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Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations for Fiscal Year 2018

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Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations for Fiscal Year 2018 DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS FOR FISCAL YEAR 2018 THURSDAY, JUNE 22, 2017 U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, DC. The subcommittee met at 10 a.m. in room SD–138, Dirksen Sen- ate Office Building, Hon. Roy Blunt (chairman) presiding. Present: Senators Blunt, Cochran, Shelby, Alexander, Moran, Lankford, Kennedy, Murray, Durbin, Shaheen, Murphy, Manchin, and Leahy. DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES OF HEALTH STATEMENT OF FRANCIS S. COLLINS, M.D., Ph.D., DIRECTOR ACCOMPANIED BY: DOUGLAS LOWY, M.D., ACTING DIRECTOR, NATIONAL CANCER IN- STITUTE GARY GIBBONS, M.D., DIRECTOR, NATIONAL HEART, LUNG, AND BLOOD INSTITUTE ANTHONY FAUCI, M.D., DIRECTOR, NATIONAL INSTITUTE OF AL- LERGY AND INFECTIOUS DISEASES RICHARD HODES, DIRECTOR, NATIONAL INSTITUTE ON AGING NORA VOLKOW, M.D., DIRECTOR, NATIONAL INSTITUTE ON DRUG ABUSE JOSHUA GORDON, M.D., Ph.D., DIRECTOR, NATIONAL INSTITUTE OF MENTAL HEALTH OPENING STATEMENT OF SENATOR ROY BLUNT Senator BLUNT. The committee will come to order. The Appro- priations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will come to order. Before my opening statement, I want to recognize Melinda Bachini, who we had a chance, nine of us did, to meet and talk to about her cancer fight and the success she’s made there when we were out at NIH (National Institutes of Health) a few days ago. And we are glad you’re here, and I was just told that the young- est of your six children just got their driver’s license, so good luck with that. [Laughter.] (1) 2 Senator BLUNT. Good luck with all of that. And we were glad to have a chance to meet with her. We’re glad to have Dr. Collins and the other Institute Directors here today. The budget, of course, proposes cuts that I think that you can rest assured the committee will find unacceptable. The $7.5 billion cut from NIH would, according to analysts, cost nearly 90,000 jobs na- tionwide, result in $15.3 billion of lost economic activity. In my home State of Missouri, that equates to a loss of nearly 1,700 jobs and $292 million in economic activity. The cut is one that I think you can rest assured this committee will not take. I certainly fun- damentally disagree with the proposed funding reduction. However, this isn’t the first President to propose a reduction. President Obama proposed a $1 billion cut in his budget last year. We went $3 billion above his proposal. I’m not sure we could do anything like that this year, but I also mentioned in a hearing ear- lier this week that when his budget was submitted to the Senate, 98 Senators voted against it, and 1 Senator voted for it. So we have a long history of the Congress asserting itself on issues of how to allocate money. I believe this committee will do the same thing this year. In the last 2 years we were able to increase funding by $4 billion, with significant encouragement from the whole committee, and particularly from Senator Murray, Senator Alexander, Senator Durbin, and really the whole committee, we had nine of our com- mittee out at NIH recently. I think it was the biggest Senate dele- gation to ever go to NIH. We spent most of the afternoon. I hope you, Dr. Collins, and your Institute Directors, know how much your work is appreciated. In the last 2 years, we have in- creased NIH funding by a little more than 13 percent, and we’re going to be listening carefully to your presentations today. But before that, I would like to turn to Senator Murray for her opening comments. [The statement follows:] PREPARED STATEMENT OF SENATOR ROY BLUNT Good morning. Thank you, Dr. Collins and the other Institute Directors, for ap- pearing before the Subcommittee today to discuss the National Institutes of Health’s fiscal year 2018 budget request. The budget request proposes to cut $7.5 billion from the NIH. According to anal- ysis from United for Medical Research, this funding reduction could cost nearly 90,000 jobs nationwide and result in a $15.3 billion loss in economic activity. In my home State of Missouri, that equates to a loss of nearly 1,700 jobs and $292 million. A cut to NIH is not a cut to Washington bureaucracy; it is a cut to life-saving treat- ments and cures, affecting research performed all across the country. I fundamentally disagree with the proposed funding reduction for NIH. However, this is not the first President’s budget to propose reducing NIH funding. Just last year, the Obama Administration proposed cutting $1 billion in discretionary funding from NIH. This Committee and Congress did not agree, instead, appropriating a $2 billion increase for a second year in a row. Yet, simply proposing a drastic reduction to medical research is the wrong mes- sage to send. It’s the wrong message for the millions of Americans suffering from life-threatening diseases; it’s the wrong message to the medical research community tirelessly working to develop new treatments and cures; and it’s the wrong message to the young scientists deciding whether medical research is the career path they should pursue. When I became Chairman of the Labor/HHS Appropriations Subcommittee 2 years ago, I worked with colleagues on both sides of the aisle, including Senators Murray, Alexander, and Durbin, to realign the priorities of this bill, putting a re- newed focus back on medical research funding. 3 For over a decade, funding for the National Institutes of Health remained stag- nant, its purchasing power decreased by 22 percent since 2003, and grant success rates, in some NIH Institutes, fell to as low as 9 percent. This had to change and, over the past 2 years, it has. We have increased funding in the past 2 years by $4 billion, an increase of 13.3 percent. This is a larger increase for NIH in 2 years than in the previous 10 years combined. In the last 2 years, we have more than doubled the amount of research funding for Alzheimer’s disease and started directly funding precision medicine pro- grams. Together, these initiatives could transform the way healthcare is delivered and help stabilize the long-term viability of Medicare. But under the proposed budg- et, these programs may not move forward as envisioned. In fact, Alzheimer’s disease funding is cut by $549 million and the National Cancer Institute cannot even pro- vide a Precision Medicine funding level. I am also deeply concerned about several of the specific proposals in the budget request, including capping indirect costs and eliminating the Fogarty International Center. The funding cut to NIH is so deep that it is difficult to determine if these proposals are recommended because you truly believe they will gain efficiencies for the agency, or if they are proposed because the topline funding levels forced you to do so. I know each of the witnesses today remains committed to biomedical research, just like I do. And, I know we all want to ensure that our researchers have the sup- port and funding they need to make the life-saving breakthroughs that could change so many Americans’ lives. I know this is a budget they do not want to defend. It’s a request no one should have to defend. Thank you for being here today. STATEMENT OF SENATOR PATTY MURRAY Senator MURRAY. Well, thank you very much, Mr. Chairman. Dr. Collins, thank you to you and all of your team for being here today. We appreciate all that you do to champion the critical work of NIH. You’ve been a great partner, and I really appreciate your leadership and all your teams. And I, too, welcome Ms. Bakini. It’s good to see you again up from Montana. And I look forward to having a discussion today about really the devastating impact that President Trump’s budget would have on NIH. As you all know, President Trump has proposed cutting NIH by 22 percent, most of it by arbitrarily capping indirect costs, re- sulting in the lowest funding level for biomedical research since 2002. Three months after releasing this proposal, we still do not have basic information from the administration about how NIH would implement a $7.5 billion reduction without severe consequences for thousands of research facilities and tens of thousands of scientists that rely on its grants to support their work, facilities like Fred Hutchinson Institute in my home State of Washington, just to cite one example, where scientists have pioneered bone marrow trans- plants and today are searching for cures to cancer and an HIV vac- cine, but because of this proposal, could be forced to dramatically scale back their efforts to develop cures for patients. So these cuts are deeply concerning, which is why I’ve said re- peatedly I really hope that both parties will once again reject Presi- dent Trump’s budget proposal and continue to work together, as we have, to ensure NIH is able to carry out its vital work that gives hope to those living with chronic and life-threatening disease and bolster economic growth and competitiveness. But before this discussion can happen, however, I have to note that today’s hearing takes place in the midst of a very pivotal mo- ment for our healthcare system as a whole. As we have heard all 4 week, our Republican colleagues appear to be dead set on jamming their version of Trumpcare through the Senate in just a matter of days.
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