Fiscal 2008 Presidential Budget Proposal

Action to Preserve and Support Research Funding at the National Institues of Health (NIH) Falls Short

(December 22, 2007) Congress finished up the 1st session of the 110th Congress with a flurry of activity, including passing an omnibus appropriations bill for fiscal year 2008. The omnibus package is expected to be signed by the President.

The Consumer Price Index (CPI) for all Urban Consumers, a measure of inflation, rose by 4.3% from Nov 2006 to Nov 2007.  Another way of looking at funding changes is, by adjusting for inflation, any increase less than 4.3% represents a cut in support.

Highlights of the Fiscal Year (FY) 2008 omnibus package include:

• $29.23 billion for the National Institutes of Health (NIH), an increase of $328.65 million (1.1%) over FY 2007
  • Within the NIH budget: 
    $1.85 billion for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), an increase of $252 thousand (0.016%) over FY 2007
• $6.38 billion for the Centers for Disease Control and Prevention (CDC), an increase of $173 million (2.8%) over FY 2007

Our thanks to all of you who contacted your congressional representatives urging increased support of the NIH and the CDC in Fiscal Year 2008. Please continue your efforts.

ACTION ALERT 
Fiscal Year 2008 Appropriations Action Needed by December 7, 2007

House Vote Falls Short to Override Presidential Veto of Bill that had Included Gains in NIH and CDC Funding in the Fiscal Year 2008 Labor, HHS, Education Appropriations

On November 15, 2007 the House of Representatives convened to vote on overriding the President’s veto of the fiscal year 2008 Labor-Health and Human Services-Education Appropriations bill. A 2/3 majority was required to enact the legislation despite the President’s objection. However, the final tally was 277 to 141 (with 15 not voting) – just 5 votes shy of the required 2/3 majority.

On Tuesday November 13th, President Bush vetoed the FY 2008 Labor-HHS-Education Appropriations Bill that was passed by Congress the previous week. This legislation contains critical funding increases for the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), such as: 

• $30 billion for NIH, an increase of 1.1 billion over FY 2007, and $1.38 billion more than the President’s request. The President’s budget actually called for a cut in overall NIH funding. 
• $1.75 billion for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), an increase of $40 million over FY 2007 and the President’s request. 
• $6.29 billion for the CDC, an increase of $90 million over FY 2007, and $310 million more than the President’s budget request.

The House of Representatives is expected to vote to override the President’s veto on Thursday or Friday of this week. If you support the funding increases for health in the congressional budget it is important to contact your representative in the House and urge them to vote YES on the Labor-HHS-Education veto override. A two-thirds majority vote is required to override a presidential veto. If the President’s veto is not overridden, NIH and CDC may have to operate under a year-long continuing resolution that will provide no funding increases.

To locate your member of the House please visit www.congress.org and enter your zip code, then call the Capitol Switchboard at (202) 225-3121 to contact them.

November 14, 2007

On November 7, 2007 the U.S. House of Representatives passed the Labor-HHS / VA-Military construction package by a vote of 269-142. (The vote tally is listed below.) But this falls short of the 286 votes that will be needed to override the president's veto. As this process continues to move forward it remains important to contact your members of Congress and ask them to support the bill to ensure that a veto override is possible now that the president vetoed the measure as expected.

This fiscal year 2008 appropriations bill for the Departments of Labor, Health and Human Services, Education and Related Agencies (Labor-HHS) contains significant increased funding for the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). Specific to the interests of IFFGD, the bill increases funding for NIH by 3.8% and bolsters support for the CDC by 5.9%.

The president had threatened to veto the bill because it exceeds the overall amount requested in his fiscal year 2008 budget proposal. The president’s budget proposal actually calls for a cut for NIH and deep reductions in CDC’s budget. If Congress is forced to adhere to the president’s budget proposal’s funding levels, or if a bill cannot be enacted and Congress is forced to pass a year-long continuing resolution, all of the gains made during this year’s appropriations process will be eliminated.

To support health funding, we urge you contact your member of the House of Representatives and your two Senators to insist that they vote in favor of the Labor-HHS appropriations bill when it is considered. Additionally, advocates are urged to contact all members of the House and Senate. A two-thirds majority vote in favor of the bill will help position the bill for a veto-override if the president does in fact veto the legislation. Without the two-thirds majority vote, Congress will be forced to negotiate a more modest package closely aligned with the cuts proposed by the president, or be forced to pass a year-long continuing resolution which level-funds all programs and wipes out any new spending contained in the Labor-HHS bill.

Here is a brief chronological summary of key events. 

1. House and Senate negotiators produced a final FY 2008 Labor-HHS-Education Appropriations bill which included significant funding increases for many health and education programs. The negotiators also married the FY 2008 Labor-HHS-Education Appropriations bill to the popular FY 2008 Military Construction and Veterans Affairs (MilCon-VA) Appropriations bill in an attempt to gain the support necessary to override a threatened Presidential veto. 
2. The House passed the joint FY 2008 Labor-HHS-Education, MilCon-VA Appropriations bill, sending it to the Senate for consideration. It is important to note that, while the House passed the bill, the bill was not passed by the 2/3 majority needed to override a Presidential veto.
3. The Senate has a new procedural rule as of this year that allows a member to make a motion to strike any provision of a bill that was added by conference negotiators and never considered on the floor of the chamber. Since the FY 2008 MilCon-VA Appropriations bill was never formally considered as part of the Labor-HHS-Education Appropriations bill, the Republican minority in the Senate invoked this rule. The Senate separated the two bills and sent them back to the House for consideration independent of one another.
4. The House passed the stand alone FY 2008 Labor-HHS-Education Appropriations bill, but once again fell just short of doing so by a 2/3 majority.
5. The final FY 2008 Labor-HHS-Education Appropriations bill will now be returned to the Senate, where it will likely be passed by a 2/3 majority, before being sent on to the President. 
6. It is important to note that efforts should not cease to gain the 2/3 support in the House needed for overriding an impending Presidential veto of the FY 2008 Labor-HHS-Education Appropriations bill. Currently, only a handful of Representatives need to add their support to the bill to gain the necessary majority. Below is the breakdown of the most recent House vote on the FY 2008 Labor-HHS-Education Appropriations bill so that you can quickly identify members that voted nay or did not vote and petition their support.

FINAL (BI-PARTISAN) VOTE RESULTS FOR ROLL CALL 1075

      H R 3043      YEA-AND-NAY      8-Nov-2007      8:24 PM
      QUESTION:  On Agreeing to the Senate Amendment
      BILL TITLE: Making appropriations for the Department of Labor, Health and Human Services, and Education, and related agencies for fiscal year ending September 30, 2008, and for other purposes

Contact representatives. To find your member of the House and your senators, go to www.congress.org. When prompted, enter your zip code. Please act as soon as possible.

##

Additional Background

Voice Your Concerns: Fiscal Year 2008 Budget Support for Health Research Falls Short

(June 21, 2007) Today the Senate Appropriations Committee marked-up its fiscal year 2008 Labor-Health and Human Services-Education spending bill. Among other things, this bill provides annual appropriations for biomedical research at the National Institutes of Health (NIH). Highlights of the bill include (all amounts approximated):

• $29.9 billion for the National Institutes of Health, an increase of exactly $1 billion dollars over FY 2007 and $1.3 billion more than the President’s request. (This amount is $250 million more than the mark set by the House.)
• $6.87 billion for the Health Resources and Services Administration, an increase of $450 million over FY 2007 and $1.1 billion more than the President’s request. This amount is $22 million less than the mark set by the House.) 
• $6.43 billion for the Centers for Disease Control and Prevention, an increase of $230 million over FY 2007 and $449 million more than the President’s request.  (This amount is $20 million less than the mark set by the House.) 
• $329.56 million for the Agency for Health Care Research and Quality, an increase of $11 million over FY 2007 and the same amount as the President’s request. (

We supported a 6.7% funding increase for NIH. The Senate increase is just 3.5% - an amount less than biomedical inflation and far less than needed. A 6.7% increase would halt the erosion of the nation’s medical research enterprise, and enable investigators to accelerate the momentum of discovery for conditions like irritable bowel syndrome. The proposed 6.7% increase has been endorsed by hundreds of the nation’s leading medical research organizations and patient advocacy groups – including IFFGD.

We encourage you to please contact your own Congressional representatives to voice your concerns for adequate funding of medical research. Make your opinion count.     

The members of the Senate Labor-HHS-Education Appropriations Subcommittee are listed below. If you do not know who your specific Representative is, please go to www.congress.org and enter your zip code. Phone numbers for all congressional offices are also listed on www.congress.org. While calling is most effective, you can communicate via e-mail through www.congress.org, if you prefer.  

Tips for calling Senate offices:

1)      Ask to speak with the Senator’s Health Legislative Assistant.

2)      Introduce yourself and explain your interest in advancing gastrointestinal disorders research at the NIH.

3)      Specifically ask the Senator to support a 6.7% funding increase for NIH in FY 2008. If that Senator is not on the Labor-HHS-Education Appropriations Subcommittee, ask them to communicate their support for a 6.7% increase to the Subcommittee.

4)      Provide the office with your contact information and ask to be kept informed of the legislator’s actions regarding your request. 

5)      Never be argumentative and always be polite, remember to thank them for their time.

6)      Be persistent and follow up, these offices receive numerous requests, but if you maintain your interest they will get back to you.

Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies

Proposed House FY08 Spending Bill

(June 7, 2007)Today, the House Labor-HHS-Education Appropriations Subcommittee favorably reported its Fiscal Year 2008 (FY08) spending bill. Complete details regarding the content of the legislation will become available when the Full Appropriations Committee considers the bill during the week of June 11, 2007. Highlights of the measure are below: 

• $6.952 billion for the Health Resources and Services Administration, an increase of $537 million (8.4%) over FY07, and $1.13 billion (19.4%) over the President's request.  Included in this amount is $228.2 million for the Title VII Health Professions Training Programs, an increase of $43.5 million (23.6%) over FY07, and $218.5 million more than the President's request.
• $29.650 billion for the National Institutes of Health, an increase of $750 million (2.6%) over FY07 and $1.029 billion (3.6%) more than the President's request.
• $6.448 billion for the Centers for Disease Control and Prevention, an increase of $245.8 million over FY07 (4%), and $465.9 million (7%) more than the President's request.
• $329.546 million for the Agency for Healthcare Research and Quality, an increase of $10.5 million (3.3%) over FY07, and the same amount as the President's request.

Take part in the process. Contact your representative and let him or her know your views. It does make a difference.

MEMBERS OF THE HOUSE LABOR-HEALTH AND HUMAN SERVICES-EDUCATION APPROPRIATIONS SUBCOMMITTEE

Background

When the new Congress convened in early January 2007 they assumed control of a tumultuous budget situation. Despite already being in the second quarter of fiscal year 2007 (FY07), only 2 of 11 FY07 appropriations bills had been completed. Most notably, the Labor-Health and Human Services (HHS)-Education Appropriations Bill, which provides financial support for critical health and education programs, remained unfinished.

Rather than undertake a time consuming process to finish and pass the remaining appropriations bills, the leadership opted instead to pass a yearlong funding resolution (FR). The FR extended the FY06 level of funding for most federal programs until September 30, 2007, but also allowed for funding adjustments to be made to specific programs.    

Biomedical inflation has been rising at an average rate of 4.4% annually for several years. IFFGD has been encouraging congressional leaders to support funding a 6.7% increase for biomedical research at the National Institutes of Health (NIH). We have also been encouraging support of federal initiatives essential to increasing progress toward the needed research on functional GI and motility disorders.

However, for the past five years, the NIH budget has lost ground when adjusted for inflation. This was the case again in the FY07 budget.

Within the NIH, the Office of the Director received additional funding from which a significant portion was set aside for the newly created NIH Common Fund. The NIH Common Fund was recently established during the NIH’s reauthorization and is intended to enhance research efforts through the promotion of cross-cutting initiatives.

Fiscal 2008 Budget Proposal

Even though the FY07 budget was recently enacted, its belated completion means that work on the fiscal 2008 (FY08) budget has already begun. On February 5, 2007 President Bush sent his fiscal year 2008 budget proposal to Congress for their consideration.

On one positive note, the President’s budget proposes an increase of $265 million, to $2.09 billion, for the Food and Drug Administration (FDA). IFFGD is one of dozens of nonprofit health groups, along with other organizations and individuals, which are members of advocacy groups calling for increasing the budget funding for the FDA. The mission of the FDA is to protect and enhance the public health. Adequate funding is needed for this to succeed. The proposed FY08 budget is one step forward in this process, as the FDA will need several hundred million dollars additional in each of the next five fiscal years to meet the demand being placed upon it. The proposed FY08 budget includes increases in a number of areas at the FDA including regulation of Human Drugs (12.2%), Biologics (12.5%), Generic Drug Review (35.9%), and Drug Safety Funding (17.8%).

However, the 2008 budget proposal includes $28.86 billion for the NIH, an increase of $232 million (only 0.8%) from FY07. Again, the NIH budget is falling far short of inflation. What is more, the proposed budget for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which funds most NIH research of the functional GI and motility disorders, calls for a decrease of $4 million from the current budget. We remain concerned that the $1.858 billion proposed NIDDK budget is not enough to sustain existing research funding, let alone support new studies.

Action Needed

Action is needed now. Please consider contacting your House Representative and Senators to urge an increase in the NIDDK budget. An increase of $124 million is required just to stay even with biomedical inflation and not loose research ground. 

Here are some points to consider:

• The functional GI and motility disorders such as irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), gastroparesis, Hirschsprung’s disease, chronic pseudo-obstruction, chronic constipation, and fecal incontinence affect up to 25% of the US population.
• Functional GI and motility disorders comprise about 40% of the GI problems for which patients seek health care.
• These disorders are complex, not yet fully understood and difficult to treat with few effective therapies.
• The economic burden is high: direct annual healthcare costs of IBS alone are around $10 billion and indirect costs, such as lost productivity, are as high as $20 billion annually.

You can contact your congressional representatives by going to this web site: www.congress.org. Thank you.