The appropriations committees in the House and Senate have finished “marking up” their fiscal year 2019 (FY19) spending bills and, when it comes to our nation’s health and science focused agencies, the news has been largely positive. Of particular note, the Senate provided an increase of $2 billion for NIH and, net of transfers and one-time funding, provided a $695 million increase for CDC. The House provided a $296 million increase for FDA as well as a $408 million increase for NSF. Both the House and Senate provided $334 million – the same level as FY18 – to AHRQ, but explicitly rejected calls to roll the agency into NIH.
While both Houses have made significant progress in their respective appropriations efforts, it remains unlikely that the process will be complete by the September 30 end of FY18. We anticipate at least one and potentially several continuing resolutions flat-funding the government before final FY19 budget numbers are signed into law.
As the bills for FY19 were being drafted and sent for mark up, Congress was simultaneously working to address the administration’s rescissions package, which called for impounding and ultimately cutting $15.4 billion in unused discretionary and mandatory spending authority. Two areas of particular concern in the package were cuts of $400 million in USAID Ebola funding and $800 million in Center for Medicare and Medicaid Innovation (CMMI) funding. Although the administration cancelled the proposed Ebola funding rescission, the House passed legislation to implement the other proposed cuts. The Senate, however, voted not to discharge the bill by the June 22 deadline, so no rescissions took place.
The House passed bipartisan legislation giving shape to more than 50 discrete proposals aimed at addressing the opioid crisis, including language intended to amplify efforts to research and develop non-addictive pain treatments.
Another bipartisan bill pending in the House would repeal the medical device excise tax, which has twice been suspended, the second suspension expiring in 2020. While these serial, two-year suspensions are a welcome reprieve from the unintended consequences of this tax on medical technology innovation, a permanent repeal is the only way to alleviate investment uncertainty and fully restore the pace of medical device progress. The most likely path to passage for this legislation is tax extenders or omnibus legislation.
On July 12, Agency for Healthcare Research and Quality (AHRQ) Director Gopal Khanna met with Research!America and Health IT Coalition member organizations to discuss his goals for the agency and vision for a health care system that leverages advances in IT to maximize the societal return on every health care dollar. Mr. Khanna said that to maximize its own return, AHRQ must not only fulfill the continuing demand for health services research, but work closely with other health care stakeholders to anticipate and meet the research needs of a rapidly evolving health care system.