Funding climate may change
if some get their way
It is budget season in Washington, and, just as the famed cherry blossoms around the city’s tidal basin are starting to fall, the U.S. Congress is providing the National Institutes of Health advocates with several tempting yet delicate proposals aimed at increasing funding for biomedical research. Unfortunately, just like the spring flower, the proposals are incredibly fragile and can be blown away in the blink of an eye, leaving those of us advocating for funding support stuck waiting for next year’s blossoms.
This year’s budget season actually started last year, with the U.S. House of Representatives overwhelmingly passing the 21st Century Cures Act. The proposal, among other things, explicitly called for five years of increases to the NIH’s baseline funding and developed a new model for providing additional funds. NIH funding today comes from discretionary appropriations. Just as the name implies, these funds are at the discretion of the Congress and can change year to year based on political priorities. The 21st Century Cures Act created an additional fund to support the NIH that was not discretionary but mandatory. In this way, while the NIH’s baseline operations would continue to be funded through discretionary funding, a bonus of $8 billion in funding over five years automatically would be baked into the budget process. The House passed this legislation nearly a year ago, but the U.S. Senate has not decided to move it forward. It is, at the moment, withering on the congressional vine.
In February, President Barack Obama proposed his fiscal year 2017 budget, which included a funding plan for the NIH that called for$1 billion in cuts to the NIH’s baseline appropriation. These cuts — the White House argued — should be supplanted by a mandatory fund from Congress. In other words, the president requested a $1 billion increase to the NIH’s budget that just needed to be provided through a blend of discretionary and mandatory appropriations. As is often the case when one political party controls the Congress while the other controls the White House, the president’s proposal was soundly rejected.
The Senate, which could have adopted the 21st Century Cures Act, instead decided on a legislative agenda focusing on proposals outlined in a Bipartison Policy Center report that would support “innovation for a healthier America.” Currently, the Senate is considering a series of individual pieces of legislation, each aimed at supporting the NIH, the Food and Drug Administration, and other parts of the treatment and drug development process. There has not yet been a piece of legislation as part of the Senate’s agenda calling for any funding increases to the NIH. Both U.S. Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., who chair the Senate committee that has jurisdiction over NIH, have supported the need for increased investments at the NIH. But there has been little agreement about the mechanism (discretionary or mandatory), the amount, or the targets for the funding.
U.S. Sen. Elizabeth Warren, D-Mass., last month introduced her own funding plan to support the NIH: the National Biomedical Research Act. Warren’s act would provide an additional $5 billion in funding above the annual NIH appropriation and help recover the financial support that has eroded after nearly a decade of level funding. Warren’s proposal is supported by a handful of her Democratic colleagues in the Senate.
After five years of austere budgets that caused advocates to scratch and claw for even flat funding for the NIH, there is a new level of congressional support for biomedical research and political leaders from both parties are thinking about ways to support the research enterprise. The challenge now is making any of these proposals a reality.