House Holds First Hearing of 2013 Focused on Research and Major Public Health Agencies Funded by the LHHS Appropriations Bill

Legislative Update
March 5, 2013

Rep. Jack Kingston (R-GA)

Today, House Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittee Chair Jack Kingston (R-GA) presided over a hearing that included Department of Health and Human Services (DHHS) agency heads as follows:

• Francis Collins, M.D., Ph.D. (Director, National Institute of Health, NIH);
• Thomas Frieden, M.D., M.P.H. (Director, Centers for Disease Control and Prevention, CDC);
• Carolyn Clancy, M.D. (Director, Agency for Healthcare Research and Quality, AHRQ);
• Mary Makefield, Ph.D., R.N. (Health Resources and Services Administration, HRSA); and
• Patrick Conway, M.D. (Director, Center for Clinical Standards and Quality, Center for Medicare and Medicaid Services, CMS).

In his opening comments, Chairman Kingston noted that, although Congress had not yet finalized Fiscal Year (FY) 2013 appropriations and the President and Congress had not yet proposed an FY2014 budget, the Subcommittee was taking initial steps regarding development of an FY2014 LHHS funding bill, which he hopes to develop by April. On March 13, the Subcommittee will hold a Public Witness hearing regarding LHHS programs, at which NAEVR has been asked to testify.

Chairman Kingston was joined by Ranking Member Rosa DeLauro (D-CT), who noted in her opening statement the critical nature of the work done by the represented agencies and the budget challenges they face, in terms of past flat funding and biomedical inflation that have reduced purchasing power, as well as the current impact of the sequester’s 5.1 cut on FY2013 spending. Cong. Nita Lowey (D-NY), a former Subcommittee member who now serves as the Ranking Member on the House Appropriations Committee, also attended. All Subcommittee members attended at one time or another and posed questions to the witnesses.

The panelists provided brief formal comments, followed by questions. In his formal testimony, Dr. Collins emphasized the value of NIH, in terms of public health impact (progress in the fight to understand and manage disease) and as a domestic and global economic engine (in terms of creating jobs and driving economic development). In response to a question from Cong. Lowey about sustained U.S. competitiveness in the biomedical arena, Dr. Collins stated that he chairs a group of research agency directors from several countries and that they have “read the U.S. playbook” in terms of investing in research. “As we go around the table, I hear about planned increases in research funding in these countries, and when it is my turn to speak, I indicate that if we are lucky, NIH will have flat funding.” In a response to a question from Ranking Member DeLauro, he lamented the budget’s impact on young investigators and whether they will have a career path that keeps them in research.

Republican members had a common theme in questions, specifically about duplication of efforts and if each agency was efficiently using resources. When asked about numerous diabetes initiatives, Dr. Collins responded that “each of the agencies has its own real estate in this complicated landscape, but are working together,” noting NIH’s basic and clinical research, CDC’s efforts to survey incidence and provide prevention education, AHRQ’s efforts to evaluate treatments with best outcomes measures, HRSA’s efforts to facilitate access to underserved patients, and CMS’s efforts to deliver better and more effective care. When asked about the number of inter-agency working groups among DHHS agencies, Dr. Collins noted that, although they most often serve to foster communication and avoid duplication, they enable one agency to advise another and potentially save resources. He concluded by stating that, “Budgets are tight, we get that, and would not want to waste a single dollar.”