FY 2021 — a $16.16 million (2.2%) increase above FY 2020 comparable levels. By comparison, the House bill passed over the summer would provide $782.5 million for the Title VII and Title VIII programs — a $48 million (6.5%) increase over FY 2020 enacted levels.
While the Senate legislation proposes eliminating the Health Careers Opportunity Program (HCOP), the bill includes increases for other health workforce diversity programs, such as Scholarships for Disadvantaged Students and Minority Faculty Loan Repayment.
The legislation includes funding for additional programs administered by HRSA. The committee allocates $355 million for the Children’s Hospitals Graduate Medical Education program (CHGME) — a $15 million (4.4%) increase over FY 2020 enacted levels. The legislation also proposes $120 million for the National Health Service Corps (NHSC) and $10 million for the Rural Residency Program, both flat-funded from FY 2020.
The Labor-HHS-Education bill, which also funds the Department of Education, provides $1.18 billion for the Federal Work Study program, flat-funded from FY 2020. By comparison, the House bill provided $1.21 billion — a $30 million (2.5%) increase over FY 2020 enacted levels for Federal Work Study. The draft bill provides no additional funds for the Temporary Extended Public Service Loan Forgiveness (PSLF) program, while the House bill provided $50 million.
The draft Military Construction, Veterans Affairs, and Related Agencies spending bill and explanatory statement provides a total of $800 million for the VA Medical and Prosthetic Research program, providing no change from the FY 2020 funding level. This compares to a House-passed budget of $840 million for VA research (a 5% increase over FY 2020). The bill also provides a total of $20.9 billion for FY 2021 VA Medical Community Care at non-VA facilities — a $5.6 billion (36.6%) increase over FY 2020.
Finally, the Commerce, Justice, Science, and Related Agencies spending bill and explanatory statement would provide the NSF with $8.48 billion in FY 2021, representing an increase of $198 million (2.4%) from the comparable FY 2020 funding level. This compares to $8.55 billion (3.3%) in the House-passed FY 2021 bill.