Inside the House’s budget bill for HHS: Cuts for CMS, more money for NIH, CDC

The House appropriations bill covering HHS would increase the agency’s funding by $73.2 billion over fiscal year 2016, but includes policy amendments likely to stir up opposition among Democrats and cuts for CMS and programs tied to the Affordable Care Act.

According to a summary released by the majority Republicans on the House Appropriations Committee, several health agencies would see increases to their funding:

• $33.3 billion for the National Institutes of Health (NIH), $1.25 billion above the FY16 appropriation and $2.25 billion above President Barack Obama’s budget request.
• $7.8 billion for the Centers for Disease Control and Prevention (CDC), $605 million above FY16 and $800 million over Obama’s budget request.
• $4.2 billion for the Substance Abuse and Mental Health Administration (SAMHSA), $431 million above FY16 and $490 million over Obama’s budget request.

The most notable increases within the bill deal with opioids, which has been the subject of a separate funding fight on Capitol Hill over the past few months. The House bill includes $500 million for a state grant program for combating opioid and heroin abuse.

Those increases are below what Obama and congressional Democrats have sought on treating addiction and preventing abuse, but Rep. Tom Cole, R-Okla., chairman of the Labor-HHS appropriations subcommittee, accused the president of orchestrating “a misleading PR campaign” on Republicans’ anti-opioid abuse efforts.

“We understand that adding response funding to our already out-of-control mandatory ledger is neither realistic nor responsible," Cole said at the appropriations markup July 7.

There are increases for other agency programs and research in the bill, but set at levels below what the Senate’s appropriations committee has approved for HHS. For example, the Senate’s version has a $400 million increase for Alzheimer’s research, while the House bill gives it a smaller boost of $350 million.

The bill also includes $390 million for programs to combat the Zika virus. Obama had asked for $1.9 billion in emergency funding, which doesn’t have to go through the normal appropriations process.

Like the Zika bill which passed the House and has stalled in the Senate, the appropriations bill also includes policy riders Democrats on the subcommittee objecting to including.

The measure adopts the text the Health Care Conscience Rights Act, dealing with abortion and contraceptive services offered in insurance plans, along with cuts or elimination of women’s health programs.

“The bill hurts women’s health by completely eliminating funding for Title X Family Planning at a time when it is needed most—especially considering the public health threat of the Zika virus,” said Rep. Rosa DeLauro, D-Conn. “The bill also eliminates the Teen Pregnancy Prevention program—an action I find baffling given that teen pregnancy has been on the decline over the past twenty years.

Cole defended those amendments, along with cuts to the CMS budget aimed at the ACA, such as providing zero funding to the Center for Consumer Information and Information Oversight or to fund navigators to help health insurance exchange customers.

 “As always, one person’s poison pill is another person’s action to rein in over-regulation and executive overreach,” Cole said.

Republicans on the Labor-HHS appropriations subcommittee voted down several Democratic amendments, including one to remove restrictions on CDC funding studies on the effects of gun violence. Groups like the American Medical Association have asked Congress to allow federal funding of such studies, but Congress has maintained limits on any money going to studies which “promote gun control.”

More amendments and further changes may be made when the bill is evaluated by the full House Appropriations Committee on July 13.