House Committee would provide $1.1 Billion increase to NIH
The U.S. Capitol Dome in the background with a marble column in the foreground

On July 13, the House Appropriations Subcommittee on L-HHS-Education approved an FY 2018 spending bill that provided NIH with a $1.1 billion increase over its FY 2017 funding level. Although this would amount to only about half of the increases Congress has given NIH in each of the past 2 years, it is $8.6 billion above the Trump budget request. The full Appropriations Committee approved the bill on July 19.

The $35.2 billion represents a 3% increase over FY 2017 and consists of just under $34.7 billion in regular appropriations plus $496 million designated for the NIH Innovation Account established under the 21st Century Cures Act. NIH’s FY 2017 budget is $34.1 billion including $33.7 billion in regular appropriations and $400 million for the Innovation Account.

The bill designates these funds for specific areas of research:

  • $1.8 billion for Alzheimer’s Disease research (up $400 million)
  • $336 million for the Brain Research through Application of Innovative Neurotechnologies or BRAIN initiative (up $76 million)
  • $400 million for “All of Us” (formerly the Precision Medicine Initiative) (up $80 million)
  • $300 million for the Cancer Moonshot
  • $10 million for regenerative medicine research (up $8 million)

It also provides:

  • $526 million for Clinical and Translational Sciences Awards (up $10 million)
  • $374 million for Institutional Development Awards (IDeA) programs (up $40 million)
  • $493 million for Combating Antibiotic-Resistant Bacteria (up $30 million)

The bill has language blocking the President’s proposal to slash NIH payments for facilities and administration costs by two-thirds. The White House had argued that the NIH budget could be reduced by $7.5 billion with little impact on research by reducing indirect cost reimbursements from 28% of the agency’s overall extramural research spending to a flat rate of 10% per grant. The bill also prohibits NIH from using any of its 2018 budget to “develop or implement a modified approach to such provisions.”

In addition, the bill maintains the HHS salary cap at Executive Level II rather than the reducing it to Executive Level V and rejects the proposals to abolish the Fogarty International Center to fold the Agency for Healthcare Research and Quality into a new NIH institute for safety and quality.

However, the bill also has language that would prohibit the use of funds “to conduct or support research using human fetal tissue if such tissue is obtained pursuant to an induced abortion.” This language mirrors a recommendation made earlier this year by the now-disbanded House Select Investigative Committee on Infant Lives. The provision echoes past Republican efforts to pass legislation restricting research with fetal tissue from induced abortions, none of which have become law.

“We are disappointed that the bill places arbitrary restrictions on research using fetal tissue,” said AAMC CEO Darrell Kirch in a statement. Kirch noted that such research contributes to scientists’ understanding of Alzheimer’s disease, birth defects, blindness, spinal cord injuries, stroke, and amyotrophic lateral sclerosis. NIH expects to spend $107 million on projects using fetal tissue in FY 2017, up from $103 million in 2016, when it funded 228 such projects. Although the House is likely to approve the language, it would likely face a filibuster in the Senate, which means it would need 60 votes to pass.

The bill also proposes funding cuts for other health agencies:

  • A $198 million cut to the Centers for Disease Control and Prevention
  • A $306 million cut to the Substance Abuse and Mental Health Services Administration
  • A $398 million cut to the Health Resources and Services Administration, mainly by eliminating funding for Title X family planning

L-HHS Appropriations Subcommittee Chair Rep. Tom Cole (R-Okla.) referred to the bill as “the opening position,” noting that his panel had to “work with the [budget] allocation we have, which is $5 billion less than last year. Cole expressed optimism that if additional funds are made available under a budget deal, “we can plug some holes and make some improvements.”