NIH Funding: Reason for Optimism?

Why I Rally for Medical Research

By Ross A. Frommer, vice president for Government and Community Affairs and associate dean at Columbia University Medical Center  

The biomedical research community has felt the squeeze of a lean NIH budget for many years, first as funding flat-lined for nearly a decade before dipping during the 2013 sequestration. In real terms, funding is down 20 percent since 2003, impacting current and future research alike.

But change may be on the horizon. Why do I say that? First, there is strong bipartisan support for biomedical research in both the House and Senate. Earlier this year, 169 members of the House and 54 senators cosigned letters supporting an increase in funding, with more Republicans signing than ever before. Republican presidential hopefuls have also expressed their support in some form or another: nine of the Republican candidates have come out publicly in support of funding for biomedical research in some form or another.

President Obama’s budget request includes $31.1 billion for NIH, which would be a $1 billion increase from 2015. The House does him $100 million better, appropriating $31.2 billion for the agency. The Senate beats them all with $32.1 billion, a roughly 6 percent increase for the NIH in its Appropriations bill. Regardless of the exact number, we are looking at a significant increase that would bring the agency funding level to its highest amount ever.

This is in addition to an $8.75 billion funding increase included in the bipartisan proposal, 21st Century Cures Act, led by Reps. Fred Upton (R-MI) and Dianna DeGette (D-CO), to move biomedical research forward. This would be in addition to the annual appropriation, and because it is mandatory, not subject to the annual budget process. HR 6 passed the House on July 10 by a strong bipartisan margin of 344 to 77. Next stop is the Senate.

By Ross A. Frommer, vice president for Government and Community Affairs and associate dean at Columbia University Medical Center

Ross Frommer

While the chances of seeing a significant bump up in the NIH budget are higher than they have been in a long time, the budget process is far from complete and an increase in funding is by no means a certainty. Most, if not all, of the potential roadblocks are unrelated to the NIH itself. Despite the strong bipartisan support for the NIH, significant disagreement among the President and Republicans and Democrats in Congress over the broad budget picture will at least delay and possibly prevent a final spending plan for 2016. The federal fiscal year ends on September 30, and given delays, we will need a continuing resolution (CR), a temporary spending bill that will allow the government to continue to operate at their existing funding levels. This means that even though the President, the House, and the Senate all want to give the NIH a big increase, the agency will operate at its 2015 level until a final appropriations bill has passed. Of course, all this assumes there is a CR and we avoid another government shutdown.

Despite the bipartisan expressions of support for the NIH, increased funding is far from certain. Since 2011, there has been a cap on overall discretionary spending. With this cap in place, it is very difficult to fund increased spending, even for agreed upon priorities like the NIH. President Obama has called on Congress to lift the caps, but so far there has been no movement on this. Further complicating matters is that the partial relief from the budget caps provided in the 2013 Ryan/Murray budget agreement expires in 2016 and sequestration could come back into effect.

Even 21st Century Cures is far from being a done deal. Although Sen. Lamar Alexander (R-TN), chair of the Committee on Health, Education, Labor, and Pensions (HELP) is a strong NIH supporter, he has not committed to including additional funding in the Senate version of the bill. Further complicating matters is that some provisions of the bill, notably the offsets used to pay for the increased NIH funding, lie outside the HELP Committee’s jurisdiction, meaning the bill would have to be reviewed by at least one other committee before coming to the Senate floor.

This is why it is so important to advocate strongly for increased NIH funding. Patients, scientists, health care providers, and others must make their voices heard and let Congress know how important this issue is.

Advocacy works. During consideration of the 21st Century Cures Act, there was an amendment that would have converted the additional NIH funding from mandatory to discretionary. This would have subjected the funding to the whims of the annual budget process. In response, members of the research advocacy community came out in strong opposition. Columbia worked with other research institutions across the State to urge the New York Congressional delegation to oppose it. Every member from New York—Republican/Democrat, upstate/downstate—voted no, and the amendment went down in defeat by a large margin.

Examples like this underscore how important it is to take a stand, and there are several ways to do so. You can always contact your senators and member of Congress (www.senate.gov and www.house.gov) to let them know how you feel. From time to time, the Association of American Medical Colleges and other patient advocacy or professional organizations will run very effective web-based grassroots efforts which you can support. When participating in such efforts, please remember to use your home address, not your work address (you may use your Columbia email address).

There is a special opportunity to participate in advocacy on September 17. That day, patients, scientists, health professionals, families, and friends will gather in Washington for the Rally for Medical Research. Columbia is co-sponsoring the rally, and all students, faculty, staff, and friends are invited to participate. For more information, please visit www.rallyformedicalresearch.org.

Please also feel free to reach out to the Office of Government & Community Affairs with any questions about advocacy or policy. We can be reached at (212) 305-8060 or at cumcgca@columbia.edu.