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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 Slams Administration’s NIH Budget Request, F&A Proposal

June 23, 2017—Both Republican and Democratic members of the Senate Labor-HHS-Education Appropriations Subcommittee rejected the president’s fiscal year (FY) 2018 budget request for the National Institutes of Health (NIH) [see Washington Highlights, May 26] – including the administration’s proposal to limit NIH reimbursement for facilities and administrative (F&A) expenses – at a June 22 hearing featuring NIH Director Francis Collins, M.D., Ph.D. and the directors of six NIH institutes.

Subcommittee Chair Roy Blunt (R-Mo.) characterized the administration’s proposed cut to NIH as “unacceptable,” describing the job losses and decreased economic activity that would result.

Senators in both parties also expressed strong concerns over the budget proposal to limit NIH F&A support, also referred to as “indirect costs.” Senator Lamar Alexander (R-Tenn.), who chairs the Senate Health, Education, Labor, and Pensions (HELP) Committee, slammed the recommendation as “harebrained” and an “awful idea” that is “bad policy,” noting that institutions use their own funds to pay for many expenses that current F&A reimbursement does not cover. “The net effect [of proposals to reduce F&A support] would be less research,” he chided, “and less research ... means more jobs moving overseas.”

Senator Alexander also warned the administration, “If there’s to be any changes to this, Congress wants to be involved. I’m going to get in the middle of that, and I’ll bet I can get a bipartisan group up to make sure we are.” Instead, he said, the administration should be looking at opportunities to reduce the administrative burden associated with research, a point Senator James Lankford (R-Okla.) also encouraged.

Full Committee Ranking Member Patrick Leahy (D-Vt.) and Subcommittee Ranking Member Patty Murray (D-Wash.) described the expected consequences of the F&A proposal on research institutions in their states. In response to a question from Senator Murray about what the impact would be if the F&A limitation were applied to the NIH’s intramural program, Dr. Collins responded, “I’m having a hard time imagining how we would manage that.”

Dr. Collins also noted that NIH is hoping to work with the community to identify and potentially address some administrative burdens, such as regulations on conflicts of interest, animal care, and effort reporting, but indicated, “Frankly, I don’t think it would add up to an enormous difference in what we’re currently asking our grantee institutions to do, and they are the ones who do the work. We depend on them.”

Chairman Blunt also inquired about the administration’s proposal to eliminate the NIH’s Fogarty International Center (FIC), which Anthony Fauci, M.D., director of the NIH’s National Institute of Allergy and Infectious Disease (NIAID), described as central to recent efforts to combat Ebola and Zika by training scientists abroad, since “Infectious disease knows no borders.”

In response to a question from the chairman about the budget request’s establishment of a new NIH institute to replace the Agency for Healthcare Research and Quality (AHRQ), Dr. Collins described the two agencies’ work as complementary, and acknowledged that an alternative model to the president’s proposal would be to disperse AHRQ’s existing work throughout NIH’s existing institutes and centers.

Senators Dick Durbin (D-Ill.) and Jerry Moran (R-Kan.) both suggested opportunities to help NIH attract better name recognition within the general public, with Senator Durbin hinting at an interest in labelling products that originate from NIH-funded research.

Senator Moran also asked how NIH research differs from research supported through the Department of Veterans Affairs and expressed concern over NIH’s support for researcher salaries, which he indicated he planned to revisit after the hearing.

In addition to the questions about NIH’s work, Senators Murray and Jeanne Shaheen (D-N.H.) also alluded to legislation released the same day to replace the Affordable Care Act (see related story). Both senators described challenges that would result from the efforts, including reduced access for patients seeking treatment for substance use disorders and other conditions.

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

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