In Hearing with Dr. Collins, House Appropriators Reiterate Concerns about Mandatory Funding for NIH in President’s FY2017 Budget Request

Legislative Update
March 16, 2016

NIH Director Francis Collins, M.D., Ph.D.

On March 16, the House Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittee held a hearing with National Institutes of Health (NIH) Director Francis Collins, M.D., Ph.D. and several of his senior staff (see below) regarding the President’s Fiscal Year (FY) 2017 budget request for NIH, submitted to Congress on February 9. As in the Subcommittee’s February 25 hearing with Department of Health and Human Services Secretary Sylvia Burwell (and the Senate Subcommittee’s March 3 hearing with Secretary Burwell), a major issue was the budget’s reliance on mandatory funding, specifically the $33.1 billion NIH budget that includes mandatory funding of $1.825 billion, reflecting $1 billion of that which was previously discretionary funding—essentially supplanting the discretionary base—and $825 million for new and existing trans-NIH initiatives, including the National Cancer Moonshot, Precision Medicine Initiative, and the Brain Research through Advancing Innovative Neurotechnologies Initiative (BI).

In his opening statement, Subcommittee Chairman Tom Cole (R-OK) acknowledged that several Subcommittee members had visited the NIH campus on February 29, including full Appropriations Committee Ranking Member Nita Lowey (D-NY), Cong. Charlie Dent (R-PA), Cong. Andy Harris, M.D. (R-MD), Cong. Mike Simpson (R-ID), and Cong. Steve Womack ((R-AR). He reiterated his concern that the President proposes to “divert $1 billion of biomedical research funds to the mandatory side of the budget ledger and rely on new and, perhaps unlikely, authorizations to continue the advances that we have made in increasing research funding.” He again called this “disheartening,” adding that, “Frankly, I do not plan to let the $1 billion cut stand,” emphasizing that Congress needs to ensure a sufficient basic biomedical research base.

Full Appropriations Committee Chair Hal Rogers (R-KY), who acknowledged his recent visit to the University of Kentucky Markey Cancer Center, echoed those concerns stating that, “Funding must come through regular discretionary channels and not through mandatory funding, which is soaring out of control.”

While promising that she would work with Chairman Rogers to ensure that NIH’s discretionary base would not be cut, full Committee Ranking Member Lowey added that, despite the $2 billion FY2016 increase, NIH funding is “still behind,” expressing her concern for young investigators. As in the hearing with Secretary Burwell, Subcommittee Ranking Member Rosa DeLauro (D-CT) cited “budget constraints by sequestration and artificial budget caps” as the driving force for why NIH funding is $7.5 billion below its FY2003 level, when adjusted for biomedical inflation.

In his verbal testimony, Dr. Collins built upon his written testimony by describing ten areas in which NIH’s basic science is moving research forward:

• Analysis of individual cells and their functions.
• BI tools identifying brain cells and circuits, enabling earlier diagnosis, treatment and prevention of neurological conditions.
• BI imaging that may enable earlier diagnosis, especially in Alzheimer’s disease.
• New treatments for spinal cord injuries.
• Development of an artificial pancreas.
• Rebuilding a patient’s heart with his/her own modified cells.
• New vaccines, including a universal flu vaccine and an HIV vaccine in the next ten years.
• Using all of the new scientific tools to better understand
and more safely treat pain.
• Precision medicine/tailored approaches to treat disease.
• Improved cancer survival, as a result of the National Cancer Moonshot.

In the ensuing question and answer period, and after cautioning that mandatory funding is outside the jurisdiction of the Subcommittee and in its absence the President’s budget reflects a $1 billion cut to NIH, Chairman Cole asked Dr. Collins about the impact of such a cut. “Severe, across all of NIH, and affecting new initiatives that are just getting started,” replied Dr. Collins. When asked by Chairman Cole what NIH would do with a discretionary base greater than that proposed, Dr. Collins responded, “Fund areas ripe for research, especially investigator-initiated research where we get most of the new ideas.”

Among the Republican members of the Subcommittee, Cong. Dent again expressed his strong concern for extramural researchers, noting that the budget only assumes mandatory funding for one year, resulting in a “cliff” due to the switch away from discretionary funding.

Committee members queried Dr. Collins and his colleagues about a number of key issues, including opioid abuse, the Zika virus, cancer, the application of precision medicine to various diseases, and children’s health. Directors joining Dr. Collins included:

• Anthony Fauci, M.D., National Institute of Allergy and Infectious Diseases (NIAID)
• Richard Hodes, M.D., National Institute of Aging (NIA)
• Doug Lowy, M.D., National Cancer Institute (NCI)
• Nora Volkow, M.D. National Institute on Drug Abuse (NIDA)

In a February 10 statement on the President’s budget request, NAEVR expressed its disappointment in its use of mandatory funding to supplant the discretionary base, especially at it relates to most of the Institutes and Centers (I/Cs) which are flat-funded, including the National Eye Institute (NEI). The President requests NEI funding at $708 million—the same as its FY2016 operating budget, which was reduced from its enacted level of $715.9 million due to pass-throughs. The flat-funding relies, however, on mandatory funding—without it, I/Cs would be funded at the level proposed in the President’s FY2016 budget request. For NEI, that would be $687 million. The budget proposal essentially reduces the discretionary funding base for I/Cs.

In FY2016, the NEI budget finally had minimal growth (0.8 percent) above its FY2012 funding level for the first time in four years after the devastating impact of the $36 million sequester cut in FY2013. That trend to rebuild the NEI budget must continue through an increase in the appropriated base for the Institute. As a result, NAEVR is urging Congress to appropriate at least $34.5 billion for NIH and $770 million for the NEI in FY2017, a 7.5 percent increase over FY2016 for each that reflects five percent real growth above the projected 2.5 percent rate of biomedical inflation.