After Election 2014: BIOMEDICAL FUNDING

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After Election 2014: BIOMEDICAL FUNDING

This story is the first in ScienceInsider’s After Election 2014 series. Through Election Day on 4 November, we will periodically examine research issues that will face U.S. lawmakers when they return to Washington, D.C., for a lame-duck session and when a new Congress convenes in January. Click here to see all the stories published so far; click here for a list of published and planned stories.

Today, a look at a perennial concern: funding for biomedical science.

Biomedical lobbyists are hoping that Congress will soon give the National Institutes of Health (NIH) a big budget increase, despite tight caps that lawmakers have placed on overall federal spending. But even if that campaign succeeds—and the odds are very long—victory could come with some undesirable side effects.

Before digging into the details, it’s worth noting that trying to predict funding trends can be a fool’s errand. Numerous factors, from domestic politics to foreign crises, affect how Congress divvies up the federal budget pie in any given year.

The disintegration of the regular appropriations process, with now-routine extensions beyond the 1 October start of the next fiscal year, makes prognostication even harder. This year, for example, Congress has frozen spending at existing levels until at least mid-December, in part because of uncertainty about whether Republicans will win back the Senate in next month’s election and, with it, control of both houses of Congress come January. And in February, the White House will weigh in when President Barack Obama releases his proposed budget for the 2016 fiscal year (even if there’s been no agreement on the final 2015 budget numbers).

Should NIH be exempt?

Against that backdrop, a major topic of discussion on all sides will be how to deal with the spending caps mandated under the 2011 Budget Control Act. That law requires annual spending reductions of $110 billion through 2021, which are automatically apportioned across all defense and civilian programs unless Congress acts otherwise. In the spring of 2013, these automatic cuts, known as the sequester, hit some research budgets hard: NIH saw a 5% cut to its $30 billion budget. After a major political showdown, Congress and the White House agreed last December to suspend the sequester for the 2014 and 2015 fiscal years. But it will come roaring back in FY 2016 (which begins on 1 October 2015).

That prospect has research leaders worried—especially about NIH, which accounts for about one-half of all U.S. civilian science spending. They argue that such automatic cuts will only exacerbate what they have dubbed the innovation deficit. That phrase refers to an alleged shortfall in realizing the full potential of scientific advances because of anemic spending on research. In a particularly dramatic example of this line of argument—which some have questioned—NIH Director Francis Collins has said that progress on an Ebola vaccine has been hindered by flat budgets.

Similar arguments have gotten a friendly hearing from some members of Congress. A few Democratic legislators, for instance, have suggested exempting NIH from the 2011 law on the grounds that biomedical research is too important to be the victim of arbitrary reductions. Senator Tom Harkin (D–IA) and Representative Rosa DeLauro (D–CT) have sponsored identical bills that would designate NIH as “emergency spending” and boost its authorized budget by 10% annually in 2015 and 2016 and by 5% for each of the next 5 years. “This bill will put a plan in place for the Appropriations Committee to reverse the 10-year retrenchment in biomedical research funding over the remaining years of the Budget Control Act,” Harkin said in July when he introduced the legislation, called the Accelerating Biomedical Research Act.

In March, Senator Richard Durbin (D–IL) proposed reaching a similar goal through a different funding mechanism. His American Cures Act calls for a 5% annual increase after inflation for NIH, the Centers for Disease Control and Prevention, and several military biomedical research programs. The money would be drawn from a newly created trust fund, although the bill doesn’t specify how the fund would be financed.

The bills stand almost no chance of becoming law this year. But Harkin’s mechanism is potentially attractive to legislators, because it offers them a free lunch—that is, a chance to support NIH without having to take money from another federal agency. Specifically, the bill would eliminate the often fierce competition for money between NIH and other agencies overseen by the appropriations subcommittee that funds health, education, and welfare programs, as well as between that panel and the 11 other subcommittees that make up the overall federal budget pie.

Harkin is retiring in December after 40 years in Congress. But biomedical lobbyists hope that he will use his clout as chair of both the Senate spending panel that controls NIH’s budget and the authorizing committee that sets policy for the agency to make things happen when the lame-duck Congress returns after the fall election. One veteran advocate who asked to remain unnamed estimates that Harkin’s approach has a one-in-five chance of being folded into an omnibus spending bill that covers the rest of the 2015 fiscal year if Democrats maintain control of the Senate. Of course, that would be only a 1-year fix, because Congress appropriates on an annual basis.

Those odds grow longer, however, if Republicans take charge of the Senate. Under that scenario, pundits say, the election would be seen as a vote for continued fiscal restraint. In addition, spending decisions would likely be delayed until after the new Congress is seated.

Has steady funding ever existed?

Regardless of which party ends up controlling the Senate, the research community is unlikely to abandon its embrace of the innovation deficit as a persuasive tool in funding battles. (A coalition of scientific societies, including AAAS, publisher of ScienceInsider, has even created a website for the concept.) More money for research is only part of the pitch, however; groups are also using the phrase to highlight the importance of steady, predictable growth in the research enterprise.

In applauding Harkin’s bill, for example, the Association of American Medical Colleges touches on both ideas. Its leaders cite the need “not only to restore the purchasing power the NIH has lost to inflation over the past decade, but also to provide the sustained, long-term predictable funding growth essential to catalyze scientific momentum and address current and emerging health challenges.”

But is there really such a thing as steady, sustained growth? An analysis of federal spending over the past 20 years for what amounts to basic research suggests that the answer is no (see graph, below). In the case of NIH, for example, the 2 recent decades include two sharp rises—a 5-year doubling between 1998 to 2003 and a one-time bolus of money in 2009 that increased NIH’s budget by roughly one-third. Those peaks are interspersed with stretches of essentially flat budgets and punctuated with a dip from the 2013 sequester.

Matthew Hourihan, AAAS

That history poses a potential dilemma for policy wonks concerned about U.S. research funding. On one hand, for instance, legislation such as Harkin’s bill would bring much desired additional funding to NIH. At the same time, however, it would trigger yet another dramatic upward budget swing. Research leaders have long argued that such sudden swings are quite disruptive and make long-range planning nearly impossible. In addition, a sudden upturn can send a false message of hope to aspiring scientists that the good times will last into the foreseeable future.

Biomedical advocates readily acknowledge the dilemma. But it isn’t stopping them from pushing for Harkin’s bill. Jennifer Zeitzer, a lobbyist for the Federation of American Societies for Experimental Biology in Bethesda, Maryland, says the decision to embrace Harkin’s bill was easy. “We support anything that helps NIH. It’s our No. 1 priority,” she explains.

Other biomedical lobbyists say they try to cast a big net when talking with legislators about the importance of more research funding, but that NIH is a logical place to start. “We’re advocating for the bill because of the need to get NIH back on track,” says Jennifer Poulakidas of the Association of Public and Land-grant Universities in Washington, D.C. “If there’s the possibility of expanding that approach to all federally funded research, then we’d be in favor of that, too. But the key is to take that first step. And you can make a special case for NIH because of the importance of finding cures and better treatments for a host of deadly diseases.”

Lobbyists outside of the biomedical field say the community’s fervent support for the Harkin bill is understandable, even if its prospects may be slim. “Biomedical advocates are so beaten down by a decade of flat funding that they will grab for anything they can get,” says Joel Widder of Federal Science Partners, a boutique government relations firm in Washington, D.C.

An end to the sequester?

The effort to exempt NIH from the Budget Control Act assumes that the law will remain in place. But one major player in the budget game, President Obama, appears to be preparing a major push to unplug the automatic sequestration mechanism that enforces it. Last week, Shaun Donovan, director of the Office of Management and Budget (OMB), told reporters that "we've cut too much" and that the White House is looking to strike a “larger agreement [with Congress] around relieving sequester." The carrot for Republicans, he said, would be cuts in some mandatory spending programs.

Administration officials argue that the 2011 law has done its job: Last week, OMB announced that the budget deficit for 2014 was $483 billion, the lowest since 2008; at 2.8% of GDP, it’s below the average for the past 40 years. Instead of levying further cuts, they add, it’s time to make the sort of investments—in research, education, and infrastructure—that will produce long-term economic growth.

How large an investment Obama will propose is hard to predict—as is whether Congress would be willing to go along. But given the president’s plummeting popularity and the likely Republican gains in next month’s election, some observers say, the White House may find itself on the sidelines as a Republican Congress tackles federal spending over the next 2 years.

ScienceInsider’s After Election 2014 series will look at a range of issues that will be on policymakers’ agenda once the voters have spoken on 4 November. Look for stories on:

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