Weekly updates of the budget and appropriation process - news events that affect your digestive health.

 

We will update you on the federal budget process which includes a detailed spending plan. Each fiscal year (FY) runs from October 1 through September 30 of the following year. As authorized by the Constitution, Congress is in charge of deciding the budget, granting the power to collect taxes, borrow money and approve spending.

 

September

September 22, 2020 -After negotiations with the White House, the House of Representatives passed H.R. 8337. This stopgap measure has bipartisan support, and will keep federal agencies funded through December 11th. The Senate is expected to follow suit and pass the bill before the September 30th end of the current fiscal year. While the bill keeps agencies level-funded, the relatively “clean” CR does include a provision which would extend the availability of funding for certain multiyear NIH research grants that were interrupted by COVID-19 and set to expire on September 30th. Here is a summary of the continuing resoltion, and more information on the bill.

September 11, 2020 - The White House and legislators have agreed to work to advance a stopgap continuing resolution (CR) to fund federal agencies from Oct. 1 until after the November election. Political considerations are being weighed by both Democrats and Republicans. Republicans want the CR to last until sometime after the election, but expire before the end of the calendar year so they can work with the existing set of congressional and administration players to finish off the process. Democrats, are pressing for a CR that lasts into calendar year 2021.

 

August

August 14, 2020 - As September 30 marks the end of FY 2020, a continuing appropriations resolution (CR) is expected. This will provide funding for government agencies through the fall, until regular appropriations measures can be enacted.

The House and Senate are both expected to halt negotiations on the HEROS Act and HEALS Act COVID-19 legislation until after the August recess has concluded.

August 7, 2020 - House and Senate appropriators are poised to begin negotiations on the spending details of the COVID-19 stimulus bill. Scientific, patient, provider, and academic groups are encouraging the House and Senate leadership to adopt a funding level of $15.5 billion for National Institutes of Health in the upcoming COVID-19 spending package. This funding would support coronavirus research and support research that was halted or otherwise negatively impacted by the pandemic situation.

 

July

HEALS Act

July 31, 2020 - Senate Republicans issued the HEALS Act—their $1 trillion alternative to the House-passed $3 trillion HEROES legislation addressing COVID-19. The HEALS Act takes a more limited approach, but does contain important economic stimulus, spending, and healthcare access provisions. Notably absent in the Senate package is a COVID-19 National Testing Plan mandate, and meaningful relief for large and mid-sized not-profits. Senators will continue working towards a complete COVID-19 package, which will require bipartisan cooperation.

Fiscal Year (FY) 2021 Appropriations

July 27, 2020 - House Appropriations Committee Chairwoman Nita Lowey (D-NY) worked another major spending bill through the full House of Representatives the week of July 27th, rolling six annual FY 2021 appropriations measures into one package that cleared the House on July 31st. The minibus includes the annual funding bills for 1) Labor-HHS-Education; 2) Defense; 3) Energy and Water; 4) Commerce, Justice and Science; 5) Financial Services; and 6) Transportation, Housing, and Urban Development. See the House Appropriations Committee Press Release here. The full bill text is available here.

July 10, 2020 - Beginning in July, the House Appropriations Committee considered and passed its Fiscal Year (FY) 2021 appropriations bills for the departments of Labor, Health and Human Services, Education, and Related Agencies (L-HHS), Defense, Military Construction, Veterans Affairs, and Related Agencies, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies, Interior, Environment, and Related Agencies, and State, Foreign Operations, and Related Programs. These bills are the first significant movement of the FY 2021 appropriations process and may be voted on in the full House of Representatives in the coming weeks.

Labor-HHS bill key provisions:

$96.4 billion for the Department of Health and Human Services, an increase of $1.5
billion above the FY 2020 enacted level.

  • $7.2 billion for Health Resources Services Administration (HRSA), an increase of $157 million above the 2020 enacted level.

    • $8 billion for Centers for Disease Control and Prevention (CDC), an increase of $232 million above the FY 2020 enacted level.

    • $9 billion in emergency supplemental funding for public health and emergency response activities.

    • $1.31 billion for Chronic Disease Prevention and Health Promotion, a proposed increase of $66.5 million over FY 2020.

      • $3 million for a new Chronic Disease Education and Awareness Program, a
        proposed increase of $3 million over FY 2020.

  • $ 47 billion for the National Institutes of Health (NIH), $5.5 billion above the FY 2020 enacted level.

    • Within the total, the bill provides $42 billion in annual appropriations (including the full $404 million provided in FY 2021 through the Innovation Account established in the 21st Century Cures Act for specific initiatives), an increase of $500 million above the 2020 enacted level (1.2%), as well as $5 billion in emergency appropriations available through FY 2025. The $5 billion in emergency funding may be used “to offset costs related to reductions in laboratory productivity resulting from interruptions or shutdowns of research activity” in FY 2020, and would be provided to the Office of the Director, with the requirement that at least $2.5 billion be distributed across NIH proportionate to each institute and center’s FY 2020 funding level.
  • $2.27 billion for the National Institute of Diabetes and Digestive and Kidney Diseases, a proposed increase of $154.24 million over FY 2020.
  • $893.65 million for the National Center for Advancing Translational Sciences, a proposed increase of $60.76 million over FY 2020.
  • $4.61 billion for the Office of the Director, a proposed increase of $2.4 billion over FY 2020.
    • $631.9 million for the Common Fund, a proposed increase of $5.4 million over

      FY 2020.

  • $6 billion for Substance Abuse and Mental Health Services Administration (SAMHSA) an increase of $96 million above the FY 2020 enacted level.
  • $343 million for the Agency for Healthcare Research and Quality (AHRQ), an increase of $5 million above the FY 2020 enacted level.
  • $4 billion for Centers for Medicare and Medicaid Services (CMS) administrative expenses, an increase of $315 million above the FY 2020 enacted level.

$73.5 billion in discretionary appropriations for the Department of Education, an increase of $716 million above the FY 2020 enacted level.

Defense Bill key provisions:

$33.3 billion for the Defense Heath Program (basically level-funding from FY2020), including $1.02 billion for congressionally directed medical research activities.

Military Construction/VA Bill key provisions:

$840 million is proposed for the VA Medical and Prosthetic Research Program, an increase of $40 million above the FY 2020 enacted level.

Agriculture-FDA Bill key provisions:

$3.212 billion in discretionary funding for the Food and Drug Administration (FDA), an increase of $40.8 million above the FY 2020 enacted level.



June

June 5, 2020 - House Appropriations Committee Chairwoman Nita Lowey (D-NY) issued a “Dear Colleague” letter to House members announcing the committee’s plans to hold all subcommittee and full committee markups of FY 2021 bills during the weeks of July 6 and 13th. The bills are then expected to be on the House floor the weeks of July 20th and 27th.

 

May

House Resolution 965 - Authorizing remote voting by proxy in the House of Representatives and providing for official remote committee proceedings during a public health emergency due to a novel coronavirus, and for other purposes, was passed on May 15th. Remote voting is allowed for 45 days with the possibility of extending this period by another 45 days or shortening it, depending on the status of the public health emergency. The new remote voting rules require committees to hold a few hearings and practice deliberations before advancing legislation.

A House Appropriations Committee spokesperson advised the media that the committee would be holding off on FY 2021 markups until after the COVID-19 (HEROES) legislation is finalized. The committee staff is working hard to be prepared to move forward with markups when they do occur.

 

March 2020

House and Senate Labor-HHS appropriations subcommittees held hearings on February 27th with Health and Human Services Secretary Azar. Congress is prepared to spend emergency funding to respond to needs identified by health officials. On March 5th, President Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) allotting $8.3 billion in emergency spending to respond to the outbreak.

 

February 2020

The House and Senate are both holding subcommittee hearings in the beginning of March to examine the proposed budget of the National Institutes of Health for FY 2021. These links will provide upcoming hearing information for the House and Senate appropriations subcommittees.

House and Senate Labor-HHS appropriations subcommittees held hearings on February 27th with Health and Human Services Secretary Azar. Much of the time at the hearing was dedicated to discussing questions about the coronavirus and the adequacy of the administration’s request for supplemental funding to respond to the public health threat. Congress is preparing to spend emergency funding to respond to needs identified by health officials. Read Secretary Azar's oral testimony to the House Committee on Ways and Means here.

 

 

FY 2021 Appropriations

The President's administration budget proposal for FY 2021 was issued to Congress on February 10. These funding recommendations do not conform to the two-year budget deal released last year. Congress will now examine this budget proposal and develop the twelve annual appropriations bulls based on funding levels provided by the two-year budget deal. Find the entire budget document here.

  • $6.21 billion for FDA, a proposed increase of $265 million above FY 2020.

    • $2.02 billion for Human Drugs at FDA, a proposed increase of $49 million over FY 2020. 

    • $1.12 billion in Prescription Drug User Fees at FDA, a proposed increase of $52 million over FY 2020.

    • $526 million in Generic Drug User Fees at FDA, a proposed increase of $10 million over FY 2020.

    • $425 million for Biologics at FDA, a proposed increase of $6 million over FY 2020. 

    • $43 million in Biosimilar User Fees at FDA, a proposed increase of $1 million over FY 2020.

  • $7 billion for CDC, a proposed decrease of $693.29 million below FY 2020.

    • $813 million for Chronic Disease Prevention and Health Promotion at CDC, a proposed decrease of $427 million from FY 2020. 

  • Individual chronic disease programs are consolidated into a new proposed block grant program.

  • $38.69 billion for NIH, a proposed decrease of $2.99 billion below FY 2020.

      • $2.01 billion for the National Institute of Diabetes and Digestive and Kidney Diseases at NIH, a proposed decrease of $191 million from FY 2020.

      • $788 million for the National Center for Advancing Translational Sciences at NIH, a proposed decrease of $45 million from FY 2020.$2.1 billion for the Office of the Director at NIH, a proposed decrease of $148 million from FY 2020.

      • $788 million for the National Center for Advancing Translational Sciences at NIH, a proposed decrease of $45 million from FY 2020.

    $2.1 billion for the Office of the Director at NIH, a proposed decrease of $148 million from FY 2020.

FY 2020 Appropriations

Congressional leaders and administration officials have agreed on a comprehensive package for Fiscal Year (FY) 2020 spending which includes all 12 annual appropriations bills that are lumped into two minibus spending measures. Find a press release from the House Committee on Appropriations containing a full summary and the minibus text here.

 

Key spending highlights of the bills include:

  • $95 billion in discretionary spending for the Department of Health & Human Services, an increase of $4.4 billion above FY 2019.
  • $7.3 billion for the Health Resources and Services Administration, an increase of $177 million above FY 2019.
  • $8 billion for the Centers for Disease Control and Prevention, an increase of $636 million above FY 2019.
  • $41.7 billion for the National Institutes of Health, an increase of $2.6 billion above FY 2019.
  • $5.9 billion for the Substance Abuse and Mental Health Services Administration, an increase of $140 million above FY 2019.
  • $338 million for the Agency for Healthcare Research and Quality, level-funded with FY 2019.
  • $73 billion in discretionary spending for the Department of Education, an increase of $1.3 billion above FY 2019.
  • $800 million for the VA Medical and Prosthetic Research Program, an increase of $20 million above FY 2019.
  • $34 billion for the Defense Health Program, level-funded with FY 2019.
  • $5.77 billion including user fees and $3.16 billion in discretionary funding for the Food and Drug Administration, an increase of $91 million above FY 2019.

 

January 2020

Retiring House Appropriations Committee Chairperson Nita Lowey (D-NY) is expected to push the FY 2021 bills out of committee during her last year in office, and there is similar optimism in the Senate for swift committee action.

 

For FY 2021, the expectation is that appropriators will hit the ground running in February once the administration’s budget proposal is issued (on the 10th). The recent overarching budget deal covers both FY 2020 and FY 2021, so there is relatively little holding back the FY 2021 process. Retiring House Appropriations Committee Chairperson Nita Lowey (D-NY) is expected to push the FY 2021 bills out of committee as expeditiously as possible during her last year in office, and there is similar optimism in the Senate for swift committee action.

 

 

 

 

Senate Republicans issued the HEALS Act—their $1 trillion alternative to the House-passed $3 trillion HEROES legislation addressing COVID-19. The HEALS Act takes a more limited approach, but does contain important economic stimulus, spending, and healthcare access provisions. Notably absent in the Senate package is a COVID-19 National Testing Plan mandate, and meaningful relief for large and mid-sized not-profits. See the attached DDNC memo for a more detailed look. Senators will try again next week to find a path forward on the COVID-19 package, which will require bipartisan cooperation.

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