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Pediatric Research Bill Offers Guidance, No Clear Funding Guarantees

A pediatric research bill Congress cleared this week is winning praise for boosting efforts to combat childhood diseases, but the measure will not change any spending levels unless appropriators allocate money for the work to the National Institutes of Health.

The bill (HR 2019) seeks to reprogram $126 million over 10 years that would have been used to finance political conventions for research grants to combat childhood diseases under the NIH’s Common Fund.

But the measure does not actually deliver funding to the NIH. Appropriations will still have to do that in a spending bill.

“It is so very, very important that we not claim victory for the NIH because of this,” Senate Majority Leader Harry Reid of Nevada, a former appropriator, said in a floor speech Tuesday.

The Senate passed the legislation by unanimous consent Tuesday, sending the measure to the president’s desk roughly three months after the House reported the measure.

Supporters — most prominently House Majority Leader Eric Cantor of Virginia — have touted the legislation for funding research targeting childhood diseases. “Putting pediatric research over politics was the entire point of this bill, and we have achieved that in more ways than one,” Cantor said in a statement.

Clearing such an authorization bill is not a guarantee that appropriators will send more money to the NIH’s pediatric research programs, even though the measure includes language requiring appropriators to supplement and not supplant money that would otherwise be allocated to NIH for the children’s research.

Instead, the measure serves as a guiding document telling appropriators to prioritize the research program in the fiscal 2015 spending cycle, aides said.

“Decisions on NIH funding will be made through the normal process, and be subject to approval by the committee and the House,” said one House GOP appropriations aide.

Open Authorization

The NIH effectively has an open authorization and appropriators already have broad leeway to decide how much money they allocate the agency, according to aides.

The agency’s funding is one of the few areas of bipartisanship in the often contentious Labor-HHS-Education spending bill.

Congress has effectively doubled the NIH’s budget since the late 1990s. However, like many federal agencies, NIH saw its budget flatline in recent years as budget battles consumed Congress.

President Barack Obama’s budget blueprint for fiscal 2015 requested $30.2 billion for the agency, roughly the same as Congress appropriated in the 2014 omnibus (PL 113-76). While the January spending package boosted the agency’s post-sequester budget to the tune of $1 billion, the measure still did not fully reverse the more than $1.5 billion in cuts the agency experienced under sequestration.

The White House budget request also included an extra $970 million for NIH in a sidecar appropriations proposal that is unlikely to be considered by the spending panels this year.

Although NIH’s medical research has enjoyed broad support in Congress, the use of continuing resolutions for Labor-HHS-Education spending bills in recent years has often left the agency running on previous year’s spending plans rather than fresh appropriations.

Top appropriators, like Tom Harkin, D-Iowa, have vowed to make the Labor-HHS-Education bill a priority this year. But NIH funding is subject to the discretionary spending caps under the December budget deal (PL 113-67), which the pediatric research bill does not alter.

Uncertainties remain even if appropriators choose to boost funding to NIH’s Common Fund this year, as the pediatric research bill requests.

Although Congress can direct Common Fund research through report language accompanying appropriations bills, a board of NIH scientists ultimately has the final say over the research the agency undertakes, leaving few guarantees for research areas like pediatrics.

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