Breakthroughs Blog: US budget

In this feature on Breakthroughs, we provide an update on what’s currently happening with global health in Congress and an outlook for future legislative activity. Foremost on Congress’ plate this week was, of course, the appropriations process. Last week, House Budget Committee Chair Paul Ryan (R-Wisconsin) released his fiscal year (FY) 2013 budget resolution, which the House Budget Committee has now approved by a 19-18 vote. The full House passed the resolution yesterday 228-191, making the appropriations process even more complicated, as the legislation conflicts with much of the Budget Control Act (BCA) signed into law last year. In the resolution, international affairs funding in the approved resolution totals $49.1 billion. This is a reduction of $7.1 billion, or 12.6 percent, compared with President Obama’s FY 2013 requested funding levels. A report accompanying the resolution outlines some potential cuts that could help achieve this $7.1 billion cut. The section that covers the State and Foreign Operations account does not mention any global health-specific policy changes, so it is unclear at this stage how global health, as well as research and development for new health tools, would fare under Ryan’s resolution. Regardless of the House’s approval, the resolution will be dead on arrival in the Senate. House Democrats introduced their own budget alternative, authored by Maryland Democrat Chris Van Hollen. Their approach follows what President Obama requested fairly closely, but both this alternative as well as a more conservative resolution—supported by the Republican Study Committee—did not garner the votes needed to pass. Also this week, the National Institutes of Health (NIH) Director Francis Collins testified before the Senate Appropriations Committee. When he spoke at a similar House hearing recently, the new National Center for Advancing Translational Sciences (NCATS)—which Collins stated has the potential to support the development of new tools for rare and neglected diseases—was a hot topic, and the same was true with the Senate. Collins was questioned on plans for future projects at NCATS, and whether they would affect the NIH basic research budget. The effect of across-the-board federal budget cuts on the NIH was discussed during the Senate hearing, with Collins stating that there would be hundreds of great research projects that would not be funded if these widespread cuts take place. You can read testimony from Collins—as well as National Institute of Allergy and Infectious Diseases Director Anthony Fauci and other NIH leaders—here. Now that most of the hearings have been completed on the President’s budget request, appropriations committees in both the House and Senate will soon move to approve legislation for all accounts in the federal budget. It’s likely that the House subcommittee will start to approve funding legislation in May, with the Senate following suit shortly after. The process is moving along normally—for now. With growing anxiety about whether Congress will alter the required across-the-board budget cuts, and the Presidential election drawing closer, we may still see a replay of previous years’ deadlock.