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Appropriations Subcommittees Hear Testimony From Secretary Sebelius on FY13 Budget

March 9, 2012—Members of the House and Senate Labor-HHS-Education Appropriations Subcommittees questioned Secretary of Health and Human Services (HHS) Kathleen Sebelius at two respective hearings about the administration’s proposed FY 2013 funding levels for the National Institutes of Health (NIH), Children’s Hospitals Graduate Medical Education (CHGME), and Title VII health professions programs [see Washington Highlights, Feb. 17].

At the March 7 Senate hearing, Ranking Member Richard Shelby (R-Ala.) said the president’s budget request “abandons  our nation’s commitment to  advancing medical research” and asked how the NIH will “maintain its scientific rigor and innovation when the budget request does not keep pace with biomedical inflation.” Similarly, Senator Jerry Moran (R-Kan.) expressed concern that without consistent funding at the NIH “we [will] begin to lose the infrastructure and the commitment of young people to research and to science.” The senator also noted that NIH funding “is critical in our global competitiveness and ultimately in saving health care costs.” The secretary responded that NIH is prepared to do more with less by reforming grant policies to allow for 672 new grants and by creating the National Center for Advancing Translational Sciences (NCATS).

In response to a question from Subcommittee Chair Tom Harkin (D-Iowa) about the impact of “possible sequestration” on HHS programs, Secretary Sebelius described that the expected 7.8 percent cut to discretionary programs scheduled to take effect January 2013 “would have a huge impact across our department.” She projected that as a result of the cut, 2300 NIH grants would be discontinued.

Senators Mark Pryor (D-Ark.) and Sherrod Brown (D-Ohio) praised the Title VII Area Health Education Center (AHEC) program as a key component in meeting the health care needs of rural and underserved populations. The president’s budget proposes to eliminate the program, which Senator Brown said only will increase the shortage of primary care providers and hurt vulnerable populations.

Like her Senate counterpart, House Subcommittee Ranking Member Rosa DeLauro (D-Conn.) at the March 6 House hearing expressed disappointment over the proposed flat funding of the NIH, saying that a “key priority is medical research at the NIH, the National Institutes of Health to find better treatments and cures for diseases like cancer and Alzheimer's. While we were able to provide a modest increase for NIH in 2012, it was not enough to reverse the cut enacted for 2011, and due to the combination of reduced funding and rising cost, the number of research project grants made by the NIH is now at the lowest level since 2001.” She also criticized the president’s budget cuts to CHGME, and health professions training, and said she hopes to find a way to avoid the cuts. 

Rep. Kay Granger (R-Texas) questioned how some areas in the budget such as the Centers for Medicaid and Medicare Services (CMS) received significant boosts while others like CHGME were hit with major cuts. Secretary Sebelius told the subcommittee that the administration made strategic choices to best use the resources in the budget climate. The secretary went on to say that there are other venues that support pediatrics such as the National Health Service Corps, Title VII Scholarships for Disadvantaged Students, the previously unfunded Title VII Pediatric Loan Repayment program, and other Affordable Care Act initiatives.

Rep. Jesse Jackson, Jr., (D-Ill.) challenged the president’s proposal to eliminate the Title VII Health Careers Opportunity Program (HCOP) and to instead focus those funds on programs that immediately produce primary care providers. Rep. Jackson said this strategy does not take into account the importance of recruiting individuals into health professions or encouraging health care providers to practice in underserved communities. He said that “if no effort is made to provide opportunities for disadvantaged students from medically underserved communities like through HCOP, the training funds are more likely to be distributed among those who will end up serving in non-medically underserved communities.” Rep. Jackson urged Congress to focus funding on programs such as HCOP that not only improve diversity of the health professions and help address the nation’s health disparities, but also graduate individuals who are more likely to serve in underserved areas.

Members at both hearings inquired about the administration’s implementation of the Affordable Care Act (P.L. 111-148 and P.L. 111-152), including the expected cost for states and HHS’s fraud and abuse efforts. Senator Barbara Mikulski (D-Md.) emphasized the importance of training the next generation of health providers and researchers in quality, and Senator Herb Kohl (D-Wis.) encouraged HHS to expedite implementation of the “Sunshine” rule [see Washington Highlights, Feb. 24].


Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525

Alexandra Khalife
Legislative Analyst
Telephone: 202-828-0418


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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