Following intense negotiations, in March the House and Senate finally passed an appropriations package that funded the federal government for Fiscal Year (FY) 2022, which technically began October 1, 2021.
The $1.5-trillion package received bipartisan support and follows months of advocacy by the Endocrine Society with increased funding for our priorities. The bill includes several important wins for Endocrine Society members, starting with the fact that it is a final appropriations bill with increases rather than relying on flat funding through short-term stopgap measures. The legislation included several increases, such as an increase of 7%, an additional $582 million, for the Centers for Disease Control and Prevention (CDC) and an additional $2.25 billion, or 5% increase for the National Institutes of Health (NIH). The bill also provides $1 billion to launch the Advanced Research Projects Agency for Health (ARPA-H), a new agency modeled after the Defense Advanced Research Projects Agency (DARPA) and charged with developing high-risk/high-reward research programs.
The legislation also takes steps to address telehealth reform, which is a key priority for the Society. The bill included a five-month extension of Medicare telehealth waivers which would go into effect after the COVID-19 public health emergency (PHE) ends. Additionally, the legislation would reinstate policy that allows pre-deductible coverage of telehealth services in high-deductible health plans with health savings accounts through January 1, 2023. The bill includes language which encourages the Center for Medicare and Medicaid Services (CMS) to review the data collected on audio-only services delivered during the PHE and provide a report on the evidence collected and recommendations to inform future policy on delivering audio-only telehealth. The Endocrine Society strongly advocated for this report language last year. Our members recommended this language during our physician focused Hill Day, and we also launched an advocacy campaign urging Congress to include this language.
The Endocrine Society sincerely appreciates the bicameral, bipartisan negotiations that achieved this result and avoids further continuing resolutions which are extremely disruptive to the biomedical research enterprise and other federal programs.
The Endocrine Society sincerely appreciates the bicameral, bipartisan negotiations that achieved this result and avoids further continuing resolutions which are extremely disruptive to the biomedical research enterprise and other federal programs. We also support the appropriators’ request that each Institute and Center at the NIH receive at least a ~3.4% increase, in addition to an increase of $8 million for the Office of Research on Women’s Health at the NIH. However, we note that the final appropriation for the NIH and other public health programs falls short of earlier proposals in the House, Senate, and President’s Budget, and comes in below our recommended level for the NIH, the CDC, and Title X. Title X, for instance, is flat funded in the omnibus at $286.5 million despite proposed increases from the House.
The final bill also did not include an earlier proposal to provide $100 million to the National Institutes of Environmental Health Sciences (NIEHS) for research on climate change and health. Furthermore, as this article went to press, the final fate of ARPA-H remains somewhat unresolved. Congressional authorizers are still debating whether to house the new agency within the NIH or elsewhere within the Department of Health and Human Services. Finally, while the five-month extension of telehealth waivers will ensure that telehealth reimbursement will not end abruptly after the public health emergency ends, more work will need to be done to pass permanent Medicare telehealth reform.
With inflation expected to blunt the impact of these funding increases, our attention now turns to advocating for adequate funding in FY 2023 to continue our recommended long-term trajectory of ‘steady, sustainable increases’ in funding for critical public health and research programs. The Endocrine Society is working with other stakeholders to determine our federal funding recommendations, and members should look out for opportunities to contact their representatives as offices quickly pivot to the debate for the next year.