Senate FY16 LHHS Post Mark-Up Summary

Last week, the Fiscal Year (FY) 2016 Senate Labor, Health and Human Services, and Education (LHHS) Appropriation bill was approved by the Senate Appropriations Committee along a party line vote of 16-14. This legislation proposes $32 billion for the National Institutes of Health (NIH) an increase of $2 billion over FY15 and $415.1 million  for the National Institute of Dental and Craniofacial Research (NIDCR) which is $17.4 million over the enacted FY15 level of $397.7 million.  Some of the increases for NIH were provided for the following initiatives:

  • $200 million for Precision Medicine;
  • $350 million increase for the National Institute on Aging, the lead Institute researching Alzheimer’s disease;
  • $135 million, an increase of $70 million, for the BRAIN Initiative to map the human brain;
  • $461 million, an increase of $100 million, to Combat Antibiotic Resistance;
  • $300 million, an increase of $26.7 million, for the Institutional Development Award;
  • And increases to every Institute and Center to continue investments in innovative research that will advance fundamental knowledge and speed the development of new therapies, diagnostics, and preventive measures to improve the health of all Americans.

The Committee report also included report language pertinent to NIDCR. Specifically:

 “Temporomandibular Disorders {TMD }.-Temporomandibular Disorders affect approximately 35 million Americans; the majority affected are women in their childbearing years. The Committee encourages NIBIB, NIAMS, and NIDCR to consider the recommendations that resulted from their jointly sponsored Roundtable on the Temporomandibular Joint in Health and Disease in 2013. Research to develop safe and effective techniques for joint repair and regeneration is essential. An analysis of problems associated with current joint replacements should provide guidance in these efforts. The Committee commends NIDCR for its ongoing support for the OPPERA program, which is yielding valuable information on many physiological aspects, not only of temporomandibular disorders, but of other pain conditions that overlap with TMD. To capitalize on the research to continue the momentum gained from OPPERA, the Committee urges NIH to continue research of this caliber and direction, and to consider measures to encourage NIH-funded investigators from related fields to include TMD and comorbid conditions in their studies.”

However, since the overall allocation for this bill is $3.6 billion below the FY15 enacted level, the proposed increased funding came at the expense of other important public health programs. Funding for the Agency for Healthcare Research and Quality was cut by 35% and the National Center for Health Statistics received a $10 million reduction.

During the committee mark-up Ranking Member Mikulski (D-MD) and Senators Collins (R-ME) and Shelby (R-AL) voiced their support of the $2 billion increase for NIH, including the $300 million budgeted specifically for Alzheimer’s research.  During the committee mark-up Senator Durbin (D-IL) strongly supported NIH research and said, “There should be a standard in which the NIH would have a 5% increase in the budget every year. This would then help to break a long run of mediocre investments and sequestration.”

Senator Cassidy (R-LA) also proposed an amendment which would take $235 million away from the National Institute of Allergy and Infectious Diseases (NIAID) and reallocate those funds to the National Institute of Neurological Disorders and Stroke, the National Institute for Mental Health and the National Institute of Biomedical Imaging and Bioengineering. Senator Cassidy argued that, “The NIH spending priorities are no longer on the current main health issues that Americans are facing today.” He mentioned that AIDS research received 10% of the NIH’s funding for the past 25 years and other diseases and conditions such as Alzheimer’s disease, Parkinson’s, and ALS warrant our attention. This amendment failed by a 6-23 vote.

Senator Murray (D-WA) voted against approval of the appropriations bill noting that she would like the sequestration caps lifted so that more money is available to fund other important programs.

Below is additional information about programs of importance to AADR:

  • HRSA Title VII Training in Oral Health Care received $32 million  which is a slight decrease from the FY15 level of $33.9 million The Committee provides $32,000,000 for Training in Oral Health Care programs, which includes not less than $9,000,000 each for general and pediatric dentistry. Funds may be used to expand training in general dentistry, pediatric dentistry, public health dentistry, dental hygiene, and other oral health access programs. Funds may also be used to plan and operate training programs, as well as to provide financial assistance to students and residents. The Committee directs HRSA to prioritize programs that support underserved communities and applicants from disadvantaged background in any new grant competition. Further, the Committee encourages HRSA to focus on training programs that target vulnerable populations in risk-based clinical disease management of all populations. The Committee urges HRSA to work with Centers for Medicare and Medicaid Services [CMS] on the evaluation and support of additional models for expanding access to oral healthcare. Such models should include emergency room diversion programs and efforts under State law to deploy and evaluate new provider types.  The Committee continues long-standing bill language that prohibits funding for section 340G-1 of the PHS Act.
  • HRSA Maternal and Child Health Bureau Prenatal Oral Health.-The Committee recognizes the importance of prenatal oral healthcare for the health of both mother and child and encourages the MCH Bureau within HRSA to continue its efforts to improve the oral health of pregnant women. on these activities in the fiscal year 2017 CJ.
  • CDC Division of Oral Health received $15.7 million which is level with FY15. The Committee urges CDC to support clinical and public health interventions that target pregnant women and young children at highest risk for dental caries. These interventions result in significant cost-savings to State Medicaid programs. CDC is encouraged to continue to work across the Department to improve coordination of oral health surveillance that reliably measures and reports health outcomes.

AADR will continue to work with Congress to lift the caps on discretionary spending so all research and public health programs received increased, sustained and predictable funding.

Budget Update

This week Congress approved their budget resolutions by a 52-46 vote in the Senate and a 228-199 vote in the House. The budget resolutions essentially are a blueprint laying out Congressional priorities for the next year. The House and Senate will now develop a compromise agreement or conference report in the upcoming weeks. Unfortunately, both bills keep in place the sequester level caps on non-defense discretionary spending. Non-defense discretionary spending funds important components of the federal government including the National Institutes of Health (NIH) and the National Institute of Dental and Craniofacial Research (NIDCR). By adhering to the austere spending caps it will be virtually impossible for Congress to provide meaningful increases in funding for NIH in the upcoming fiscal year.

There may be a small glimmer of hope however, according to CQHealthbeat, “Some in the GOP see the House and Senate budgets as an opening bid in a likely negotiation with the White House later this year. Such talks would look for broader changes in the spending caps that many lawmakers argue should be raised both for defense and domestic programs.” AADR will continue to advocate on behalf of our members urging Congress to undo sequestration, raise the caps on non-defense discretionary spending and reinvest in biomedical research.

What is next? After Congress votes on the budget resolution conference report, the appropriations committees receive their funding allocations and will begin their work drafting appropriations bills. Historically, Congress will release the text of those bills in early summer.

AADR Issues Statement about House FY16 Budget Resolution

House FY16 Budget Resolution: Bad for Biomedical Research, Unhealthy for Americans

The American Association for Dental Research (AADR) is deeply disappointed with the fiscal year (FY) 2016 Budget Resolution adopted today by the House Budget Committee. By adhering to austere spending caps in the short term, this spending blueprint will further slow progress on improving the health and well-being of all Americans as well as effectively stifle any opportunities to develop personalized medicine approaches to improve dental, oral and craniofacial health, reduce oral health inequalities, or ensure a robust and diverse pipeline of dental, oral, and craniofacial researchers.

By cutting nondefense discretionary spending an additional $759 billion from FY2017 through FY2025, this budget plan all but assures that the US will continue to lose ground as the world leader in research and development, that its economic growth will be hampered and that American families will lose their best hope for treating and curing debilitating diseases.

Non-defense discretionary spending funds important components of the federal government, including the National Institutes of Health (NIH) and the National Institute of Dental and Craniofacial Research (NIDCR). Many members of Congress have voiced their support for biomedical research, but unless Congress provides a sufficient and reliable investment for NIH, American’s health will suffer.

Over the past several years, funding for NIDCR has dropped 25 percent when adjusted for inflation. This decline in purchasing power is especially troubling because past achievements in oral health during the last half century are in large part the fruits of research supported by NIDCR. Any hope of restoring that momentum would be lost under this budget resolution.

“We hope lawmakers will reject this resolution and work together to develop a balanced approach to deficit reduction that does not rely on additional cuts to non-defense discretionary programs,” said AADR President Paul Krebsbach from the University of Michigan School of Dentistry.