Academy of Radiology Research LEGISLATIVE UPDATE: Budget and 21st Century Cures
The following is an update on the current status of the Fiscal Year 2017 budget negotiations and several of the challenges it faces next year as well as information on the signing into law the 21st Century Cures legislation by President Obama:
Fiscal Year 2017 Budget Information (CR)
- Last week, Congress completed its final major business of the 114th Congress by passing a Continuing Resolution (CR) for FY 2017 that extends current funding levels for most federal agencies through April 28, 2017. This was a disappointing result for the advocates for NIH because all throughout 2016 there was a lot of support from Congress to provide NIH with another $2 billion increase in FY 2017.
- Under the CR, all agencies are subject to a 0.1901 percent across the board cut to reach previously agreed budget targets. The bill makes numerous adjustments based on statutory law and other program changes. Based on the passage of the 21st Century Cures Act (see below), the CR provides the FDA with an additional $20 million, the NIH with an additional $352 million, and $500 million in state grants to supplement current opioid abuse prevention and treatment activities.
- The danger in a CR that lasts through April, 2017, is that federal agencies will continue to operate in financial limbo, without a new budget or the ability to shift spending priorities, for most of the fiscal year — and possibly all of it…..because by stretching the stopgap measure into April there are many lawmakers in both chambers who are already talking about the temptation Congress will have in April to simply extend the CR for the rest of the year.
- Further challenging the budget scenario is the goal of the Republican controlled Congress to do budget reconciliation bills that would provide them with a blueprint for the budget process and a method for taking action on such items as repealing the ACA and changing the direction of many domestic discretionary programs.
- It is important to remember that within the discretionary side of the federal budget is both the defense budget and all non-defense discretionary programs – all fighting for the same budget dollars.
- Democrats throughout President Barack Obama’s budget wars relied on this premise: Any extra dollar for the military has to be matched by a dollar for domestic programs.
- Now without the power of the White House, the Democrats appropriately fear they may be powerless to stop Republicans from trampling that principle since Trump plans for hundreds of billions of dollars in new defense spending – funding that would be taken from the domestic programs (NonDefense Discretionary (NDD)) – programs that would already be further cut under sequestration which is returns next year.
- Also of interesting note, the CR includes an anomaly requested by the White House, to postpone the effective date of the “enforcement sequester” until 15 days after the expiration of the CR April 28, 2017. It is up to OMB to determine within 15 days of Congress’ adjournment whether enacted spending levels exceed the BCA caps. If so, the president must order across-the-board cuts to bring spending under the caps. The Congressional Budget Office has estimated that the stopgap spending measure will exceed the $518.5 billion NDD cap by $1.6 billion. So cuts may be in the offing this coming spring (not to mention potentially deeper cuts through, as previously mentioned budget reconciliation and sequestration).
The greater research advocacy community, including the Academy, will be working hard to try to obtain the $2billion increase for NIH in FY 2017 that was intended, as opposed to the NIH being part of a full-year CR that flat funds the agency in FY 2017.
This effort will include meetings with congressional offices and with staff of key committees to assure that they hear the Academy’s important message on the need for continued federal investment in imaging research at NIH and in particular a need for increasing the budget to the NIH’s National Institute of Biomedical Imaging and Bioengineering.
It is imperative that the Academy, along with the greater advocacy community of researchers, physicians, physician scientists, patient advocates, research support personnel, industry representatives, and many others, to continue to be extremely influential in providing overall guidance and direction to policy makers, especially in regard to the many scientific opportunities (which are made possible through robust, sustained and predictable funding increases for the NIH) that exist today to make inroads against the thousands of diseases that afflict millions of Americans.
21st Century Cures
The 21st Century Cures bill was passed by the 114th Congress last week and was signed into law by President Obama yesterday.
As expected the bill contains a great deal of detail on NIH under Division A including the following topics: the reauthorization of the Agency, requiring a 6 year strategic plan, triennial reports to congress, increased accountability of directors of ICs through term appointments, programs to support young emerging scientists, review of regulations and policies, addressing reproducibility of science issues, high risk/high reward research grants, expanding NCATS support of clinical trials(CTs), increased collaboration and coordination, researching pregnant women and importance of demographic data (inclusion) in CTs, greater access to data, and pediatric research. (A full outline Division A of the new law is attached).
Important to note that the law provides for:
- $4.8bil over 10 years to NIH (through the Office of the Director) that will be for the Cancer Moonshot ($1.802bil), the BRAIN Initiative ($1.564bil) and the Personalized Medicine Initiative ($1.4bil) which is allocated annually. Funding will be from the Prevention and Public Health Fund ($3.5 bil) and the rest from drawing down from the Strategic Petroleum Reserve.
- $500mil over 10 years to FDA and additional $30 mil to FDA for regenerative medicine.
- Continues Patient-Focused Drug Development at FDA and increases reporting of patient experience.