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In House Hearing, NIH Director Collins Details How the $ 3 Billion FY2018 NIH Increase Will Support Programs, Addresses Trump Administration FY2019 Proposed Budget

Legislative Update
April 11, 2018

On April 11, the House Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittee held a hearing with National Institutes of Health (NIH) Director Francis Collins, MD, PhD and members of his senior team (see box below).

In his Opening Statement, Subcommittee Chair Tom Cole (R-OK) commented that:

“I am proud that Congress again provided a significant increase in funding for NIH in the fiscal year 2018 omnibus. The omnibus increased NIH’s funding by $3 billion, which was the second highest annual funding increase in NIH’s history. This funding will accelerate the discovery of knowledge that will lead to new treatments and cures for diseases such as Alzheimer’s, cancer, and heart disease.”
He then expressed concern about the President’s Fiscal Year (FY) 2019 budget proposal—which issued before Congress finalized the FY2018 omnibus—and is well below that funding level. “I am still concerned that funding NIH at the [Administration’s] requested level would prevent the U.S. biomedical research enterprise from achieving the progress we have begun to make with the past few years of funding increases,” said Chairman Cole. In that regard, while acknowledging that the strong bipartisan support for NIH is a show of confidence for what the agency accomplishes, he commented that he cannot guarantee another $3 billion increase in FY2019.

In her opening statement, Ranking Member Rosa DeLauro (D-CT) acknowledged that, despite the $7 billion increase in NIH funding over the past three fiscal years, its funding is still $5 billion below that of FY2003, when adjusted for inflation. She recognized that the FY2018 increase facilitates 2,000-2,500 new grants, and “that is the direction that we should be going.” She expressed concern about the potential for a rescission of the nondefense spending portion of the FY2018 omnibus, led by conservative Members of Congress, and vowed to fight to preserve the funding. She also expressed concern about the President’s FY2019 proposed budget, including reduction of the Extramural Salary Cap from Executive Level (EL) II ($189,600) to EL V ($153,800, expressed in FY2018 dollars), which was also proposed in FY2018 and rejected by Congress in the final funding omnibus. She voiced opposition to the President’s proposal to consolidate the budgets of the Agency for Healthcare Research and Quality (AHRQ), the National Institute for Occupational Safety and Health (NIOSH), and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) into NIH.

Dr. Collins thanked Congress for its support during this time of unprecedented scientific opportunity, then departed from his prepared testimony to focus on five factors that currently have the greatest impact on NIH:

  • Stable Funding Trajectory—which Congress has provided since FY2016;
  • Vibrant Biomedical Research Workforce—which he noted has benefitted from the past three years of NIH increases;
  • Computational Power—as evidenced by the current enrollment of 1 million individuals in the All of Us biomedical data resource cohort within the Precision Medicine Initiative;
  • New Technologies and Facilities—such as gene therapy and immunotherapy; and
  • Scientific Inspiration—in Dr. Collins words, “innovative ideas about which he could speak all day.”

In the two rounds of questions from Subcommittee members on a variety of diseases and the Opioid Crisis, two major issues emerged:

  • Concern about NIH’s ability to proceed with programs in FY2019 under the President’s proposed budget. In particular, Chairman Cole questioned NIH’s ability to fund the Cancer Moonshot—one of the four special initiatives (including BRAIN Initiative, Precision Medicine, and Regenerative Medicine) that are funded by the NIH Innovation Account created by the 21st Century Cures Act, passed in December 2016.

  • As raised by Ranking Member DeLauro and Cong. Andy Harris, MD (R-MD), the plight of early-stage investigators. Dr. Collins described several NIH programs to fund such investigators, noting that the sustained NIH increases have been critical to funding these initiatives.
The Subcommittee will hold a Members Day on April 17 and a Citizen Witness Hearing on April 26.

The following Institute Directors joined Dr. Collins in responding to questions:

  • Diana Bianchi, MD (Eunice Kennedy Shriver National Institute of Child Health and Human Development
  • Anthony Fauci, MD (National Institute of Allergy and Infectious Diseases)
  • Norman Sharpless, MD (National Cancer Institute)
  • Nora Volow, MD (National Institute on Drug Abuse)