LEGISLATIVE UPDATE: Rescission Package & the Status of Appropriations
The Senate has voted down a key White House priority when it defeated the House amended rescission package, in a procedural 48-50 vote. The vote on the measure, which had already passed in the House, was held open for 90 minutes. The Academy is delighted that the Senate is continuing to support NIH and its increases, by defeating this rescission package.
Status of Appropriations:
June 28, 2018 – The Senate Committee on Appropriations has advanced the Labor, Health and Human Services, Education, and Related Agencies Appropriations Act, 2019, the largest non-defense bill. The committee approved funding measure contains $179.3 billion, an increase of $2.2 billion from FY2018, of base discretionary funding for the Departments of Labor, Health and Human Services, and Education and Related Agencies. This bill also includes $711 million in accordance with the 21st Century Cures Act, $2.3 billion for Alzheimer’s disease research, $429 million for the BRAIN initiative, $560 million for the Clinical and Translational Science Award, $376 million for the All of Us precision medicine initiative, and $120 million for research on a universal flu vaccine. This measure was passed with a vote of 30-1.
The House Appropriations Committee was scheduled to consider its version of the FY 2019 spending bill, but the committee has postponed that markup until a date to be determined; the House committee did, however, post the report to accompany the committee’s spending bill, with language on NIH running from pages 51 through 75 of the report and funding tables on pages 211 through 213.
LEGISLATIVE UPDATE: Rescission Package
The Trump administration has submitted to Congress last Thursday a $15.4 billion rescissions package. The rescission package does not directly impact the FY2018 Omnibus nor does it take any funds from NIH. Nearly half of the cuts, or $7 billion, would come from unspent Children’s Health Insurance Program funds, and almost $5 billion would be cut from dormant Energy Department loan programs, in addition to other programs listed.
It is not clear yet whether there is any potential indirect impact on FY2019 appropriations efforts re subcommittee allocations. This is important to note as Congress understood that these “unallocated or dormant” funds would be available to them in the appropriations process when it set overall funding levels in the 2017 budget deal for FY2018 and FY2019. Congress was already, in essence, including responsible rescissions of CHIP funds and the “changes in mandatory programs savings” (CHIMPS) to make room in the bill for more adequate funding levels for public health and health research. To take them back now is a backdoor way of reneging on the deal and would reduce nondefense discretionary funding BELOW what members of Congress agreed to in the two year budget deal, particularly for the Labor-HHS bill, where NIH receives its funds.
Under the 1974 Impoundment Control Act (ICA) budget law, Congress will have 45 calendar days “of continuous session” (includes weekends and holidays, but not days where Congress recesses for more than 3 days) to consider the rescission package. If the relevant committees have not acted within 25 days, a member of either chamber supporting the rescissions measure may seek to discharge the package from committee with the support of at least one-fifth of the chamber in question. It is expected that the House will pass the package. It is far less certain what will happen in the Senate. The Senate parliamentarian is likely looking into the requirement for a 60-vote threshold.
The following is a summary on the status of funding for NIH broadly and NIBIB specifically. The most recent Consolidated Appropriations Act of 2018 signed into law last Friday, March 23rd paved the way for large budget increases for NIH and NIBIB. This is great news and the Academy and the medical research advocacy community hope to continue that robust budget trajectory into the FY2019 appropriation determinations.
Recall, in February of this year, a two-year budget deal (Bipartisan Budget Act of 2018) was agreed to by Congress that raised the spending caps for both defense and non-defense spending for FY2018 and FY2019 by $296 billion. Thus, while more than a majority goes to defense it did provide non-defense discretionary spending with an additional $60 billion in FY2018 and $18 billion in FY2019. Please note that in FY19 the money available will be just a fraction of the extra money they were able to spread around for FY2018 (from 60B to 18B), and the competition for this will be strong.
When discussing appropriations, there are many complicating factors. One must know if they are talking about budget authority (the amount Congress appropriates) or outlays (the amount the agency actually spends). It does not matter which you use, as long as the numbers are consistent. We generally will use budget authority, because that is the lobbying target. Outlays are influenced by a series of external factors that we often cannot control. The numbers below are stated in budget authority.
The Consolidated Appropriations Act of 2018 provides $37.084 billion for NIH, including the full $496 million from the 21st Century Cures Act Innovation Account and $500 million split evenly between NINDS and NIDA for research related to opioid addiction, development of opioid alternatives, pain management, and addiction treatment (available through Sept. 30, 2019). The total funding level for NIH represents a $3 billion increase over the comparable FY 2017 program level for the agency.
For every patient awaiting a cure, for every researcher working toward the next breakthrough, and for every aspiring scientist considering a career in the lab, this increase marks a day of real hope and opportunity.
This is an important increase in NIH funding – not only in both dollar terms and as a percentage of the base but also for specific targeted programs as mentioned previously – since the completion of the doubling in FY2003. During that time, the value of NIH funding has dropped by more than 20 percent and the success rate for NIH grantees has plunged to unprecedented levels. Note, that when adjusting for inflation, the FY 2018 NIH budget is only still just above where it was in 2003
The increase is a wonderful recognition of NIH when you consider the fact that the Health and Human Services Department, the Education Department and the Labor Department all come from and therefore compete for money within the same congressional subcommittee allocation. For FY2018 the amount was set at $177.1 billion, compared with $161 billion for the prior fiscal year. Out of that $16 billion increase, the $34 billion NIH received a $3 billion boost while the $70.9 billion Education Department got a $4 billion spending hike and the Labor Department received a $192 million increase.
The unexpected increase is not enough yet to reverse the decline, however, it is perhaps indicative of a commitment by members of Congress that have been champions for NIH to continue to fight for its investment and the results of many years of hard fought by the health research community that is paying dividends.
For researchers who have struggled under tight budgets and low success rates, this money creates new opportunities. Since 84 percent of NIH’s funding is spent extramurally (versus 10 percent intramural and six percent on administration), we should strongly encourage researchers to seek funding aggressively utilizing existing Investigator-Initiated Research mechanisms and current Program Announcements. We must encourage our investigators to pursue grants and to reach out to NIH directly to ask questions to determine how to act quickly and to create the strongest possible applications based on the current state of the science.
What does the success for FY18 indicate about the likelihood of success in FY2019? The short answer is “really not sure in the current political environment”
Every appropriation year is an entity unto itself. As of today, despite the budget agreement and the release of the President’s proposed budget for FY2019, we do not know what Congress will decide for FY2019 as many events occur prior to final decision-making, not the least of which is the 2018 election.
We believe our congressional champions will continue to support NIH and we will work to avoid any feeling that NIH “got more” this year and they need to put money in other health or non-health agencies. (After the doubling of the NIH budget in 2003 this was the feeling of many in Congress and was responsible for more than a decade of flat budgets.)
The two-year budget agreement provides the advantage of taking the numbers game off the table with bottom line number for government spending for FY2019 moves the committee discussion to where it needs to be – on the funding levels for the different agencies. We remain focused on the LHHS bill funding level which will only increase by $18 billion next year.
We haven’t solved the NIH funding issue by getting this increase in this year as the goal in research funding must be to obtain steady, predictable and robust funding increases every year. We cannot have the NIH flat-funded going forward as we have seen what devastating effects that has on research and those choosing careers in science. We all agree that research funding is not a faucet that should be turned on and turned off at will.
The Academy, along with the rest of the health research community, would be well-served by maintaining and even intensifying the focus on research funding in 2019. To do less risks losing the gains already obtained. Advocacy is a team sport, without efforts from each of you we may not be where we are today with this positive momentum Congress has created!
February 8, 2018
A two-year deal to lift strict discretionary budget caps on defense and domestic spending was agreed to by Congressional leaders putting an end to the series of short-term congressional resolutions (CR) to keep the government funded. The deal increases defense and domestic spending by about $300 billion over two years (FY18 and FY19) as well lift the debt ceiling and disaster aid. While the bill is not perfect it was a hard negotiation between Democratic and Republican leaders that found common ground around what the American people need.
Under the agreement, in FY18 defense spending will increase by $80 billion and nondefense (domestic) by $63 billion beyond the budget caps. For FY 19 the increases are $85 and $68 respectively. The deal also included $140 billion for defense and $20 billion for emergency spending over two years. The agreement also includes a commitment to provide “$2 billion for important research at NIH (above the CURES Act increases)” and also specifies that the figures cited are “over two years”. The documents do not provide additional details about whether the deal would reserve a minimum of $1 billion for increases to NIH in FY 2018 and another $1 billion for increases in FY 2019, or distribute the NIH funding another way.
President Trump has signaled he supports the bill. However, House Minority Leader Nancy Pelosi does not support the agreement without a commitment from House Speaker Ryan to vote on an immigration bill to protect DACA immigrants, though the Speaker has already said he will only take up an immigration bill that Trump supports. It is expected that the House Freedom Caucus of hardline GOP conservatives will oppose the budget deal-making Speaker Ryan need Democratic votes to pass the bill in the House.
What happens next is the Senate amends the House CR bill to include the deal that was reached and votes it out, sending the bill back to the House for approval prior to tomorrow’s Feb 8th deadline. This will keep the government funded until March 23 by which time Congress will have written a new spending bill that outlines the levels set by the budget deal. This deal also potentially avoids a budget showdown in an election year.