Funding for health research will face some of the most severe cuts in a decade if the House Republicans’ agreement sets next year’s spending at 2022 levels, which could cut billions of dollars in medical research.
House Republicans agreed to suspend government funding for 2024 at their fiscal levels for 2022 as part of the deal reached by Rep. Kevin McCarthy (R-Calif.) to secure the speaker role after a historic 15 votes spanning several days. Such a move could cut total funding by 7% for the 2023 fiscal year. However, Democrats will have plenty of opportunities to scale back these efforts.
“Going back to the 22 levels of spending, this is clearly difficult,” said Sudip Parikh, CEO of the American Association for the Advancement of Science. “Our previous investments in the United States put us on the cusp of all these amazing therapies—mRNA, CRISPR, and gene therapy. Those therapies will be discovered and developed somewhere, whether it’s here in the United States or somewhere else. I hope they’re here in the United States.”
Spending limits usually mean restrictions on discretionary programs, since about two-thirds of the budget includes mandatory funding for defense, Social Security, and Medicare. In health care, discretionary dollars fund federal programs in public health, research in medicine, health outcomes, and the physical sciences.
Ellie Dhoni, vice president of policy and advocacy at Research! America: “In general, any kind of cut in the top lines is not good for research.”
Just catch up to 2003
The potential limitations will come as the National Institutes of Health has returned to its 2003 funding level, when accounting for inflation, with the agency’s funding increasing 58% over the past eight years. It was a move to reverse a 22% decline in purchasing power after twelve years of steady financing. The NIH’s 2023 budget is quite close to the 2003 spending level in real dollars, after Congress provided $2.5 billion to bring the agency’s budget to $47.5 billion.
Dhoni said the details of the GOP deal are not public, and that the shape of the research budget will depend on how flexible lawmakers are with it.
“If it’s a total isolation, it’s not good,” she said. But with some flexibility, there may still be a desire in both houses to increase funding for at least the National Institutes of Health and possibly the Biomedical Advanced Research and Development Authority, Dhoni said.
Rep. Tom Cole (Okla.), who has been the top Republican on the House Appropriations Subcommittee on Labor and Health and Human Services since 2015, has long supported increasing funding for the NIH and has indicated he will continue to do so.
“There are a lot of good things out there and frankly, things that I think we should continue to invest in like the National Institutes of Health, the CDC, strategic stockpiles, all that kind of stuff,” he told Bloomberg Government.
Just the beginning
“Frankly, you have to remember that the initial budget is really just a negotiating position,” Cole said of the proposed cuts. The Senate will produce something, and the administration will have something to say about it. So you know, where you start, it won’t be where you end up.”
Rep. Rosa DeLauro (D-Connecticut) issued a statement calling the potential freeze a “secret deal” that kills the 2024 government funding process before it even begins, all but the shutdown guarantee.
Al-Dahouni said the Senate was unlikely to cut non-defense spending without cutting defense. “So we’re looking at another stalemate, potentially, unless somehow, there’s a way to get past the debt ceiling and then deal with the budget.”
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With bipartisan support for medical research, Al-Dahouni said, lawmakers can try to protect the NIH’s budget from cuts as much as possible. “The CDC may not be doing as well,” she added.
said Tanaz Rasouli, executive director of the Ad Hoc Group Medical Research Alliance. “But it’s also really good for the economy, helping us innovate.”