Congress Starts the Appropriations Process, But Has a Long Way To Go

As the House and Senate get ready to go on their traditional August recess, we have seen the first signs of movement in the congressional appropriations process.  The House Appropriations Committee has released 10 of its 12 FY22 bills, seven of which have been combined into a single bill and passed the House on July 29.  Those seven bills include funding for NIH, CDC, HRSA, and the VA.

The good news is that the House appropriators have recommended increased funding each of these agencies. Below are some specific examples:

National Institutes of Health – The NIH has seen its budget steadily increase over the last six years.  If the House provision prevails, this trend will continue.  The House bill sets the funding level for NIH at $49.4 billion, a $6.5 billion increase in total funding for this very popular agency.  Of that amount, $3.5 billion will go to the existing 27 institutes and centers at NIH, and the Office of the Director.  The remaining $3.0 billion would be used to establish the Advanced Research Projects Agency for Health (ARPA-H), a high priority of the Biden administration. Also of interest to many AASLD members is directive language to the National Cancer Institute to focus research on primary liver cancer and cholangiocarcinoma.

Centers for Disease Control and Prevention – The CDC, which has suffered under tight budgets for years has gotten some significant relief this year. Of specific interest to AASLD members, the Division of Viral Hepatitis has been recommended for an increase from $39.0 million to $44.5 million, although much more will be needed to eliminate viral hepatitis. Increases throughout the agency will significantly expand public health efforts and are, of course a direct result of the experienced with Covid-19 over the last 18 months.

Health Resources and Services Administration – HRSA also fared well in the House appropriations bill when compared to previous years. For example, the Division of Organ Transplantation’s budget for FY2022 was set at $34 million, an increase of $5.0 million over the current fiscal year. The program to provide reimbursement for living organ donors for travel and subsistence saw an even larger increase, moving from $6.0 million in the current year to a recommended level of $18.8 million in FY2022.

VA Medical and Prosthetics Research – For AASLD members who do all or part of their research through the Department of Veterans Affairs, there is still more good news.  The Medical and Prosthetics Research line item has also shown a considerable increase.  From an FY21 level of $815 million, the House committee is recommending $902 million, and $87 million increase.  This is the precise level that AASLD and our partners in the Friends of the VA advocacy coalition sought for the upcoming fiscal year.

It is important to note that this is just the beginning of the process and there remain many more steps, including Senate committee action, Senate passage, conferencing the differences between House and Senate bills, passage of identical measures in both houses, and signature by the President.  But this is a significantly better starting point than we have seen in recent years and we look forward to working with Congress to carry these numbers through all the steps ahead.