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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

Senate Panel Boosts NIH, Health Professions Funding

July 12, 2013—The Senate Appropriations Committee July 11 approved an FY 2014 Labor-HHS spending bill (S. 1284) that restores funding for medical research and health professions training to pre-sequestration levels.  The committee approved the $164.3 billion bill by a 16-14 party-line vote.

The Senate Labor-HHS-Education Appropriations Committee approved the bill July 9 by voice vote. In a July 9 statement, AAMC President and CEO Darrell Kirch, M.D., praised the subcommittee for restoring funding “for essential federal health programs such as the National Institutes of Health, workforce development programs under the Health Resources and Services Administration (HRSA), and other critical elements of the nation’s public health infrastructure.”  Dr. Kirch also thanked Labor-HHS Chair Tom Harkin (D-Iowa) for his leadership and support of these programs.

The committee defeated, 14-16, an amendment offered by Senator Jerry Moran (R-Kan.) to take a proposed $1.35 billion increase to the Centers for Medicare and Medicaid Services (CMS) for implementation of health insurance exchanges and transfer it to NIH.  The committee also rejected, 15-15, a Moran amendment to defund the Independent Payment Advisory Board and transfer those funds to the Children’s Hospital Graduate Medical Education program.

NIH: The bill provides $30.947 billion for NIH, an increase of $307 million over the FY 2013 enacted level prior to sequestration, and $2.021 billion (7 percent) over the FY 2013 level after sequestration and transfers. The bill retains the salary limit on extramural grants at NIH and other programs funded by the bill at Level II of the Executive Pay Schedule ($179,700 in 2013).

According to a summary released by the committee, the funding level in the bill will allow NIH to allocate $40 million for the new Brain Research through Application of Innovative Neurotechnologies (BRAIN) Initiative.

The committee rejected the administration’s proposal to eliminate the Science Education and Partnership Awards (SEPA) program within the Office of the Director (OD) and consolidate it within the Education Department as part of a government-wide reorganization of STEM education activities. In report language, the committee notes it “is not convinced that the quality of these programs would be maintained if they were moved to other Federal agencies” and directs NIH to continue funding these programs in FY 2014. The committee’s bill includes sufficient funding within OD to support SEPA and the Office of Science Education.

The bill also provides: 

  • $276 million for the Institutional Development Award (IDeA) program, the same as FY 2013 before sequestration; 
  • $50 million for the Cures Acceleration Network; and 
  • An $84 million increase for the National Institute on Aging for research on Alzheimer’s disease.

The bill also expands the requirement to provide access to the tax payer funded research beyond NIH to other federal agencies funded in the bill.

Health Professions: The bill provides $536.2 million for the Health Resources and Services Administration (HRSA)’s Title VII health professions and Title VIII nursing workforce programs, a $98 million (22.4 percent) increase over the FY 2013 post-sequestration levels. Within this total, Title VII receives $285.1 million, a $64.5 million (29.3 percent) increase over the FY 2013 post-sequestration levels. The bill provides $14.9 million for the Health Careers Opportunity Program (HCOP) and $30 million for the Area Health Education Centers (AHEC) program, which the president’s FY 2014 budget proposed to eliminate. The bill provides increases for physician assistant training programs and workforce information and analysis, as well as $5 million for the previously unfunded Pediatric Specialty Loan Repayment program authorized in the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). As proposed in the president’s FY 2014 budget, the bill includes a $5.3 million transfer from the Prevention and Public Health Fund (PPHF) Alzheimer’s Fund to the geriatrics programs. The bill also includes a $25 million transfer from the PPHF to the public health and preventive medicine programs, which did not not receive a transfer from the Fund in FY 2013. Remaining Title VII programs are funded at essentially the FY 2013 pre-sequestration levels.

For Title VIII nursing workforce programs, the bill provides $251.1 million, a $33.6 million (15.4 percent) increase over the FY 2013 post-sequestration levels. Within this total, the bill provides $83.5 million for the Advanced Education Nursing program intended to increase the number of advanced practice registered nurses, and funds remaining Title VIII programs at essentially FY 2013 pre-sequestration levels.

More information on the funding levels for each of the Title VII and Title VIII programs can be found in the AAMC-led Health Professions and Nursing Education Coalition (HPNEC) funding chart.

Children’s Hospitals Graduate Medical Education (CHGME): The bill provides $267.3 million for HRSA’s CHGME program, rejecting the president’s FY 2014 proposal to eliminate “indirect” funding for the program. The committee-approved funding level is level with funding appropriated in FY 2013, pre-sequestration.

National Health Care Workforce Commission: As in past years, the committee provides $3 million for the National Health Care Workforce Commission established in the Affordable Care Act as an independent advisory body. Though the Government Accountability Office appointed commissioners  Sept. 30, 2010 [see Washington Highlights, Oct. 1, 2010], to date, Congress has not approved an appropriation to fund the commission’s activities. Like the committee, the president’s FY 2014 budget request proposed $3 million for the commission.

Agency for Healthcare Research and Quality (AHRQ): For AHRQ, the committee provides $364 million through the Public Health Service Evaluation tap, $5 million less than the FY 2013 funding level but $30 million more than the president’s FY 2014 request. The committee also transfers $7 million from the Prevention and Public Health Fund to AHRQ to administer the U.S. Preventive Services Task Force, for $371 million in total appropriations. AHRQ also is scheduled to receive $100 million from the Patient-Centered Outcomes Research Trust Fund (PCORTF) in FY 2014, bringing total funding for the agency to $471 million, $37 million over FY 2013 and the president’s FY 2014 request.

Senate Appropriations Chair Barbara Mikulski (D-Md.) said she plans to take the Labor-H bill to the Senate floor, which would mark the first time that has occurred since 2007. However, Senator Jeff Sessions (Ala.), the ranking Republican on the Senate Budget Committee, said he will block the appropriations bills from coming to the Senate floor because they are based on an overall spending cap of $1.058 trillion, which exceeds the $967 billion discretionary spending cap mandated under the Budget Control Act (BCA) of 2011 [P.L. 112-25]. 

House Republicans adopted the BCA limit when making their subcommittee allocations, but exceeded the $498 billion cap on defense spending [see Washington Highlights, May 24]. As a result, the allocation for the House Labor-HHS bill is $121.8 billion, which is $43 billion (26 percent) less than the Senate bill.  No date has been set for the House Labor-HHS subcommittee markup, and Democrats on the subcommittee have expressed skepticism the subcommittee will consider a bill.

Contact:

Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559
Email: dbmoore@aamc.org

Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525
Email: trasouli@aamc.org

Alexandra Khalife
Legislative Analyst
Telephone: 202-828-0418
Email: akhalife@aamc.org

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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org