American Society of Hematology

House Appropriations Committee Moves Forward with Legislation; Proposes Flat Funding for NIH, Cuts to Health Reform & Other Programs

Published on: July 18, 2012

The House Appropriations Subcommittee on Labor Health & Human Services approved its version of the FY 2013 funding bill.

The House Subcommittee bill, authored by Republicans focused on debt reduction, takes aim at several Obama administration priorities and calls for deep spending cuts for the departments of Labor, Health and Human Services, and Education.

The House bill allows Republicans to set down markers on what spending they want to continue and what they want to cut. Not surprisingly, those priorities are at odds with both President Obama's fiscal 2013 budget request and the measure (S. 3295) approved by the Senate Appropriations Committee last month. (The Senate Appropriations Committee bill represents the best case scenario for the NIH. The Senate Committee provided $30.723 billion for the National Institutes of Health (NIH), a $100 million increase over the FY 2012-enacted level and the president's FY 2013 request.)

Strong Democratic opposition gives the House Republicans' bill little chance of becoming law as written. But the draft measure reflects the party's goals of shrinking the deficit, derailing the health care law and stopping administration regulations. And the low overall spending figure could serve as a starting point for negotiations on a final measure.

The House bill provides for $150 billion in discretionary funding, $6.3 billion below fiscal 2012 funding levels and $8.8 billion below President Obama's budget request and the Senate bill.

Below is a summary of the major provisions in the House bill:

National Institutes of Health - The House subcommittee bill sets overall funding at $30.6 billion, the same as current year funding. The majority of institutes and centers are reduced by 0.02 percent below the FY 2012 comparable level. The Senate bill provides a $100 million (0.3 percent) increase.

  • Salary Cap: The House subcommittee draft reduces the limit on salaries on grants or other extramural mechanisms funded by the bill to Executive Level III. The Senate committee bill retains the limit at executive Level II.
  • NRSA Training Grants: The House subcommittee draft includes language mandating the NIH Director shall ensure that at least 16,670 new and competing Ruth L. Kirschstein National Research Service Awards are funded in FY 2013 from all Institute, Center, and Office of the Director accounts.
  • NCATS: The House subcommittee draft provides $574.7 million for the National Center for Advancing Translational Sciences, a decrease of 0.02 percent. The Senate committee bill provides $631.3 million, a 9.8 percent increase.
  • CTSAs: Within the NCATS budget, the House subcommittee draft specifies that "at least" $487.767 million is provided for the Clinical Translational Science Award program and states that no changes shall be made to the CTSA program until IOM review described in the joint explanatory statement accompanying the FY 2012 Consolidated Appropriations Act [P.L. 112–74] is completed. The Senate committee bill does not specify a funding level for the CTSAs.
  • Cures Acceleration Network: Within the NCATS budget, the House subcommittee draft states that "up to $10,000,000 shall be available to implement section 402C of the PHS Act (relating to the Cures Acceleration Network) after NIH has published in the Federal Register a notice of proposed rulemaking and request for comments with respect to a rule to ensure that all programs, projects, and activities of the National Center for Advancing Translational Sciences do not create duplication, redundancy or competition with industry…." The Senate committee bill provides up to $40 million to implement CAN.
  • Institutional Development Award (IDeA) program: The House subcommittee draft increases the overall NIGMS budget by $100 million and includes bill language that "not less than" $376.48 million is provided for the IDeA program, an increase of $100 million. The Senate committee bill funds the program at the FY 2012 level of $276 million.
  • National Children's Study (NCS): The House subcommittee bill provides $175 million for "continuation of the National Children's Study with no changes to the current design or Vanguard pilot structure until at least 90 days after the IOM conducts a review of the proposed changes and impact on the results." The Senate committee bill provides $165 million for the NCS.

Agency for Healthcare Research & Quality: The House bill terminates the agency. The Senate bill provides $364 million, $5 million less than FY12 funding.

Centers for Disease Control and Prevention: The reported $66 million increase for CDC in Chairman Roger's summary is misleading. While it's true CDC's budget authority receives an increase over FY 2012, the elimination of the Prevention Fund and other transfers results in an 11 percent decrease for the agency--$815 million less than FY 2012, and $876 million less than the Senate.

Health Resources and Services Administration: The House provides $5.9 billion in discretionary budget authority, which is $453 million below last year's level and $315 million below the President's budget request. Within this total, Community Health Centers are funded at $1.5 billion – the same as last year's level. This includes a rescission of $300 million in previous-year funding that was provided under the ACA for this program. The bill includes $139 million for rural health programs, an increase of $1.4 million above last year, and eliminates funding for the Family Planning Program. For health professions training, the House bill provides $623 million total, $137 million belowthe FY2012 enacted level (20 percent cut). The Senate bill provides $725.6 million.

Health Reform Overhaul – The House bill would block funding to implement the Patient Protection and Affordable Care Act despite the recent ruling by the Supreme Court that the law is constitutional.

Having met the tough hurdle of getting a subcommittee markup, the measure is expected to go to the full House Appropriations Committee for approval next week.

Beyond that, the future of FY 2013 appropriations is not clear. Some House Republican leaders want to pass a three-month temporary funding measure that adheres to last year's debt-limit agreement, but that could cause friction with some House and Senate conservatives who want to impose lower funding numbers. Senator Jim DeMint (R-SC), the TEA Party leader, has joined with the Republican leaders to urge House Speaker John Boehner to pass a short-term continuing resolution before the August congressional recess to avoid a lame-duck session of Congress, believing Democrats would use the threat of a government shutdown to have the upper hand in a host of policy negotiations. But House Speaker John Boehner (R-OH), Majority Leader Eric Cantor (R-VA) and others still are unwilling to yield to spending levels agreed to last year. Consequently, it remains to be seen how the Congress may finalize funding.

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