Lawmakers voice concerns about $5.8B budget cut to NIH

The Trump administration’s plans to cut the Fiscal Year 2018 budget for the National Institutes of Health by $5.8 billion is facing opposition from members of Congress who are concerned that the reduction will hurt medical research that is critical to finding cures for major diseases.

Among other challenges, critics say the budget cuts would affect IT initiatives that the NIH is pursuing, such as the 21st Century Cures Act, as well as Precision Medicine, the Cancer Moonshot or the BRAIN Initiative, which also have strong information technology components.

Earlier this month, President Trump released his “America First” budget blueprint calling for the $5.8 billion decrease in NIH’s FY18 budget as part of a major reorganization of NIH’s institutes and centers. However, legislators expressed their opposition to HHS Secretary Tom Price during a March 29 budget hearing before a House Appropriations Subcommittee.

“The National Institutes of Health is the primary funder of basic biomedical research in the country. This research is the foundation upon which all treatments and cures are based,” said Tom Cole, (R-Okla.), Chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies. “I am extremely concerned about the potential impact of the 18 percent cut the Administration has proposed at the NIH.”

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Price responded in his testimony that NIH’s proposed budget of $25.9 billion in FY18 represents more than a third of the total budget for HHS. In addition, he pointed out that at NIH “about 30 percent of the grant money that goes out is used for indirect expenses,” which Price said “means that the money goes for something other than the research that’s being done.”

While Price agreed that the research funded by NIH is incredibly important, he made the case that the Trump administration’s proposed $5.8 billion reduction of the agency’s budget is an attempt to “get a bigger bang for our buck.” Slashing NIH’s budget will “decrease the areas where there are either duplications or redundancies or waste,” according to Price.

However, Rep. Rosa DeLauro (D-Conn.), the senior Democrat on the House Appropriations subcommittee, charged that slashing funding for NIH would “decimate” the agency and have grave repercussions.

“To be clear, President Trump is proposing to cut NIH funding by $6 billion—this is really an understatement, since we just saw that the Administration wants to cut an additional $1.2 billion from NIH in (FY) 2017 as well,” said DeLauro. “Cutting billions from NIH would be devastating—(it would affect) cancer research, Alzheimer’s research, HIV/AIDS research, as well as research to prevent or cure any other disease that is causing misery for millions of Americans and their families. Make no mistake—this cut will turn back the clock on lifesaving biomedical research that you know, and I know, and the Chairman knows, and everyone on this committee knows, has the power to save lives.”

Likewise, Jeff Smith, vice president of public policy for the American Medical Informatics Association, contends that Trump’s proposed budget would hinder America’s national capacity to rapidly advance discovery and deploy better cures for patients.

“The NIH cuts undermine the promises Congress made as part of the 21st Century Cures Act,” says Smith. “It’s hard to see how programs like Precision Medicine, the Cancer Moonshot or the BRAIN Initiative can deliver on their potential with a 20 percent cut to NIH. Basic research done at the bench in universities across the country is interconnected to treatments delivered at the bedside, so even targeted cuts at one end of the discovery spectrum will impact the whole.”

In addition to the $5.8 billion reduction to NIH’s budget, the Trump proposal would also consolidate the Agency for Healthcare Research and Quality within NIH.

With that consolidation, Rep. Lucille Roybal-Allard (D-Calif.) told Price the agency’s almost 20 percent budget cut under the Trump plan will make it “nearly impossible for NIH to fulfill its own core mission—let alone the mission of another agency.” Roybal-Allard said AHRQ’s research portfolio is critical because it is “the only federal agency whose entire mission is to generate evidence on how to improve healthcare quality, facilitate access to care and control healthcare costs.”

Price responded that he sees NIH assuming the “important duties of AHRQ and then to decrease, reduce or eliminate the duplication and redundancies.” He added that he’s looking forward to folding AHRQ into NIH in order to gain efficiencies. “Clearly, some of the kinds of things that are being done at NIH are also being done at AHRQ,” Price suggested.

The Trump administration’s FY18 budget is being unveiled in pieces. The blueprint published earlier this month provides details only on discretionary funding proposals. The full budget will be released in May.

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