July 21, 2012
On July 17, the House Labor-Health and Human Services-Education Appropriations Committee (Labor-HHS Committee) released its FY13 spending bill. The draft House bill freezes funding for the National Institutes of Health (NIH) for FY13 and recommends funding at $30.6 billion. This matches the President’s request but is $100 million below what the Senate appropriators approved.
Most institutes/centers would see slight reductions compared with FY12—including a 2% decrease for the National Center for Advancing Translational Sciences (NCATS). The draft House bill provides $574.7 million for NCATS, while the Senate bill provides $631.3 million, a 9.8% increase. Within the NCATS budget, the draft House bill specifies that “at least” $487.767 million be provided for Clinical and Translational Scientific Awards (CTSA). The Senate bill does not specify a funding level for CTSAs. The draft House bill also provides up to $10 million within the NCATS budget to implement the Cures Acceleration Network (CAN). The Senate bill provides up to $40 million to implement CAN.
The draft House bill reduces the limit on salaries on grants or other extramural mechanisms funded by the bill to Executive Level III or $165,300. The Senate bill retains the current salary cap at Executive Level II or $179,700.
The draft House bill increases the National Institutes of General Medical Sciences budget by $100 million, but that increase was provided to offset an increase for the Institutional Development Awards (IDeA) program. The IDeA program is designed to broaden the geographic distribution of NIH funding for biomedical research. As authorized by Congress, the program’s intent is to enhance the competitiveness for research funding of institutions located in states with historically low levels of funding and low aggregate success rates for grant applications to the NIH. The House draft bill language states that “not less than” $376.48 million is provided for the IDeA program, an increase of $100 million over FY12. The Senate bill funds the program at the FY12 level of $276 million.
In addition to spending cuts, the draft House bill contains policy provisions. The bill forbids “patient-oriented outcomes research,” mandates at least 16,670 new and competing Ruth L. Kirschstein National Research Service Awards, and stipulates that NIH maintain an allocation of 90% to extramural activities, 10% for intramural activities, and at least 55% toward basic science. Some provisions may be helpful, but others could undermine the agency’s ability to fund the best science. Institute and center directors currently are trying to reprioritize budgets to deal with the threat of sequestration and will now be forced to shift scarce dollars to mandated Research Project Grants or other mechanisms. The bill also forbids Dr. Collins or his staff from traveling until they implement a pilot program Congress requested last year, which will ask third-party insurers to pay for patients on clinical trial protocols at the NIH’s Clinical Center.
The bill approved by the House Labor-HHS Subcommittee must now pass the full Appropriations Committee and House of Representatives. Ideally, the House and Senate would resolve differences between their bills, but this is unlikely until after the November elections. At that time NIH will be a small piece of the legislative agenda. Along with tying up any leftover appropriations bills, lawmakers are likely to be under incredible pressure to act on several massive pieces of legislation, including decisions on increasing the debt ceiling, expiring Bush tax cuts, and budget sequestration. Hundreds of billions of dollars will be on the line. If Congress can’t resolve the sequestration plan in the lame duck session, the FY13 appropriation approved for the NIH will not mean much given that sequestration will automatically cut 7% from the NIH budget starting January 1, 2013.