Floor debate begins on HR 6 – 21st Century Cures

With debate starting – here’s a summary of where the legislation stands as it heads to the House floor.

If you’ve been following the progress of H.R. 6, the 21st Century Cures Act, you’ve seen momentum for the bill grow, and may have felt (like we did) that its passage is a foregone conclusion. It was only a few weeks ago that we reported on the House Energy and Commerce Committee’s bipartisan and unanimous passage of the bill out of committee, and if you are a regular follower of our blog’s “Weekly Roundup” you’ve seen numerous articles and opinion pieces extolling the value of the bill. With more than half of the House of Representatives having co-sponsored the bill, passage of the bill has been all but certain.

Passage is very much in doubt at this time.

On Wednesday, the U.S. House Rules Committee (which – as its name suggests determines the rules for debate on the legislation such as time for debate, and which amendments can be considered) offered pointed criticism of the bill from Republican leadership, and allowed a potential “poison pill” amendment that threatens the legislation altogether.

First, the breakdown of unified support from House leadership. U.S. House Labor-Health and Human Services Appropriations subcommittee Chair, Rep. Tom Cole, R-Okla, voiced specific concerns over H.R. 6, and the Innovation Fund created by the bill. As a reminder, the Innovation Fund (originally $2 billion a year for five-years, and now closer to $1.8 billion) was a bolus of funding from the mandatory part of the federal budget – not the discretionary side, where NIH spending originates. Cole expressed concerns on the need for sustained increases in funding to the NIH’s base operating budget, not a new temporary line of funding.  You’ll remember Cole’s committee proposed a $1 billion increase in funding for the NIH in FY16. He also expressed concerns about the funding cliff created by a temporary bolus of funds that would occur if the NIH baseline wasn’t increased. These concerns echo those outlined by ASBMB earlier this year about 21st Century Cures.

Second, the U.S. House Rules committee has allowed debate on an amendment proposed by Rep. David Brat, R-Virginia, which would move the Innovation Fund from mandatory spending to discretionary. By moving the fund from mandatory to discretionary, the fund is automatically subject to sequestration. Also, the move into discretionary spending places the Innovation Fund squarely in the middle of the NIH-versus-public-health-programs political battle that results from the zero-sum budgetary policy forced by domestic spending caps. While some groups like the ASBMB have had concerns about the Innovation Fund, if it is going to exist, it should exist as mandatory spending to pressure the appropriators to improve baseline NIH spending. The Coalition for Health Funding, of which the ASBMB is a member, outline their opposition to this amendment here. This amendment, if passed, may be the poison pill that kills the proposal altogether.

Outside of the Rules committee, a growing chorus from conservative groups has called for members to oppose this bill.  The Heritage Action Network, for example, has encouraged lawmakers to vote no on the bill, reminding conservatives that they came to Washington to balance the budget, not increase spending. The National Journal outlines this side of the story here.

Finally, the White House issued a Statement of Administration Policy on H.R. 6. In it, while praising the bipartisan nature of the bill and expressing support for biomedical research, the Administration highlights areas of concerns with the legislation as written. The SAP states “…the Administration has concerns about providing additional funding for the National Institutes of Health (NIH) and FDA without addressing sequestration more broadly. Sequestration funding levels threaten not only NIH research, but also other investments in innovation. They threaten health care access and quality, not only by underfunding biomedical research, but also by underfunding key public health and mental health programs.”    The SAP closes by saying “The Administration looks forward to working with the Congress on continuing to improve the bill as it moves forward.”

Is that a veto threat? No. We’ve seen SAPs that outline in clear terms when President Obama will not sign a bill into law should it reach his desk. But, the SAP is strong evidence that there are concerns among Democrats that the bill, while well intended, may not be able to follow-through on the promises it makes.

The ASBMB has all along looked at H.R. 6 with optimism and concern. The bipartisan nature of the bill has been welcomed following years of Congressional partisanship and gridlock. And the proposed increases to the NIH’s budget are greatly needed following a decade of stagnant funding. However, several key policy provisions in the bill have remained unclear and undefined. The ASBMB remains optimistic that Congress is finally coming around and recognizing the need to support the biomedical research community.

The bill will come to the House floor for debate and a vote on Friday, and we will have it covered here. Why not take this opportunity to sign up to follow the Policy Blotter, so you can receive updates as they happen in your e-mail?

 

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  1. Pingback: House Passes 21st Century Cures | ASBMB Policy Blotter

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