Senate Completes HSR Budget Bill

In a tight budget year, the U.S. Senate recently completed action on the funding bill that finances most of the federal agencies that support health services research. With the House of Representatives having finished their work back in June, the only action remaining is for the House and Senate to meet in a conference committee to iron out the differences between the bills prior to sending them to the President to be signed into law. With the fiscal year ending September 30, the government has been operating under a "continuing resolution," which provides funding for those agencies that have not yet received their appropriations. The continuing resolution provides funding at last year's levels.

Agency for Healthcare Research and Quality

The Senate provides AHRQ with $5 million more than the President's budget request, bringing the total to $324 million. The additional $5 million is earmarked for comparative effectiveness research. The House did not include this additional funding. If approved, this would bring total AHRQ spending on comparative effectiveness to $20 million. The Coalition supports the additional Senate spending.

In addition, the Coalition has specific concerns regarding the overall AHRQ funding level. The Coalition recognizes that few agencies not involved in the war effort, hurricane relief, or preparing for a possible pandemic of avian flu are going to be increased. However, Congress increases AHRQ's responsibilities without increasing funding levels. Most recently, Congress passed added the "Patient Safety and Quality Improvement Act of 2005" to AHRQ's area of responsibility. Existing funds allocated to other research priorities must be reassigned to address the new responsibilities. Funding reallocation has especially affected investigator-initiated awards. It is hoped this issue can be addressed when Congress reviews the Agency and its goals next year through the reauthorization process.

National Center for Health Statistics

Like the House, the Senate funded this critical data gathering agency within the Centers for Disease Control and Prevention at last year's level of $109 million. In FY 2005, Congress provided a much needed $19 million increase recognizing that the agency required the increase to maintain its sample sizes and number of surveys. Without future increases, the agency will soon find itself again in the position of determining which surveys to postpone, reducing the number of questions asked, and/or reducing the number of people surveyed.

CDC's Public Health Research

In FY 2004, the Centers for Disease Control and Prevention identified a need to strengthen its public health research component. A Public Health Research program, was created using $15 million reallocated from an extramural prevention research program, and $15 million in new appropriations. This new program received $31 million in funding from both the House and Senate for FY 2006.

Centers for Medicare and Medicaid Services

CMS's Office of Research, Development and Information was funded at $28 million last year. For FY 2006 the House provides $65 million, while the Senate would spend $78 million -- $33 million more than the President's request. However, the Senate bill reinstates the $40 million Real Choice System Change grant program that was eliminated in the President's request and in the House bill, which means CMS faces a research shortfall of $7 million.

National Institutes of Health

According to the NIH, it currently spends 3.2 percent of its budget for health services research. This translates to $905 million spent on health services research in FY 2005. If the trend holds, NIH spending on health services research would be $912 million under the House bill and $941 million in the Senate. The Coalition supports the higher funding figure found in the Senate bill.

Veterans Health Administration

For FY 2006 the President request an overall funding level of $393 million for VHA research. This is a reduction from a current spending level in FY 2005 of $402 million. The House adopted the President's figure, while the Senate bill increases funding to $412 million. The Coalition supports the higher, Senate number.