Inside (the Beltway) Scoop

By: Jennifer Zeitzer
Thursday, June 28, 2018

Senate Rejects Rescissions Bill, Passes Minibus Package; Committee Approves $2 Billion Increase for Biomedical Research; House Postpones Action on NIH Funding; White House Releases Government Reorganization Plan

Disagreements about fiscal matters were on display again last week as the Senate continued to demonstrate different fiscal priorities than the House. On June 21, the Senate rejected Majority Leader Mitch McConnell’s (R-KY) attempt to approve the rescissions package (HR 3) that the House narrowly passed in early June.

Under special procedures requiring only a simple majority, Susan Collins (R-ME) and Richard Burr (R-NC) provided the critical no votes. The measure would have canceled unspent funding from previous years but did not affect fiscal year (FY) 2018 appropriations.

On Monday, Senators reaffirmed their support for the appropriations process by passing an FY 2019 “minibus” (HR 5898) that combined the Energy & Water, Legislative Branch, and Military Construction-Veterans Administration (VA) bills. The bipartisan 86-5 vote on the “minibus” followed several days of debate on non-controversial amendments, a welcome change from last year when the full Senate failed to consider any of the 12 spending bills.

Funding for the Department of Energy Office of Science would increase to $6.65 billion, $390 million above the current level in the Senate “minibus.” The package also included $779 million (a $57 million increase) for the VA Medical and Prosthetic Research Program. Senate “minibus” approval could trigger the appointment of a conference committee to negotiate a final agreement with the House, which passed similar legislation on June 8.

In related news, the Senate Appropriations Committee approved the Labor, Health and Human Services (LHHS) bill that funds the National Institutes of Health (NIH). According to the committee’s summary, the Senate recommended: “$39.1 billion, an increase of $2 billion, or 5.4 percent, above FY 2018” for NIH. Commenting on the bill, LHHS Subcommittee Chair Roy Blunt (R-MO) said, “I’m proud we were able to provide the fourth consecutive funding increase for the National Institutes of Health, which will pave the way for new medical breakthroughs and lower health care costs over the long term.”

Within the total for NIH, increases are specified for Alzheimer’s disease research, the Brain Research through Advancing Innovative Neurotechnologies initiative, the Institutional Development Award program, the All of Us precision medicine initiative, and research on a universal flu vaccine. As also noted in the summary, the bill provides “increases to every Institute and Center to continue investments in innovative research to advance fundamental knowledge and speed the development of new therapies, diagnostics, and preventive measures to improve the health of all Americans.”

Unfortunately, the House Appropriations Committee postponed a vote on their LHHS bill, scheduled for June 26. The House LHHS Subcommittee approved the NIH funding bill on June 15, recommending a $1.25 billion increase for the agency. According to multiple news reports, the House Appropriations Committee will consider the LHHS bill in early July after the Independence Day Recess (July 2-6).

Despite the delay, the House Appropriations Committee posted the report language accompanying the bill. Nothing in the report language affects use of animals in research or stem cell research. However, a provision is included prohibiting the use of federal funds for research using human fetal tissue from induced abortions (section 532, pages 168 and 182). This is the same language included in the FY 2018 House LHHS bill, but not part of the final FY 2018 omnibus appropriations bill due to Senate objections on fetal tissue research restrictions. In addition, the House report:

• Notes that the funding level for NIH provides an increase for every institute and center (page 51)
• States that the Appropriations Committee expects NIH to support increasing the number of new and competing Research Project Grants “with a focus on early-stage investigators and investigators seeking first-time renewals” (pages 51-52)
• Rejects the proposal in the Trump Administration FY 2019 NIH budget request to limit the percentage of research salaries that can be charged to NIH grants, noting that the impact of such a policy change is unclear. The committee also requested that NIH include an analysis of the proposed salary cap’s impact on academic institutions and the number and average costs of NIH grants in the agency’s FY 2020 budget request (page 52).

While Congress focused on the FY 2019 spending bills, the White House Office of Management and Budget released a comprehensive proposal to reorganize the federal government. The 132-page Government Reform & Reorganization Plan proposed shifting governance of federal nutrition programs from the Agriculture Department to Health and Human Services, which would be renamed the Department of Health and Public Welfare.

Other provisions would affect NIH primarily at the administrative level. The NIH restructuring notes it “will align management with best practices and break down administrative silos through standardization of structures and processes agency-wide.” No other details are provided. In addition, NIH would absorb the functions of three existing agencies including the Agency for Healthcare Research and Quality, the National Institute for Occupational Safety and Health, and the National Institute on Disability, Independent Living, and Rehabilitation Research. A similar proposal to move those entities to NIH was included in the Trump Administration’s FY 2019 budget request.

Congressional reactions to the plan ranged from mild interest to outright opposition. House LHHS Appropriations Subcommittee Chairman Tom Cole (R-OK) said, “Count me as a little skeptical just because the reason we divided up the old Department of Health, Education and Welfare was because it was just too big, too unwieldy.”

Senate Appropriations Committee Chairman Richard Shelby (R-AL) said his committee would help craft a plan to move forward with the reorganization, as long as it’s “a good plan.” Minority Whip Dick Durbin (D-IL), Senate Agriculture Committee Chairman Pat Roberts (R-KS), and former House Agriculture Committee Chairman Frank Lucas (R-OK) said they opposed shifting nutrition programs away from the Agriculture Department.

Although the House Government Reform and Oversight Committee reviewed the plan in a June 27 hearing, further consideration of the White House proposal is unlikely to be an immediate Congressional priority. In a press release, the Senate Homeland Security and Governmental Affairs Committee indicated they looked forward to discussing the administration’s ideas, but did not announce a hearing schedule or other plans.