House GOP Spending Freeze Would ‘Devastate’ Medical Research

Health research funding will face some of the steepest cuts in a decade if the House Republicans’ agreement sets next year’s spending at 2022 levels, potentially slashing billions of dollars in medical research.

House Republicans agreed to hold fiscal 2024 government funding to their fiscal 2022 levels as part of the deal reached by Rep. Kevin McCarthy (R-Calif.) to secure the speaker’s role after a historic 15 votes stretched over several days. Such a move would lead to about a 7% cut from funding total for fiscal 2023. Democrats will have plenty of opportunities to chip away at those efforts, however.

“Going back to ’22 spending levels, that’s obviously hard,” Sudip Parikh, chief executive officer of the American Association for the Advancement of Science, said. “Our US previous investments put us on the cusp of all these amazing treatments—mRNA, CRISPR, gene therapy. Those treatments are going to be discovered and developed somewhere, whether it’s here in the US or somewhere else. I hope it’s here in the US.”

Spending caps usually mean curbs for discretionary programs, since about two-thirds of the budget encompasses mandatory funding of defense, Social Security, and Medicare. In the health care area, discretionary dollars fund federal programs in public health, and research on medicine, health outcomes, and physical sciences.

“Generally, any kind of cuts to the top lines are not good for research,” said Ellie Dehoney, vice president of policy and advocacy at Research!America.

Just Catching Up to 2003

Potential curbs would come just as the National Institutes of Health caught up to its 2003 level of funding, when accounting for inflation, with Congress increasing agency funding 58% over the last eight years. It was a move to reverse a 22% decline in purchasing power after a dozen years of flat funding. The NIH’s fiscal 2023 budget is right around its 2003 spending level in real dollars, after Congress provided a $2.5 billion boost to bring the agency’s budget to $47.5 billion.

Details of the GOP deal aren’t public, and what the research budget looks like would depend on how much leeway lawmakers baked into it, Dehoney said.

“If it is an across-the-board sequestration, it is not good,” she said. But with some flexibility, there’s probably still an appetite in both chambers to increase funding for at least for the NIH and maybe the Biomedical Advanced Research and Development Authority, Dehoney said.

Rep. Tom Cole (Okla.), who’s been the top Republican on the House Labor-Health and Human Services Appropriations Subcommittee since 2015, has long supported NIH funding increases and has indicated he would continue to do so.

“There’s a lot of good things in there and frankly, things that I think we should continue to invest in like NIH, CDC, strategic stockpile, all that sort of thing,” he told Bloomberg Government.

Only the Beginning

“Honestly, you have to remember the initial budget is really just a negotiating position,” Cole said of the proposed cuts. “The Senate is going to produce something, the administration is going to have something to say about it. So you know, where you start, it’s not going to be where you end up.”

Rep. Rosa DeLauro (D-Conn.) issued a statement calling the potential freeze “a backroom deal” that “kills the 2024 government funding process before it has even started, all but guaranteeing a shutdown.”

The Senate is unlikely to cut non-defense spending without cutting defense, Dehoney said. “So we’re looking at another gridlock situation, potentially, unless somehow, on the House side there’s a way of getting past the debt ceiling and then dealing with the budget.”

See also: GOP Stops Short of Specific Demands for Hiking Debt Limit (1)

With bipartisan support for medical research, lawmakers could try to shield the NIH budget from cuts as much as possible, Dehoney said. “CDC may not fare as well,” she added.

“There has always been a recognition that the investments in NIH not only are improving people’s lives, and advancing science that brings about cures and better diagnostics, and, better preventive interventions,” said Tannaz Rasouli, executive director of the Ad Hoc Group for Medical Research coalition. “But it’s also really good for the economy, it helps us innovate.”