The House Appropriations Committee's budget proposal boosts overall funding for the Department of Health and Human Services and avoids many of the deep cuts proposed by the White House.
The draft funding bill (PDF) allocates $89.2 billion in total to HHS for fiscal year 2019, a $1 billion increase from 2018 and $2.4 billion more than was requested by the Trump administration.
"The bill funds critical programs that will protect and save lives, both now and in the future," Committee Chair Rodney Frelinghuysen, R-N.J., said in a statement.
Here's a look at where the funds would go:
The opioid crisis
A major focus in the appropriation bill is the opioid epidemic. A total of $3.85 billion under the Substance Abuse and Mental Health Administration (SAMHSA) is reserved for opioid response programs, nearly doubling the amount that was requested. The allocation represents $1 billion more than was spent on opioids last year, and a $1.75 billion boost from the request.
Of that, $1 billion is set aside for the State Opioid Response Grants program, which incentivizes states to pursue addiction treatment and prevention initiatives. Some of the opioid funding includes programs established by Congress through the 21st Century Cures Act and the Comprehensive Addiction and Recovery Act.
Overall, SAMHSA received a significant boost under the proposal, mainly in programs targeting drug addiction. The bill allocates $5.6 billion to SAMHSA, a $448 million increase from fiscal year 2018 and $2.1 billion higher than the White House requested.
The funding proposal would also advance several of the administration's health policy priorities. It calls for moving the Agency for Healthcare Research and Quality (AHRQ) into the National Institutes of Health and nixes $300 million in funding for Title X's Family Planning Program.
The bill maintains the Dickey amendment, amid calls for Congress to allow the Centers for Disease Control and Prevention conduct research into gun violence. The amendment prevents the agency from conducting activities that would "advocate" for gun control.
Priorities in Alzheimer's, cancer and preparedness
Overall, the bill would provide a funding boost to the National Institutes of Health to $38.3 billion, up $1.25 billion compared to fiscal year 2018, prioritizing research in Alzheimer's disease and cancer, as well as putting funds for infectious diseases and emergency preparedness.
The NIH's proposed budget is $4.1 billion above the President's budget request.
The budget calls for boosting research funding for Alzheimer's disease research to $2.25 billion, up $401 million over fiscal 2018. It would also set aside $429 million for the Brain Research through Application of Innovative Neurotechnologies (BRAIN) initiative, which focuses on improving understanding of the human brain in order to treat, cure and even prevent brain disorders. That's an increase of $29 million over last year.
The budget would also increase funding for the Cancer Moonshot initiative to $400 million, up $100 million over last year. It would allocate $437 million to the All of Us precision medicine research initiative, which aims to collect genetic information from 1 million people to accelerate research, is up $147 million over fiscal 2018.
The House bill would also target efforts to address infectious diseases allocating $130 million toward research to develop a universal influenza vaccine, an increase of $30 million over last year. It would also put $528 million toward research on combating antibiotic-resistant bacteria, an increase of $15 million over last year.
Increases to preparedness, but cuts to CDC's job and its budget
Under the Centers for Disease Control budget proposal, the bill includes $300 million to establish an Infectious Disease Rapid Response Reserve Fund meant to allow a to allow a rapid response to a pandemic, as well the ability to track children and families affected by the Zika virus and to address infectious disease in high-risk areas.
For emergency preparedness, the bill allocated $587 million, an increase of $50 million, for the Biomedical Advanced Research and Development Authority (BARDA).
- It also set aside $780 million, an increase of $70 million, for Project BioShield to acquire medical countermeasures, $710 million for the Strategic National Stockpile, which is an increase of $100 million, and $280 million for Hospital Preparedness Program grants, an increase of $15 million.
- It also set aside $62 million, an increase of $5 million, to expand and improve training for the National Disaster Medical System, a federally coordinated healthcare system to fill in gaps during disasters.
However, it would levy a cut to overall CDC budget, allocating $7.6 billion to the agency, which is a $663 million drop below the fiscal year 2018 level. Officials pointed out the cut accounts for the transfer of the Strategic National Stockpile to HHS, as well as one-time facilities funding in fiscal year 2018 and said the legislation would result in an increase of $427 million to the CDC on a comparable program level.
It would also terminate the CDC's Climate Change program, or about $10 million, consistent with the President's budget request.