House and Senate Adjourn Without Passing Budget Resolution; NAEVR Submits Testimony to File of April 1 Hearing of the Senate LHHS Appropriations Subcommittee

Legislative Update
April 9, 2004

Since House and Senate budget conferees could not come to agreement, the House adjourned last week before taking floor action on the budget resolution. The Senate adjourned yesterday. Conferees are scheduled to meet on April 20 when the House returns (the Senate returns on April 19) to resolve final differences on the issue of pay/go budget enforcement mechanisms (i.e. 60 votes needed to approve deficit spending not included in the resolution, and whether this would also apply to tax cuts). The budget resolution could go to the House floor by April 22 and to the Senate floor the following week. The budget resolution still faces an uncertain future, as some in Congress still oppose the anticipated levels of deficits contained.

On April 1, 2004, the Labor, Health and Human Services, and Education (LHHS) Subcommittee of the Senate Appropriations Committee held a hearing on National Institutes of Health (NIH) appropriations. Subcommittee Chair Senator Arlen Specter (R-PA) was joined by Senate Appropriations Committee Chair Ted Stevens (R-AK) and Member Thad Cochran (R-MS), as well as Subcommittee Ranking Minority Member Tom Harkin (D-IA), at this hearing at which NIH Director Dr. Elias Zerhouni and the Institute Directors were in attendance. Sen. Specter acknowledged NIH as "the crown jewel of the federal government" and summarized the doubling of the NIH budget that occurred from FY1998 to FY2003. He also acknowledged the Senate's floor action on March 11 to adopt the Specter Amendment to increase NIH spending in FY2005 by $2 billion over FY2004 in its Concurrent Budget Resolution. Sen. Stevens echoed Specter's comments, indicating that, "other than the intelligence community, no other group is as important to the future of the country as the NIH." Sen. Harkin added that Congress did not double the NIH budget to "now fall off a cliff", referring to the 2.6% NIH increase proposed for NIH in FY2005 in the President's budget.

In response to a question from Sen. Specter about what NIH could do with $1.3 billion more in FY2005 than the $700+ million in the President's budget proposal, Dr. Zerhouni responded that NIH could: keep up with inflation (see grant discussion below); accelerate the implementation of the NIH Roadmap for Medical Research; and fund clinical trials in translational research. Sen. Specter requested Dr. Zerhouni to provide more details about specific projects in a post-hearing submission.

Most important for NAEVR Members, Sen. Specter asked about the proposed Age-related Macular Degeneration (AMD) Clinical Trials Network, which the Senator referred to in his March 11 introductory comments to his amendment as a project that could be implemented if the NIH budget was increased in FY2005. In responding, National Eye Institute (NEI) Director Dr. Paul Sieving noted: the increasing incidence of AMD as the population ages; the ability to work across several Institutes due to the neurodegenerative nature of AMD; and the ability to follow up on the previous NEI-sponsored Age-related Eye Diseases Study (AREDS) that demonstrated that high levels of antioxidant nutrients and zinc significantly reduce the risk of advanced AMD. "Based on the AREDS findings, we can look at existing and new compounds to test, taking the bedside finding back to the bench to determine what is going on," responded Dr. Sieving.

Major issues addressed at the hearing included:

Number of NIH grants/inflationary factor: Dr. Zerhouni noted that, due to budget constraints in the FY2005 proposed budget, NIH has had to make some trade-offs. NIH plans to reduce inflationary increases in existing grants from 3.5% to 1.9% so that it can award 10,393 new grants (the same as in FY2003 and 258 more than in FY2004). Upon further questioning from Sen. Harkin, Dr. Zerhouni noted that with an additional $220 million in FY2005, the NIH could maintain new grant opportunities and provide cost increases for ongoing grants.

Obesity: In response to questions from Sen. Cochran about the co-morbidities of obesity, e.g. diseases such as diabetes, Dr. Zerhouni noted that the proposed $440 million in the FY2005 NIH budget for obesity research is a 10% increase over FY2004, and that its funding quadrupled while the NIH budget doubled. Sen. Cochran emphasized that this research should examine disparities in key populations (e.g. age and ethnicity).

Stem Cells: Sen. Harkin pressed NIH Stem Cell Task Force Chair Dr. James Battey about the number of stem cell lines available for US federal research and asked for a comprehensive post-hearing submission clarifying status of lines from all international sources.

NAEVR submitted a written statement by Board President Dr. Stephen Ryan and accompanying testimony that urged Congress to fund the NIH at $30 billion and the NEI at $711 million in FY2005.

The House LHHS Appropriations Subcommittee will hold two days of hearings later this month: April 21 on NIH Budget/ Roadmap for Medical Research ; and April 22 on NIH Management issues. NAEVR will submit a written statement to the file and cover these hearings. Note that NAEVR's testimony will contain a newly updated estimate by the NEI on the costs associated with visual disorders and disabilities, which is $68 billion annually compared to the previous estimate of $50 billion annually.