NIH Slated for a $2B Increase in the Senate Bill, $1.25B in the House Subcommittee Bill.
The Senate Appropriations Committee on June 28, approved the fiscal year (FY) 2019 HHS funding bill. The Senate Labor-HHS-Education Appropriations Subcommittee passed the bill on June 26, and the House subcommittee approved their version on June 15. Two mark-ups scheduled by the House Appropriations Committee (for June 19 and 26) were canceled. A new mark-up date has not been scheduled. Before the June 26 mark-up was canceled, the House Appropriations Committee posted the draft committee report on the bill. The House Subcommittee bill and report are posted on-line. The Senate Appropriations Committee is expected to post their bill and report shortly. ASPPH was able to obtain copies at the Committee mark-up.
The current House and Senate versions of the FY 2019 HHS appropriations bill fund all of ASPPH’s priorities.
Highlights of the bills:
National Institutes of Health
FY 2018 Enacted $37,084,000,000
FY 2019 House $38,334,000,000 (+$1.25B or 3.38 percent)
FY 2019 Senate $39,084,000,000 (+$2.00B or 5.39 percent)
Provisions of Note:
- The House bill provides $76.637M (+$904K or 1.2 percent) for the Fogarty International Center. The Senate bill provides $78.15M (+$2.42M or +3.4 percent).
- Both the House and Senate bills keep the NIH salary cap at Executive Level II (currently $189,600).
- Both the House and the Senate reject the Administration’s request to limit the percentage of a researcher’s salary that may be paid from NIH grant funds. The House report says, “the impact of this policy change is unclear.” The Committee requests “an analysis of the projected impact of such a policy change on the number and average cost of NIH grants, as well as on academic institutions.”
- The Senate report admonishes NIH for not having sufficient public health and behavioral or social science representation on its advisory committees. The report states, “The Committee is aware that there is a legal requirement of Federal statute (Title 42 of the US Code, Subchapter III; Part B, Subsection 284A) that all NIH Directors Advisory Councils have at least two representatives from the fields of public health and the behavioral or social sciences. There are a few Directors Advisory Councils that may not be adhering to this requirement. The Committee urges continued compliance with this statute and requests a report on compliance including a list of each Advisory Council’s behavioral, social sciences and public heath members.”
- The House report says it expects NIH to provide trainee stipend increases consistent with any FY 2019 Federal employee pay raise.
- The House report requests a detailed report on the Environmental Influences on Child Health Outcomes (ECHO) program, consisting of “a summary of progress made to date, including an analysis of the composition of the funded cohort studies, the capacity of the Network to conduct trials among rural and underserved children, and the short- and long-term goals of the program.”
- The House report imposes new reporting requirements on the Foundation for NIH Research.
- The Senate report notes that “the modular budget cap has not increased with inflation, and that grant applications with necessary costs above the modular budget cap incur additional administrative responsibilities. The Committee requests an update from NIH in the fiscal year 2020 [Congressional Justification] regarding the effect of modular budget cap increases on reducing administrative burdens while maintaining appropriate fiscal oversight of grant costs.”
- Both the House and the Senate rejected the Administration’s proposal to move parts of the National Institute for Occupational Safety and Health (NIOSH) from CDC to NIH; and to fold the Agency for Healthcare Research and Quality (AHRQ) and the National Institute on Disability, Independent Living, and Rehabilitation Research (Dept. of Education) into NIH as new institutes.
Centers for Disease Control and Prevention
FY 2018 Enacted $8,301,166,000
FY 2019 House $7,638,266,000 (-$662.9M or -8.7 percent)
FY 2019 Senate $7,868,141,000 (-$433.0M or -5.2 percent)
Other Provisions of Note:
- Due to the transfer of the Strategic National Stockpile to the Assistant Secretary for Preparedness and Response and the one-time funding provided CDC in FY 2018 for a new bio-containment facility on the CDC’s Atlanta campus, the House bill actually represents a $427M increase and the Senate bill a $47M increase in the comparable program level over FY 2018.
- Within the CDC account, both the House and the Senate provided level funding for the Prevention Research Centers ($25,461,000), the Centers for Public Health Preparedness ($8,200,000), the NIOSH Education and Research Centers ($29,000,000) and the NIOSH Agricultural Forestry and Fishing Centers ($25,500,000).
- The House bill ends the CDC Climate Change program (-$10M) but the House funded it at the same level as in FY 2018 ($10M).
- The House bill provides $300M to establish an Infectious Disease Rapid Resource Research Fund. According to the House, “The Reserve Fund, in which funds will be available until expended, will provide an immediate source of funding to quickly respond to a future, imminent infectious disease crisis that endangers American lives without waiting for Congress to act on a supplemental funding bill.” The Senate is silent on the initiative.
- The House report imposes new reporting requirements on the Foundation for the CDC.
- Both the House and the Senate provided $488.621M for CDC’s Global Health account, the same as in FY 2018.
- Both the House and the Senate bill keep the so-called Dickey amendment that prohibits the use of Federal funds for lobbying activities related to gun control. Neither the House or the Senate provided dedicated funding for firearms research.
Health Resources and Services Administration
FY 2018 Enacted $7,013,953,000
FY 2019 House $6,857,585,000 (-$156.368M or -2.23 percent)
FY 2019 Senate $7,133,953,000 (+$120.0M or +1.71 percent)
Other Provisions of Note:
- Both the House and Senate bills provide $17 million for the “Public Health and Preventive Medicine” line, the same as in FY 2018. The line funds the Public Health Training Centers ($9.86M) and Preventive Medicine Residency Programs ($7.14M).
- The House bill kills the Family Planning (Title X) program (-$286.5M).The Senate level funded the program at $286,479,000.
Agency for Healthcare Research and Quality
FY 2018 Enacted $334,000,000
FY 2019 House $334,000,000 (+$0 or 0 percent)
FY 2019 Senate $334,000,000 (+$0 or 0 percent)
Other Provisions of Note:
- AHRQ also is expected to receive $124.3M in mandatory funds from the Patient- Centered Outcomes Research Trust Fund (PCORTF), an increase of $24.5M over the FY 2018 level.
Other Appropriations News
- Within the HHS Office of the Secretary account, the House killed the Teen Pregnancy Prevention Grant Program (-$108M) but the Senate provided $101M (-$7M or -6.5 percent).
- The House and Senate Appropriations Committees have completed action on the FY 2019 Department of State, Foreign Operations, and Related Programs Appropriations Act. The House approved $8.69B for Global Health Programs at the Dept. of State and USAID, the same level as in FY 2018. The Senate approved $8.792B, an increase of +$102M or +1.2 percent. The House slashed the family planning and reproductive health account by -$146.5M (or -24 percent). The Senate funded the account at $632.6M (+$25.1M or +4.1 percent).