What we’re watching for ?>

What we’re watching for

The 115th Congress has begun its legislative work, and we’re five days into the presidency of Donald Trump.  To say that Washington, D.C., is active in these early days of 2017 is an understatement.

The focus of political leaders is not – shockingly – how to handle biomedical research and science policy over the next couple of years.  The spotlight is focused on the future of the Affordable Care Act, who is going to pay for a southern border war, and how American factory jobs are going to be protected rather than globalized.  These are important issues, to be sure – but not the issues that we’re watching in this space.

Here’s what we are watching.

National Institutes of Health – Who is going to be the next director of the NIH? As we reported in this space last week, current NIH Director Francis Collins was asked to stay on as the head of the world’s largest biomedical research enterprise, however, it remains unclear if Collins is only a temporary holdover or the long-term leader of the NIH in the Trump administration.

Given that the NIH falls under the direction of the Department of Health and Human Services, it would be logical to think that no permanent decision on NIH director will be made until U.S. Rep. Tom Price, R-Ga., is confirmed as secretary.  Price’s selection by Trump to lead HHS is a clear signal of the President’s intent to repeal the Affordable Care Act, as Rep. Price was a champion of Republican repeal efforts during his time in the House.  Little is known about his specific views on research, but some statements Price has made are enough to give the community pause.

  • Price told STAT News that he supports medical research, but isn’t willing to give the government a blank check for funding. “We’re in favor of increasing funding for cancer research. The problem that the previous administration has is that they always want to add funding on. They never want to decrease funding somewhere else.  That’s what needs to happen.”  Interestingly,  Price voted against the 21st Century Cures Act when it first came up in Congress in 2015 but changed his vote to support the second, scaled-back version of the bill late in 2016
  • Price is an outspoken opponent of the use of stem cells in research, signaling a return to President George W. Bush era restrictions on federal funding of research utilizing embryonic stem cells

National Science Foundation – Will the politicization of the grant process at the NSF continue into this next Congress? There is surprisingly scant information regarding Trump’s views on the NSF.  All indications are that current NSF Director France Cordova will continue on as the lead at NSF, she is in year three of a six-year term.  And she has worked admirably to thaw tensions between her foundation and the House Science and Technology Committee, which was aggressively targeting NSF during the previous Congress.  Will some of those tensions thaw, or will a Republican Congress with a Republican White House ramp up criticism?

Congress – Will Congress continue to increase funding for biomedical research? The 114th Congress ended on a bipartisan high-note with the passage of the 21st Century Cures Act, which promised billions of new dollars for specific research programs at the NIH for fiscal year 2018.  Will the 115th Congress follow through with the commitment?  Further, will 21st Century Cures funding supplement or supplant baseline NIH appropriations?

Congress has the unenviable task of needing to complete not just one budget and appropriations process, but two this year.  The federal government is currently operating under a continuing resolution until the end of April, keeping agencies funded at FY16 levels.  With budget conversations currently centered on utilizing the budget-reconciliation process as a vehicle for repealing the Affordable Care Act, it seems likely that the casualty of this effort will be FY17 appropriations.  It appears more and more likely that Congress will pass a full-year CR to fund the government for the remainder of the fiscal year, which would mean the NIH would not benefit from the proposed increases approved by the House and Senate last year.

Early indications for Trump’s FY18 budget hint at the president using the Heritage Foundation’s (a conservative think-tank in Washington, D.C.) 2017 budget blue print as a guide for spending levels and programmatic cuts.  The good news is that neither the NIH nor the NSF are singled out for cuts in the 180-page report.  The bad news is that some areas of funding are targeted for elimination, including a cut in funding for noncombat research conducted by the Department of Defense, which would include cuts to the Congressional Directed Medical Research Programs.   Watch this space for news on the President’s proposed FY18 budget, when it’s released.

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