Senate postpones summer recess; House appropriations bill boosts NIH, blocks proposed cuts to overhead payments; Debt ceiling looms large
Senate Postpones August Recess: Senate Majority Leader Mitch McConnell released a statement on Wednesday announcing that the Senate will stay in session until August 11 - two weeks later than planned - to tackle its lengthy to-do list. In addition to passing a health care bill, increasing the debt limit, and voting on appointments, the Senate will also devote time to passing a defense authorization bill "and other important issues," McConnell said.
Appropriations Committee Releases the Fiscal Year 2018 Labor, Health and Human Services, Education Funding Bill for Markup; $1.1 Billion Increase Recommended for NIH: The House Appropriations Committee this week released the fiscal year 2018 Labor, Health and Human Services, and Education (LHHS) funding bill which includes funding for programs within the Department of Labor, the Department of Health and Human Services, the Department of Education, and other related agencies.
Based on preliminary review, the bill provides $34.6754 billion in base funding for NIH, and utilizes the full $496 million designated for FY 2018 in the NIH Innovation Account established in the 21st Century Cures Act, for a total FY 2018 funding level of $35.1714 billion. For reference, the final FY 2017 omnibus provided $33.732 billion in base funding, and $34.084 billion when the Cures funding was included in the total.
The bill rejects the president’s proposal with respect to facilities and administration expenses and maintains the HHS salary cap at Executive Level II (rather than the president’s proposed cap at Executive Level V).
The bill also includes language in Sec. 528 stating, “None of the funds made available by this Act may be used to conduct or support research using human fetal tissue if such tissue is obtained pursuant to an induced abortion.”
The bill provides a total of $35.2 billion for NIH, an increase of $1.1 billion above the fiscal year 2017 enacted level and $8.6 billion above the President’s budget request. The bill provides increases for several critical research initiatives, including:
- $1.8 billion, a $400 million increase, for Alzheimer’s disease research
- $336 million, a $76 million increase, for the Brain Research through Application of Innovative Neurotechnologies (BRAIN) initiative
- $400 million, a $80 million increase, for the All of Us research initiative (formerly called the Precision Medicine Initiative)
- $300 million for the Cancer Moonshot
- $10 million, an $8 million increase, for regenerative medicine research
- $12.6 million for the Gabriella Miller “Kids First” pediatric cancer research initiative.
Within the total, the legislation includes $526 million (+$10 million) for Clinical and Translational Sciences Awards, $374 million (+$40 million) for Institutional Development Awards (IDeA) programs, and $493 million (+$30 million) for combating antibiotic-resistant bacteria. The bill includes a new provision requiring NIH to continue reimbursing grantee research institutions for facilities and administrative costs. The full House Appropriations Committee has not announced when they will consider the LHHS bill but we will keep you posted on the timing of that action. Additional analysis of the LHHS bill will also be provided after it is approved by the Appropriations Committee.
White House Office of Management and Budget Released FY 2019 Budget Guidance to Agencies: The White House Office of Management and Budget (OMB) sent guidance to departments and agencies for preparing FY 2019 budgets. The guidance directs agencies: Unless otherwise directed by OMB, your initial discretionary FY 2019 budget submission to OMB should continue the proposals included in the FY 2018 Budget, and should reflect a level no higher than the net total provided for your agency in the FY 2019 column of the FY 2018 Budget. Unless otherwise directed by OMB, this guidance applies to both defense (budget function 050) and non-defense spending, and agencies may not reduce one to offset increases in the other.
The memo also directs departments and agencies to: "Identify additional investments in effective programs that further support their mission and fill a clear Federal role. Overall, these investments should reflect no more than a 5 percent increase above your submission level. Submissions are due to OMB no later than September 11, 2017. In general, all agencies should maintain sufficient funding for presidential priorities, while closely scrutinizing other spending to ensure it reflects a proper Federal role and that taxpayer dollars are spent wisely." View the document.
Debt Ceiling Update: This week Senate Republican Leader Mitch McConnell told reporters he hopes to reach a bipartisan deal to raise the debt ceiling before August recess; adding that the Senate will remain in session until August 11, giving them exactly one month to strike a deal on the debt ceiling.
Reaching a deal on the debt increase will require support from Democrats who will likely demand a "clean" package, as well as fiscal conservatives who will likely call for spending cuts. So far, there has been no indication that Leader McConnell has taken a firm stance on attaching spending cuts to the debt measure.
Moderate Republicans Urge House Speaker to Negotiate a Bipartisan Deal to Raise the Budget Caps: Last Friday, 20 members of the Tuesday Group Caucus, an alliance of moderate and centrist House Republicans, wrote a letter to House Speaker Paul Ryan (R-WI) expressing “concerns with the direction of the FY 2018 budget process.” The group stated, “…we believe that it is incumbent on the White House and Congressional leaders, both Republicans and Democrats, to reach an agreement that sets spending levels for, at least, FY 2018” and suggested that a new budget deal could be paired with a vote to increase the debt limit. Signers of the letter also said that “absent such a bipartisan, bicameral agreement, we are reticent to support any budget resolution on the House floor.” This letter seems to confirm earlier rumors that moderate Republicans are supportive of efforts to raise the spending caps, increasing the likelihood that a deal could be reached this fall. Read the full letter.
New CDC Director Appointed: Department of Health and Human Services Secretary Tom Price, MD, has appointed Brenda Fitzgerald, MD, as the Centers for Disease Control and Prevention (CDC) Director. Dr. Fitzgerald has served as the Georgia Department of Public Health Commissioner and state health officer since 2011. In his statement, Secretary Price noted, “Having known Dr. Fitzgerald for many years, I know that she has a deep appreciation and understanding of medicine, public health, policy and leadership – all qualities that will prove vital as she leads the CDC in its work to protect America’s health 24/7.” Dr. Fitzgerald will succeed Tom Frieden, MD, MPH, who resigned in January after serving for eight years. Acting Director Anne Schuchat, MD, will return to her role as CDC Principal Deputy Director.
Sequestration's Impact on Non-Defense Discretionary (NDD) Programs: The Center on Budget and Policy Priorities has prepared an analysis on the impact of sequestration on specific NDD programs. The NDD piece includes 12 case studies of programs that either have been cut or are significantly underfunded from a variety of sectors. Find the full content. Additionally, Congressional justifications for the major public health agencies are available as well.