The Senate Appropriations Committee June 9 approved, 29-1, its version of the fiscal year (FY 2017) Labor-HHS-Ed appropriations bill (S. 3040, S.Rept. 114-274).
Both Republicans and Democrats praised the legislation as the first bipartisan bill to come out of the subcommittee in seven years. Sen. Barbara Mikulski (D-Md.), the ranking member of the committee, said she supports the bill, which is free of “poison pill” policy riders.
Following the June 7 approval of the bill by the Labor-HHS-Education Subcommittee, AAMC President Darrell Kirch, M.D. praised the committee for its bipartisan recognition of "the value of medical research” and said the $2 billion increase in NIH funding “would expand the capacity of researchers at medical schools and teaching hospitals nationwide to pursue potential treatments for the most pressing health challenges by continuing the momentum of real funding growth enacted last year."
The committee's bill provides $161.9 billion in base discretionary spending, which is $270 million below the FY 2016 level and $2 billion below the president's budget request.
Sen. Patty Murray (D-Wash.), the ranking member of the Labor-HHS subcommittee, said, “I am hopeful that Democrats and Republicans can work together to build on our bipartisan budget deal and restore additional investments in defense and non-defense priorities, which would allow us to improve this bill with additional resources for education and other priorities. Many Republicans are talking right now about increasing the defense investments, and I am hopeful that as this process continues we can reach an agreement to restore investments in a fair way that helps middle class families and the economy as well.”
The House Appropriations Committee has not scheduled consideration of its version of the bill.
Of particular interest for medical schools and teaching hospitals:
NIH: The bill provides $34 billion for NIH in FY 2017, a $2 billion (6.3 percent) increase.
In its report, the committee notes it “strongly believes that in this difficult budget environment that the Labor-HHS-Education appropriations bill must continue to prioritize and recognize the essential role biomedical research plays in every American’s life…. A continued commitment to NIH is essential to address our Nation’s growing health concerns, spur medical innovation, sustain America’s competitiveness, and reduce healthcare costs.”
The committee report states the “recommendation allocates funding to areas holding the most extraordinary promise of scientific advancement, while allowing NIH to maintain flexibility to pursue unplanned scientific opportunities and address unforeseen public health needs.” The committee estimates its recommendation is estimated to support over 11,200 new and competing grants in FY 2017, an increase of 4.2 percent above the current year.
The committee’s increase includes:
- $1.39 billion for Alzheimer’s disease research, an increase of $400 million;
- $300 million for the Precision Medicine Initiative, an increase of $100 million;
- $250 million for the BRAIN Initiative, an increase of $100 million;
- $333.4 million for the Institutional Development Award (IDeA) program, an increase of $12.5 million; and
- $463 million to Combat Antibiotic Resistant Bacteria, an increase of $50 million.
The bill also retains the salary cap on extramural grants at Executive Level II ($185,100 in 2016).
AHRQ: The bill provides $324 million for the Agency for Healthcare Research and Quality (AHRQ), which is $10 million (2.9 percent) below the FY 2016 level.
Children’s Hospitals Graduate Medical Education (CHGME): The committee’s bill provides $300 million for the CHGME program, which is a $5 million (1.7 percent) increase above the FY 2016 level.
Title VII and Title VIII Health Professions Programs: Title VII Health Professions receives $297.3 million, which is a 13.3 percent increase above the FY 2016 level. The dramatic increase is due in large part to the committee’s decision to transfer the Behavioral Health Workforce Education and Training (BHWET) program from the Substance Abuse and Mental Health Services Administration to the Health Resources and Services Administration and provides$50 million for the program. The committee’s bill also eliminates the Health Careers Opportunity Program (HCOP) for the second consecutive year. The bill does provide increased funding for the Scholarships for Disadvantaged Students program to $49.1 million, which is a $3.1 million (6.7 percent) increase above FY 2016 levels. The Title VIII Nursing programs receive $229.5 million, which is the same as the FY 2016 level.
340B Drug Pricing Program: The bill includes language establishing a user fee of 0.1 percent of each purchase of 340B drugs by covered entities. The committee expects the fee to generate $9 million to support HRSA’s program integrity efforts, as recommended in the administration’s FY 2017 budget request. The bill does not include the regulatory authority proposed by HRSA; instead, the committee’s report acknowledges the proposed omnibus guidance released by the agency in 2015, and calls on HRSA “to consider carefully the comments received from all stakeholders.”