American Science Alliance

Tom Price Confirmed as Health and Human Services Secretary

Tom Price was Senate-confirmed as secretary of health and human services on a party-line 52–47 vote on February 10, 2017. He will have responsibility over the National Institutes of Health and the Centers for Disease Control, among a number of other research and public health agencies.

Key Unfilled Science-Related Appointments Under HHS 

-President Trump has asked NIH Director, Francis Collins to remain for now.
-FDA Commissioner: No Nominee

-Director, Office of Science: No Nominee
-Under Secretary for Science: No Nominee
-Director, Energy Advanced Research Projects Department: No Nominee

DEPARTMENT OF HEALTH AND HUMAN SERVICES (FY2017 Funding)

The agreement funds the U.S. Department of Health and Human Services at $76.9 billion, a $1.4 billion increase above FY2016, including cap adjustments.

National Institutes of Health (NIH) – $34 billion, an increase of $2 billion above FY2016.  The bill includes:
•    $300 million for the Precision Medicine Initiative, an increase of $100 million;
•    $1.39 billion for Alzheimer’s disease research, an increase of $400 million;
•    $250 million, an increase of $100 million, for the BRAIN Initiative to map the human brain;
•    $333.4 million, an increase of $12.5 million, for the Institutional Development Award;
•    $463 million, an increase of $50 million, to Combat Antibiotic Resistant Bacteria;
•    $12.6 million for the Gabriella Miller Kids First Research Act;
•    Increases to every Institute and Center to continue investments in innovative research that will advance fundamental knowledge and speed the development of new therapies, diagnostics, and preventive measures to improve the health of all Americans.

Fighting Opioid Abuse – $261 million, an increase of $126 million or 93 percent, for Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), and Health Resources and Services Administration programs targeted to combat opioid abuse.  According to CDC, sales from prescription opioids nearly quadrupled between 1999 and 2014.  There has been a corresponding increase in deaths from prescription opioids, claiming more than 165,000 lives.

Specifically, the bill provides a $28 million increase for CDC Prescription Drug Overdose program, a $49 million increase to SAMHSA for treatment, prevention, and overdose reversal, and $50 million for Community Health Center treatment and prevention.  Further, the bill continues to provide $1.9 billion for the Substance Abuse Prevention and Treatment Block Grant, $94 million in mandatory funds to Community Health Centers, and provides an additional $52.5 million to the National Institute on Drug Abuse at the NIH.

Community Health Centers (CHCs) – $1.49 billion, level with FY2016.  There are more than 9,000 Health Centers nationally, serving 22.9 million patients per year.  Health centers advance the preventive and primary care model of coordinated and comprehensive care, coordinating a wide range of medical, dental, behavioral, and social services in communities.

Obamacare – The bill does not provide new funding for the Affordable Care Act (ACA), or Obamacare.  In addition, several oversight provisions are included in the agreement.
•    Risk Corridor – The bill continues to include a provision requiring the Administration to operate the Risk Corridor program in a budget neutral manner by prohibiting any funds from the Labor-HHS Appropriations Bill to be used as payments for the Risk Corridor program.  Last year, insurers paid $362 million into the Risk Corridor program while submitting $2.87 billion in claims for Risk Corridor payments.  Because of this provision in the FY2016 bill, the Subcommittee was able to save over $2.5 billion from potentially being transferred out of priority discretionary HHS programs in the Labor-HHS Appropriations Bill to bail out the Risk Corridor program established by the ACA.
•    ACA Congressional Notification – The agreement directs the Centers for Medicare & Medicaid Services to notify the appropriate Congressional committees two business days before any ACA-related data or grant opportunities are released to the public.
•    Health Exchange Transparency – Bill language is included requiring the Administration to publish ACA-related spending by category since its inception.
•    ACA Personnel – Bill language is included requiring the Administration to publish information on the number of employees, contractors, and activities involved in implementing, administering, or enforcing provisions of the ACA.

Independent Payment Advisory Board (IPAB) – Funding for IPAB is eliminated.  IPAB is a 15 member board of unelected bureaucrats created by the ACA to achieve a reduction in Medicare spending through the only means they have – rationing care.

Rural Health Care – $152.6 million, an increase of $3 million above FY2016, for rural health programs.  The obstacles faced by patients and providers in rural communities are unique and often significantly different than those in urban areas.  Therefore, the bill focuses resources toward efforts and programs to help rural communities, such as telehealth.

Cancer Prevention and Control – $356.2 million, level with FY2016. This includes funding for breast, cervical, colorectal, and prostate cancer screening programs, which the Administration proposed to cut by more than $54 million.

Immunization Program – $610.8 million, level with FY2016.  The Administration proposed to cut this program by $50.3 million.  Vaccines remain one of the most important and successful public health breakthroughs to prevent death and disability, and this program serves as a safety-net for the uninsured and underinsured populations.

Children’s Hospitals Graduate Medical Education (CHGME) – $300 million, an increase of $5 million above FY2016.  The CHGME program protects children’s access to high quality medical care by providing freestanding children’s hospitals with funding to support the training of pediatric providers.

Preventive Health and Health Services Block Grant (Prevent Block Grant) – $160 million, level with FY2016.  The Administration proposed to eliminate this program.  The Prevent Block Grant provides flexible funding for States to implement prevention activities according to local health needs.

Medicare Appeals Process – $112.4 million, an increase of $5 million above FY2016, for the Office of Medicare Hearings and Appeals (OMHA).  The number of cases appealed to OMHA has increased 1,000 percent over the past six years.  As of the end of 2015, OMHA takes nearly 700 days to close out an existing appeal.  A significant portion of this backlog has been driven by appeals related to Recovery Audit Contractors.

Polio Eradication – $174 million, an increase of $5 million above FY2016.  Polio is currently endemic in only three countries: Nigeria, Afghanistan and Pakistan.  Nigeria has not reported a case since August 2014 and will be declared polio-free if no cases are reported by August 2017.

Mental Health – $80 million increase above FY2016.  The bill provides $541.5 million, an increase of $30 million above FY2016, for the Mental Health Block Grant and continues the set-aside for serious mental illness activities at 10 percent.  The Block Grants represent the primary sources of mental health funding for state programs. The bill also provides $50 million within the funding for CHCs to provide mental health services at health centers across the country.

Child Care and Development Block Grant (CCDBG) – $2.8 billion, an increase of $25 million above FY2016.  This funding builds on the consistent funding increases in recent years to help states implement key quality improvement reforms in the CCDBG Act of 2014.  These reforms are intended to improve child care health and safety standards, and otherwise improve working families’ access to quality child care.

Head Start – $9.2 billion, an increase of $35 million above FY2016, to help all Head Start program keep up with costs, recruit and retain highly qualified staff, maintain enrollment, and provide high-quality early childhood service for children and families.

Low Income Home Energy Assistance Program (LIHEAP) – $3.39 billion, level with FY2016.  LIHEAP provides home heating and cooling assistance for low-income households.

Public Health Preparedness and Response – The bill does not include the President’s cuts to critical preparedness and response activities and maintains FY2016 levels for these activities:
•    Biomedical Advanced Research and Development Authority (BARDA) – $511.7 million.  BARDA is responsible for advanced research and development of medical countermeasures for national preparedness efforts.
•    Project BioShield – $510 million, $160 million above the President’s request, to enhance national preparedness activities by procuring medical countermeasures against chemical, biological, radiological, and nuclear threats.
•    Public Health Emergency Preparedness (PHEP) – $660 million. PHEP funds allow states prepare, respond, and recover from emerging threats such as natural disasters, disease outbreaks, and chemical, biological, radiological, and nuclear threats.
•    Strategic National Stockpile (SNS) – $575 million. CDC maintains and replenishes expiring medical countermeasures in the SNS for national preparedness efforts.

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