WASHINGTON -- A bipartisan duo of Senate heavyweights is set to unveil an unusual bill that would give lawmakers an incentive to fund biomedical research and, potentially, add billions to that mission.
Sens. Elizabeth Warren (D-Mass.) and Orrin Hatch (R-Utah) have been quietly working for the past year on the Invest for a Healthy Future Act, a bill that may end up increasing money for government agencies that fund research by more than $21.5 billion over the next dozen years.
The timing of the bill, amid growing concern about America’s vulnerability to Ebola or a biological attack, may give it a bit of momentum heading into the lame duck session, when aides said they hope it gets considered.
Still, the authors recognize that even during times of heightened political concern about medical research funding, there likely isn’t enough support in Congress to simply spend more for scientific studies. So the proposal puts in place a trigger mechanism that may help galvanize that political support.
The bill would create a $10 billion biomedical science fund that would be offset by cuts elsewhere. That fund could only be tapped if appropriators keep the budgets at five major government agencies at steady levels. Those agencies are the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration, the Agency for Healthcare Research and Quality, and Biomedical Advanced Research and Development Authority.
If congressional appropriators fund those agencies at the same level as the prior year’s appropriation, adjusted for biomedical inflation (different than regular inflation), then $1 billion of the $10 billion “Biomedical Science Fund” would be added to the five agencies' budgets. That $1 billion would be spread over four years ($250 million a year) to accommodate ongoing research grants. The money would be distributed to the five agencies in the same proportion as the budget itself, and would go for all forms of research -- not just research on infectious diseases, which is the main priority of the moment.
If congressional appropriators fail to fund those agencies at inflationary levels, then the $1 billion would be held over to the following year, when $2 billion would become available if appropriators hit the target. Should appropriators fail to hit the target three years in a row, the accumulated $3 billion in incentive funds would instead be used for deficit reduction.
The goal is to create an incentive structure for lawmakers to give steady increases in research funding. Advocates in the biomedical research community certainly want more money to offset the stagnant budgets of the past 10 years. But they also want stable funding -- a requirement for long-term research. You don’t fund a six-year project when you only think you’ll have two years of enhanced funding. Indeed, while the Obama administration economic stimulus package funneled billions to the NIH, officials there said it created challenges because the money wasn’t spread out over a long period.
The Invest for a Healthy Future Act places a prize in front of lawmakers if they simply fund those five agencies with consistency. And it doesn’t discriminate. The act establishes that the NIH, FDA, CDC, BARDA and AHRQ all must see funding levels matched to inflation in order for the biomedical science fund to be triggered. Lawmakers can’t move money from one pocket to another.
The larger question is whether the legislation is politically feasible. The fact that the fund would be offset by budget cuts makes the idea more appealing to conservatives. Warren and Hatch have agreed to some offsets, though others remain unsettled. Still, the bill's incentives for regular, steady increases in funding at five agencies might be a tough sell in the era of budget caps and sequestration -- and with Republicans set to win big in the midterm elections.
The bill scales back Warren's ambitions for research funding. She has called for doubling the NIH budget. The legislation would fall well short of that.
Aides said they hope the legislation will be considered in the lame duck session, when Democrats will still have 55 seats in the Senate. But even if not done then, there is some optimism about its prospects. Having Hatch on board gives the bill bipartisan bonafides. Should he end up chairing the next Senate Finance Committee, it would give the legislation an inside path toward Senate passage.
Staffers to both Warren and Hatch met with major medical research stakeholders on Oct. 20 to go over the specifics. The meeting was first reported by The Wall Street Journal. According to a source with knowledge of the meeting, the talk went well.
“The stakeholders expressed excitement about the idea and indicated the importance of being able to rally behind some sort of bipartisan proposal,” the source said. “Because they’ve all become very sensitized to the fact that if you don’t have a democrat and a republican on the proposal they know it’s not going anywhere.”