July 22, 2021

House Committee Proposes Increase in NIH Funding, Requests AUC Report

The U.S. House Committee on Appropriations advanced legislation funding agencies and programs in the U.S. Departments of Labor, Health and Human Services, and Education for federal fiscal year (FY) 2022. The spending bill passed July 15 with a 33–25 vote.

The bill includes $49 billion for the National Institutes of Health (NIH), an increase of $6.5 billion above the FY 2021 enacted level. Within the total, the bill includes $3 billion to establish the Advanced Research Projects Agency for Health, created to accelerate the pace of scientific breakthroughs for diseases such as Lou Gehrig’s disease, Alzheimer’s disease, diabetes and cancer. The bill provides an increase of $3.5 billion for existing NIH institutes and centers, including:
• $7 billion for the National Cancer Institute, an increase of $432 million above the FY 2021 enacted level, , including $194 million for the Cancer Moonshot.
• $541 million for the All of Us Research Program, an increase of $41 million above the FY 2021 enacted level.
• $612 million for the Brain Research through Advancing Innovative Neurotechnologies® Initiative, an increase of $52 million above the FY 2021 enacted level.
• $3.4 billion for Alzheimer’s disease and related dementias research, an increase of $200 million above the FY 2021 enacted level.

In addition, the bill provides $4.3 billion for the Centers for Medicare and Medicaid Services (CMS), an increase of $646 million above the FY 2021 enacted level, equal to the president’s budget request.

The bill includes a three-year extension (through Jan. 1, 2024) of the current delay in implementation of the 2009 U.S. Preventive Services Task Force (USPSTF) mammography screening recommendations as they apply to Affordable Care Act coverage and any other laws that reference the recommendations.

As part of the accompanying report language, which explains congressional intent but does not have the force of law, the committee expressed its concern about the USPSTF’s process and structure. It urged for a comprehensive reform of its methodologies and called for action on the lack of data in health equity and racial diversity to more clearly inform its decision making.

The committee also requested a report about the implementation of the Medicare Appropriate Use Criteria (AUC) Program for advanced diagnostic imaging. In developing this report, CMS was instructed to consider existing quality improvement programs and their influence on encouraging appropriate use of advanced diagnostic imaging. The committee directed CMS to consult with stakeholders, including medical professional societies and developers of AUC and clinical guidelines, when formulating its report.

The committee reiterated its ongoing concern regarding the high morbidity and mortality rates associated with lung cancer, especially among minority populations. It referenced the updated USPSTF lung cancer screening eligibility recommendations released in March, noting that the new guidelines significantly increase the number of individuals who should have access to screening. Moving forward, the committee is urging CMS to continue efforts to promote lung cancer screening for eligible individuals while also identifying and mitigating potentials barriers such as the costs associated with screening programs, limited quality measures and reducing racial disparities.

The American College of Radiology® (ACR®) and its Lung Cancer Screening 2.0 Committee remain highly engaged in establishing and promoting lung cancer screening programs. The ACR Government Relations and Economics team is continuing to engage lawmakers and relevant agency representatives regarding the merits of lung cancer screening and simultaneously seeking to identify and promote opportunities to expand and/or tailor these critical programs.

The committee adopted by voice vote a Manager’s Amendment introduced by Chairwoman Rosa DeLauro (D-Conn.) that includes additional report language urging the NIH to study the impact of the COVID-19 pandemic on the colorectal cancer rate in minority communities.

The spending bill is expected to be sent to the House floor for a full vote the week of July 26 as part of a seven-bill funding package.

For more information about the spending bill, contact Tina Getachew.