Congress rejects Trump plan to cut health research funds.

WASHINGTON — Back in March, when President Trump released the first draft of his budget proposal for the coming fiscal year, he asked lawmakers for deep cuts to one of their favorite institutions, the National Institutes of Health — part of a broad reordering of priorities, away from science and social spending, toward defense and border security.

Six months later, Congress has not only rejected the president's N.I.H. proposal; lawmakers from both parties have joined forces to increase spending on biomedical research — and have bragged about it.

The Senate Appropriations Committee approved a bipartisan bill last week providing $36.1 billion for the health institutes in the fiscal year that starts next month. Senator Roy Blunt, Republican of Missouri and the chairman of the subcommittee responsible for health spending, said it was the third consecutive year in which he had secured a $2 billion increase for the agency, amounting to an increase of about 20 percent over three years.

The audience erupted in applause when Senator Lamar Alexander, Republican of Tennessee, announced the increase at a hearing of a separate Senate committee.

Mr. Trump had proposed to cut funds for the health institutes by $7.5 billion, or 22 percent, to $26.6 billion. Congress pushed back hard.

The president's proposal "would have crippled American innovation in medical research, delayed new cures and treatments and brought N.I.H. funding to its lowest level since 2002," said Senator Richard J. Durbin of Illinois, the No. 2 Senate Democrat.

The House Appropriations Committee, though less generous than the Senate, still approved a $1.1 billion increase for the health research agency. Lawmakers on both sides of the Capitol said they expected the final figure to be close to the higher amount in the Senate bill.

"The spectacular increase provided by the Senate Appropriations Committee is amazing in the current fiscal environment," said Anthony J. Mazzaschi, a lobbyist at the Association of Schools and Programs of Public Health. "Neither the Senate nor the House paid much attention to the president's recommendations."

The appropriations committees in both houses rejected Mr. Trump's proposal to slash payments to universities for overhead — the "indirect costs" of research financed by the health institutes. These include the cost of utilities, internet service, data storage, the construction and upkeep of laboratories and compliance with federal rules protecting human subjects of clinical research.

In identical language, the House and Senate bills explicitly prohibit the Trump administration from changing the formula used for decades to calculate and pay indirect costs."The administration's proposal would radically change the nature of the federal government's relationship with the research community, abandoning the government's long-established responsibility for underwriting much of the nation's research infrastructure, and jeopardizing biomedical research nationwide," the Senate Appropriations Committee said in a report on its bill. The proposed cuts, it said, could not be made "without throwing research programs across the country into disarray."

Just to make sure the message got through to the administration, Congress included the same prohibition in a stopgap spending bill that provides money to run the government through Dec. 8. President Trump on Friday signed the bill, which also suspends the debt limit and includes aid for victims of Hurricane Harvey and other disasters.

Tom Price, the secretary of health and human services, had argued for the proposed cuts, saying they would not harm research. "About 30 percent of the grant money that goes out is used for indirect expenses, which, as you know, means that that money goes for something other than the research that's being done," Mr. Price told the House Appropriations Committee in March.

But he won few converts.

"Indirect costs are very real costs," said Dr. Landon S. King, the executive vice dean of the Johns Hopkins University School of Medicine, and "there is not another source to pay for them."

The Senate bill provides a 29 percent increase in funds for research on Alzheimer's disease, bringing the total to $1.8 billion for next year. The House bill provides a similar increase.

The Senate committee described Alzheimer's as "the most expensive disease in America.'' The nation spends nearly $260 billion a year caring for people with Alzheimer's and other forms of dementia, with Medicare and Medicaid accounting for two-thirds of that amount, according to the Alzheimer's Association.The House and Senate committees also rejected President Trump's proposal to eliminate a unit of the N.I.H. that works with other countries to combat global health threats.

"Disease knows no borders," the Senate panel said. As evidence of its value, the committee pointed to the work of the N.I.H. unit, the Fogarty International Center, in fighting Ebola, Zika, malaria and many other diseases.

The actions on both sides of the Capitol amounted to a vote of confidence in Dr. Francis S. Collins, the director of the National Institutes of Health, who was appointed by President Barack Obama in 2009 and retained by President Trump. Dr. Collins helped identify a gene responsible for cystic fibrosis and led the government's successful effort to map the human genome, deciphering the instruction book for human DNA.

The spending bill was approved by a vote of 29 to 2 in the Senate Appropriations Committee. Senator James Lankford, Republican of Oklahoma, voted no, but a spokesman said he was "very supportive of the increase in N.I.H. funds."

The spokesman, Darrell Jordan, said Mr. Lankford objected to other provisions of the bill, including one that would limit the Trump administration's ability to change the rules for federal grants to family planning clinics.

Senator Patty Murray, Democrat of Washington, said that was one of the bill's best provisions. "I'm pleased that this bill ties the Trump administration's hands as it tries to undermine family planning efforts," she said.

New York Times, September 11, 2017


September 12, 2017

Addendum. Here are the names of the members of the Appropriations Committee. You may want to call to thank them, and chastise Senator Lankford. I don't know who the other no vote was.

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