By Lyle Dennis, Cavarocchi - Ruscio - Dennis Associates, LLC, Consultants to AASLD
While Congress remains deeply mired in the morass of health insurance reform, its routine obligations to do things such as fund the federal government continue to require attention. With the presentation of the President’s budget for FY11 on February 1, the congressional budget and appropriations process has begun to take shape. It promises to be yet another excruciating year of severe budget limitations caused by an on-going economic slowdown that both reduces government revenues and increases costs.
Basically, the way the process works is that the President submits his budget to Congress in early February. Congress then passes a Budget Resolution that provides the broad outlines of the fiscal year’s spending plans for the entire government in functional categories (e.g., health, transportation, defense, etc.). When both houses of Congress agree to the Budget Resolution, the funds included in it are divided among the twelve subcommittees of the House and Senate Appropriations Committees. They then are free to begin work to produce an appropriations bill for the programs within their jurisdiction. When those bills are drafted, passed out of subcommittee, out of full committee, and passed on the floor of each house, a Conference Committee is created to work out the differences between the bills. Their work product is called a Conference Report and it must pass both houses in identical form before it can go back to the President for signature into law.
As you can imagine, the above description is sanitized. The process is far messier than this basic outline would suggest! For AASLD, however, we try not to get bogged down in every detail of every step. It is in the Association’s interest that we focus clearly on the key issues that impact the membership. The following are some of the areas that AASLD seeks to influence.
National Institutes of Health
The NIH, of course, is the bread and butter of researchers, with a current budget of $31.3 billion, spread across 27 institutes and centers. The President has recommended a $1.0 billion increase for FY11 (3.2 percent). While that sounds good on the surface, it only covers the rate of biomedical inflation. And, with the spend down of the funds appropriated in the American Recovery and Reinvestment Act (ARRA), the budget would actually result in far fewer Research Project Grants (RPGs) than in FY10 and FY09.
To address this shortfall, the medical research advocacy community in Washington has coalesced around a budget request of $35 billion for FY11. While this will not completely cover the shortfall in grant funding, it would put a significant dent in it. And, for the first time in many years, the community seems united around a single number.
CDC’s Division of Viral Hepatitis
With the release of the Institute of Medicine’s extensive report on the impact of viral hepatitis in January of this year, more attention has been focused on this issue – and the lack of resources to address it – then ever before. The budget for the Division of Viral Hepatitis at CDC represents just two percent of the funds spent by the National Center for HIV/AIDS, Viral Hepatitis, STDs, and Tuberculosis. Working with a number of different advocates in the viral hepatitis community – patients, professional, and corporate – AASLD is seeking a significant increase in funding to begin to address this ticking time bomb of an issue.
VA’s Medical and Prosthetic Research
AASLD works closely with the Friends of the VA (FOVA) to address the need for more research money in the Medical and Prosthetic Research account at the VA. Last year, the Obama administration sought funding to increase this account from $510 million to $580 million, consistent with the President’s position during the campaign that more needed to be done for veterans returning from Iraq and Afghanistan. Congress agreed with the request and included the money in the appropriations bill. This year, however, the budget calls for just a $10 million, or 1.7 percent, increase.
FOVA is seeking an increase to $700 million to both keep pace with biomedical research inflation and to enable the VA to address some of the currently unaddressed research needs. Given the incidence of viral hepatitis, alcoholic liver disease, and obesity-related liver diseases in the veteran population, AASLD is supporting this higher request.
This electronic newsletter is a bi-weekly publication of AASLD and replaces the former bi-monthly print newsletter and weekly e-news. Members are welcome to submit articles and may send suggestions to aharan@aasld.org.