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Draft budget gives HHS additional $14.5B over president's request, cuts additional funding for ACA programs

Budget provides $3.5 billion for CMS administrative expenses, which is $219 million below current levels and $137 million below amount requested.

Susan Morse, Senior Editor

The House Subcommittee on Labor, Health and Human Services will be marking up at 4:30 p.m. today a draft funding bill out of the House Appropriations Committee that contains several provisions to stop the implementation of the Affordable Care Act, including prohibiting the use of any new discretionary funding to implement the ACA.

The bill includes no additional funding to implement ACA programs, prohibits funds for the Navigators program that helps consumers understand their options for marketplace coverage, and prohibits the collection of user fees from the health insurance exchanges.

For the Department of Health and Human Services, the bill earmarks  $77.6 billion, a decrease of $542 million from current levels and $14.5 billion above the president's budget request.

President Donald Trump's budget released in May, "A New Foundation for American Greatness," cut more than $600 billion to Medicaid over the next 10 years.

[Also: Trump budget cuts $600 billion from Medicaid]

The draft budget recommendation provides $3.5 billion for the Centers for Medicare and Medicaid Services administrative expenses, which is $219 million below current levels and $137 million below the amount requested by CMS.

"This level is sufficient to maintain core operations and services," according to a released statement from the House Committee on Appropriations.

In total, the draft bill contains $156 billion in discretionary funding for Labor, HHS and Education, a $5 billion reduction below 2017 levels.

The bill provides $35.2 billion for the National Institutes of Health, an increase of $1.1 billion over 2017 and $8.6 billion above the president's budget request.

The budget request proposed to merge most of the Agency for Healthcare Research and Quality into NIH. The recommendation provides $300 million for the AHRQ, which is $24 million below the 2017 level.

[Also: Trump's budget cuts HHS spending by $15 billion, rolls AHRQ into the NIH]

The additional $1.1 billion for NIH will be targeted for public health preparedness, readiness in biodefense and research programs to find cures from cancer to Alzheimer's.

It includes $1.8 billion for Alzheimer's disease research, $336 million for the Brain Research through Application of Innovative Neurotechnologies (BRAIN) initiative and $400 million for the All of Us research initiative, which was formerly called the Precision Medicine Initiative.

NIH funding also includes $300 million for the Cancer Moonshot, $10 million for regenerative medicine research and $12.6 million for the Gabriella Miller "Kids First" pediatric cancer research initiative.

The bill includes a new provision requiring NIH to continue reimbursing grantee research institutions for facilities and administrative costs.

The legislation includes $7 billion for the Centers for Disease Control and Prevention, which is $198 million below the 2017 level and $1 billion above the president's budget request.

[Also: Tom Price: NIH budget cuts could target 'indirect expenses']

This includes $840.6 million in transfers from the Prevention and Public Health Fund. The bill also continues the longstanding prohibition against using federal funds to advocate or promote gun control.

Funding within the CDC includes $1.45 billion for CDC's Public Health Preparedness and Response programs – an increase of $45 million - to provide supplies and response efforts in the event of a bioterror attack or pandemic disease emergency.

Within the budget is $493 million, an increase of $30 million for combating antibiotic-resistant bacteria.

The bill funds Substance Abuse and Mental Health Administration at $3.5 billion – $306 million below 2017 and $68 million above the president's request.

The legislation maintains a prohibition on federal funds for the purchase of syringes or sterile needles, but allows communities with rapid increases in cases of HIV and Hepatitis to access federal funds for substance-use counseling and treatment referrals.

The bill includes $747 million to address opioid and heroin abuse, which is the same as the level from 2017 enacted level and $44 million above the request.
This amount includes $500 million for the state response grants authorized in the 21st Century Cures Act, along with funding for programs in the Comprehensive Addiction and Recovery Act.

The bill cuts spending on what it called low-priority programs, while targeting investments in medical research, public health, biodefense, and job growth. The legislation also includes provisions to rein in unnecessary regulations and to protect the sanctity of life, according to a released statement from House Committee on Appropriations Chairman Rodney Frelinghuysen.

The bill eliminates all funding for the controversial Family Planning (Title X) Program, saving nearly $300 million.

"Lower-priority" programs include a cut of $219 in CMS program management and a cut of $25 million for the National Labor Relations Board, which oversees union cases.

Funding includes $838 million for senior nutrition programs, of which $227 million is for the Meals on Wheels program.

It includes $520 million, an increase of $8.3 million, for the Biomedical Advanced Research and Development Authority, $530 million, an increase of $20 million, for Project BioShield, for the acquisition of medical countermeasures and $250 million, an increase of $178 million, for pandemic influenza preparedness to maintain flu vaccine manufacturing facilities and develop flu vaccines, therapeutics, and diagnostics.

The bill also includes enhanced transfer authority to enable HHS to take quick action to address public health emergencies.

"This bill reflects Republican priorities to cut spending and focus investments in programs our people need the most - public health and medical research, biodefense, fundamental education, and proven programs that increase job growth, for example,"  Frelinghuysen said. "It also includes important provisions to stop government overreach."

The draft budget being reviewed by the subcommittee is among the last of the allocations for the 12 spending bills.

Twitter: @SusanJMorse

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