August 2012
Bill also includes prescriptive language regarding NIH grants and programs
The fiscal year (FY) 2013 appropriations process took another step forward July 18 when the House Appropriations Subcommittee on Labor-Health and Human Services-Education (L-HHS-Ed) approved a bill that would freeze funding for the National Institutes of Health (NIH) at its fiscal year 2012 level.
The House Subcommittee’s recommended funding level of $30.6 billion is consistent with the President’s FY 2013 request and is $100 million below the funding level approved by the Senate Appropriations Committee a few weeks ago.
Under the House proposal, the National Cancer Institute (NCI) would receive $5.066 billion, a small cut of about $2 million. The bill funds the National Center for Advancing Translational Sciences (NCATS) at $574.7 million, which is a small decrease from current levels and contrasts sharply with the Senate proposal, which boosted NCATS funding by more than 9 percent to a level of $631.3 million. Within NCATS, the House bill directs up to $10 million to be used for the Cures Acceleration Network (CAN), $30 million less than the amount proposed for CAN in the Senate bill. The House also boosted funding for the Institutional Development Award (IDeA) program, which is popular with House Subcommittee Chairman Denny Rehberg (R-Mont.) and other members of the subcommittee. That program would receive a $100 million increase to $376 million for FY 2013.
Of particular concern to many in the biomedical research community is the inclusion of highly prescriptive language in the proposal that, in effect, micromanages NIH and lessens its leaders’ flexibility in managing the agency. Specifically, the bill:
- Eliminates the NIH director’s discretionary fund, which is about $1.4 million;
- Reduces the limit on salaries on grants or other extramural mechanisms funded by the bill;
- Mandates that NIH fund at least 16,670 new and competing grants in FY 2013 from all institutes, centers and office of the director accounts;
- Requires the agency to maintain a 90:10 ratio of extramural to intramural funding, and allocate at least 55 percent towards basic science activities; and
- Prohibits the use of any NIH funding for economic research programs, projects or activities.
In a public statement, Chairman Rehberg stated that the bill focuses on “high-priority programs” and eliminates 38 “ineffective and duplicative” programs and activities. Furthermore, the proposed spending bill calls for the termination of the Agency for Healthcare Research and Quality (AHRQ), and it transfers the U.S. Preventive Services Task Force to the office of the HHS Assistant Secretary of Health. This is the first time the agency has been a target for termination since 1994. (Read more in article on proposed termination of AHRQ below.)
The proposed elimination of AHRQ, which is funded through a “tap” on the NIH budget, coupled with the prohibition on the use of federal funds for patient-centered outcomes research and economic research through NIH technically increases the amount of money available to NIH despite the overall funding level being flat. In his statement, Chairman Rehberg alludes to this fact saying, “By focusing a greater percentage of these resources on basic NIH research activities rather than allowing them to be diverted by the secretary for other, less-pressing purposes, the bill actually provides an increase of $675 million for NIH to use compared with last year.” Despite this assertion, Chairman Rehberg will have a very difficult fight on his hands to preserve his proposal to eliminate AHRQ during conference negotiations because of vehement opposition from the Senate and the Obama administration, as well as push back from the health care community.
In addition to eliminating AHRQ and other programs, the bill would prohibit funding for implementation of the Affordable Care Act (ACA) and the Prevention and Public Health Fund created by the ACA.
The House is operating from a budget that is significantly lower than that being adhered to in the Senate. The two chambers will need to work out this difference in conference negotiations. Of course, a higher allocation increases the likelihood that NIH would receive a better result for FY 2013. Therefore, the cancer community will continue working tirelessly to convince House members to begin negotiations at the Senate approved level, which is also the level of overall federal spending for FY 2013 agreed to by both chambers during last summer’s budget deal. Despite the forward momentum, final decisions that will affect health research spending will not be made until after the November elections.
Links:
- Draft Bill: Fiscal Year 2013 Labor, Health and Human Services, and Education, and Related Agencies (House Appropriations Committee, July 17, 2012)
- AACR Letter to Chairman Harkin Regarding FY 2013 NIH Funding (June 22, 2012)
- Summary: Fiscal Year 2013 Labor, Health and Human Services, and Education, and Related Agencies Appropriations Bill (Senate Appropriations Committee, June 14, 2012)
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