News from the Hill: December 28, 2020

Following months of difficult negotiations and a last-minute curve ball from the administration, Congress passed and the president sighed, a comprehensive omnibus package to cap off the tumultuous 116^th Congress and bring 2020 to an end. The final package includes all Fiscal Year (FY) 2021 appropriations bills along with emergency supplemental appropriations for COVID-19 and related economic stimulus measures, as well as some timely authorizing legislation. While the legislation passed with overwhelming bipartisan support, it also represents a true compromise with neither budget-minded conservatives nor social-program inclined progressives receiving what they were hoping for. Ultimately, the legislation continued to invest in medical research and public health programs though the annual increases were modest and balanced with additional support dedicated to the COVID-19 response.    

Below, please find a summary of key items from FY 2021 omnibus appropriations/authorizing/COVID-19 response measure:

FY 2021 Annual Appropriations

• $42.9 million for the National Institutes of Health (NIH), an increase of $1.25 billion over FY 2020.
  • $855.42 million for the National Center of Advancing Translational Sciences (NCATS), an increase of $22.5 million over FY 2020.
    • $587.5 million for the Clinical and Translational Science Awards (CTSA) Program, an increase of $9 million over FY 2020.
    • “Up to” $60 million for the Cures Acceleration Network.

Full Spectrum of Medical Research.-The agreement applauds NIH efforts to support and advance the full spectrum of medical research, which ensure breakthroughs in basic science are translated into therapies and diagnostic tools that benefit patient care while disseminating cutting-edge information to the professional community. The agreement notes the importance of flagship initiatives, including the CTSA program, to these important efforts.

• $6.07 billion for the National Institute of General Medical Sciences (NIGMS), an increase of $54.2 million over FY 2020.
  • $396.57 million for the Institutional Development Award (IDeA) Program, an increase of $10 million over FY 2020.

Training the Next Generation of Physician-Scientists .-There is concern about the shrinking number of physician-scientists in the nation's biomedical workforce. These highly trained researchers with clinical expertise often discover the critical connections between what is discovered in the laboratory with their patients' conditions in the clinic. They play a critical role in translating scientific and laboratory advances into improved diagnoses, treatments, devices, procedures, and cures. The agreement commends NIGMS for its highly competitive Medical Scientist Training Program (MSTP), whereby students enter a combined, integrated MD-PhD program when they start medical school. The agreement strongly urges NIGMS to continue its support of promising physician-scientists being trained at research-intensive medical schools with high-quality laboratory and clinical training. The agreement commends NIH for its work to improve the physician-scientist pipeline. The agreement requests an update on the enhanced pathways for physicians both to pursue research training and be competitive for NIH awards, as recommended by the Advisory Committee to the NIH Director's Working Group on the Physician-Scientist Workforce. The update should highlight current activities, including increasing the diversity of physician-scientists, support provided during the transition from senior trainee to junior faculty member, and future plans. Additionally, the update should describe how feedback has been incorporated from current MSTP physician-scientist trainees, research-intensive medical schools, and biomedical industry representatives.

• $390.87 million for the National Institute on Minority Health and Health Disparities (NIMHD), an increase of $55.1 million over FY 2020.
  • $80 million for the Research Centers in Minority Institutions Program, an increase of $5 million over FY 2020. 

Chronic Diseases and Health Disparities.-In fiscal year 2020, NIH launched initiatives to address chronic diseases and health disparities in the areas of diabetes, kidney disease, and obesity. Chronic diseases and conditions are among the most common, costly, and preventable of all health conditions and disproportionately affect minority populations. These diseases can often leave those suffering from them more vulnerable to other diseases. A more comprehensive and holistic effort is needed to ensure that efforts to better address health disparities and co-morbidity encapsulate the full continuum of chronic diseases and their lethality in disparate communities. To this end, the agreement includes sufficient funding for NIMHD, working in concert with NIDDK, NHLBI, NCI, and NCA TS, to establish a comprehensive center initiative aimed at a wide variety of chronic diseases and their links to health disparities. As these diseases are often multi-faceted and often regionally linked, NIMHD is encouraged to consider funding mechanisms that would support regional multi-institutional consortiums that produce collaboration, research, and translational science on a wide and broad scale.

• $2.41 billion for the Office of the Director at NIH, an increase of $171.32 million over FY 2020.
  • $635.94 million for the Common Fund, an increase of $9.43 million over FY 2020.

• $7.9 billion for the Centers for Disease Control and Prevention (CDC), an increase of $125 million over FY 2020.

• $338 million for the Agency for Healthcare Research and Quality (AHRQ), level-funded from FY 2020.

Emergency Supplemental COVID-19 Response

• $73 billion in additional funding for HHS.
  • $8.75 billion in additional funding for CDC.
  • $1.25 billion in additional funding for NIH.