A Republican-led effort in Congress to boost funding for medical research by more than $9 billion is getting pushback from conservative activists.
The 21st Century Cures Act would grant an additional $8.75 billion to the National Institutes of Heath over five years and $550 million for the Food and Drug Administration during the same time period. The bill sailed unanimously through the House Committee on Energy and Commerce in May, 51-0, and is poised to get a vote Friday in the U.S. House of Representatives.
NIH funding has remained relatively static in recent years. Adjusted for inflation, the institutes’ $30.1 billion annual budget is about 20 percent smaller than it was in 2003.
At the moment, only 15 percent of the grant proposals submitted to NIH can be funded, said Republican Rep. Kevin Yoder of Kansas, one of the bill’s most vocal co-sponsors.
“That means that 85 percent of the ideas that are out there to cure diseases aren’t being funded,” the congressman said in an interview.
Yoder, who was elected to Congress in 2010 with strong tea party support, said the bill is consistent with the fiscally conservative principles that defined his campaign.
Investing now in cures for devastating diseases like Alzheimer’s and cancer, he said, will save taxpayer money over the long run.
“So the idea we wouldn’t invest in trying to do that is, to me, the epitome of penny-wise and pound-foolish,” Yoder said.
The University of Kansas Medical Center in Yoder’s district and other research institutions in lawmakers’ home states stand to benefit from the influx of federal grant money if the bill passes.
But Yoder and other Republican advocates for the bill might have to depend on Democrats to get it across the finish line on Friday.
That’s because Heritage Action, an influential conservative advocacy organization, is urging lawmakers to vote no on the 21st Century Cures Act. Heritage flagged the bill as a “key vote” on the group’s legislative scorecard, which rates members of Congress by how “conservative” they are.
Dan Holler, a spokesman for Heritage Action, said the bill irresponsibly circumvents bipartisan budget caps that were imposed in 2011 by creating a new “mandatory” spending program that isn’t subject to the caps.
“There is a desire among some in the Republican party to say they’re in favor of cutting spending except when it comes to NIH, and then they want to increase the spending,” Holler said. “But if it’s such a laudable goal, then they just need to do it responsibly and keep it within the budget caps.”
The Congressional Budget Office estimates that enacting the 21st Century Cures Act would cost $106.4 billion over five years.
But the budget office also calculated that cost savings included in the legislation ultimately would reduce direct spending by $11.9 billion over 10 years.
Holler says those estimates are misleading because they assume that the five-year funding increases for NIH and FDA won’t become permanent. And he thinks they will.
“Programs tend not to go away,” he said.
Heritage also dismisses the cost offsets included in the bill as “woefully inadequate.” They include administrative delays in monthly reinsurance payments to Medicare Part D and new limits on Medicaid reimbursement to states for durable medical equipment.
About 75 percent of the offsets would come from the sale of 8 million barrels of oil from the country’s Strategic Petroleum Reserve, which Heritage says is an irresponsible use of the reserve. It’s “not a piggy bank for lawmakers to use to offset their desire for immediate spending increases,” the group said in a statement.
Yoder said he’s been working on his Republican colleagues “person by person” to persuade them they can support the bill on conservative terms.
“Some of them are on the fence and the Heritage position may have pushed them away from a bill that they were considering, and that’s unfortunate,” Yoder said.
“But the bill will have strong bipartisan support. It will have a majority of both parties,” he said. “And I think it’s noteworthy that Republicans are leading this charge and are advocating for much more spending on the NIH than the president or others in Washington, D.C.”