Weekly updates of the budget and appropriation process - news events that affect your digestive health.

 

We will update you on the federal budget process which includes a detailed spending plan. Each fiscal year (FY) runs from October 1 through September 30 of the following year. As authorized by the Constitution, Congress is in charge of deciding the budget, granting the power to collect taxes, borrow money and approve spending.

 

November

November 10, 2020 - The Senate Appropriations Committee issued its 12 annual appropriations bills as a series of “Chairman’s Marks.” The bills represent the Senate’s negotiating position going into conference with the bills passed by the House earlier this summer. The existing stop gap continuing resolution is keeping government agencies operating through December 11th, and appropriators hope to reach agreement on the bills before then, roll all of them into an omnibus measure, and pass it before the December 11th deadline.

Highlights of the FY 2021 Senate bills include:

Labor-Health and Human Services-Education (L-HHS)

  • $96.4 billion for the Department of Health and Human Services (HHS), an increase of $1.5 billion above the FY 2020 enacted level.
  • $7.1 billion in programmatic funding for the Health Resources and Services Administration (HRSA), a proposed increase of $67.28 million over FY 2020 and $90 million less than the House proposal. 
  • $7.82 billion in programmatic funding for the Centers for Disease Control and Prevention (CDC), a proposed increase of $130 million over FY 2020 and $100 million less than the House proposal. 
  • $43.46 billion for the National Institutes of Health (NIH), a proposed increase of $2 billion over FY 2020 and $3.5 billion less than the House proposal.
  • $6 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA), a proposed increase of $117 million over the FY 2020 enacted level and the same allocation that was proposed by the House.
  • $256.7 million for the Agency for Healthcare Research and Quality (AHRQ), a proposed decrease of $81.24 million from FY 2020 and $86.24 million less than the House proposal.  
  • $76.86 billion for the Department of Education, a proposed increase of $490.63 million over FY 2020 and $283 million less than the House proposal. 

Department of Defense (DoD)

  • $33.2 billion for the Defense Health Program, basically a proposal of level-funding from FY 2020 and essentially the same level as the House proposal. 

Military Construction, Veterans Affairs, and Related Agencies (MilCon-VA)

  • $800 million for the VA Medical and Prosthetic Research Program, a proposal of level-funding from FY 2020 and $40 million less than the House proposal. 

Agriculture, Rural Development, Food and Drug Administration, and Related Agencies (Ag-FDA)

  • $3.21 billion for the Food and Drug Administration (FDA), excluding user fees, a proposed increase of $40 million over FY 2020 and essentially the same allocation that was proposed by the House. 

Interior, Environment, and Related Agencies (Int-Env)

  • $9.1 billion for the Environmental Protection Agency (EPA), a proposed increase of $28 million over FY 2020 and roughly $290 million less than the House proposal. 

Health Resources and Services Administration (HRSA)

  • $5.71 billion for Community Health Centers, a proposed increase of $87 million over FY 2020.
    • $137 million for Ending the HIV Epidemic initiative, a proposed increase of $87 million over FY 2020.
  • $2.44 billion for the HIV/AIDS Bureau at HRSA, an increase of $60 million over FY 2020 
    • $28.55 million for Organ Transplantation, a proposed increase of $1 million over FY 2020
  • $5.5 million for the National Living Donor Assistance Center, a proposed increase of $1 million over FY 2020

Centers for Disease Control and Prevention (CDC)

  • $1.28 billion for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, an increase of $5 million over FY 2020
    • $39 million for Viral Hepatitis, level funded with FY 2020
  • $994.71 billion for Chronic Disease Prevention and Health Promotion at CDC, a proposed increase of $9.8 million over FY 2020
    • $1 million for Inflammatory Bowel Diseases, level funded with FY 2020
  • $382 million for Cancer Prevention and Control, a proposed increase of $1 million over FY 2020
    • $43.29 million for Colorectal Cancer, level funded with FY 2020

National Institutes of Health (NIH)

  • $6.54 billion for the National Cancer Institute, a proposed increase of $282.22 million over FY 2020
  • $2.17 billion for the National Institute of Diabetes and Digestive and Kidney Diseases, a proposed increase of $53.9 million over FY 2020
  • $6.14 billion for the National Institute of Allergy and Infectious Diseases, a proposed increase of $266.35 million over FY 2020
  • $890 million for the National Center for Advancing Translational Sciences, a proposed increase of $57.12 million over FY 2020
  • $2.38 billion for the Office of the Director, a proposed increase of $138.27 million
    • $646.3 million for the Common Fund, a proposed increase of $19.79 million

Department of Defense (DoD)

  • $115 million for the Peer-Reviewed Cancer Program, a proposed increase of $5 million over FY 2020

 

November 4, 2020 - Federal agencies are operating under a continuing resolution through December 11, 2020. It is expected that the Senate will begin providing details on their 12 FY 2021 spending measures in the next few weeks. The time crunch between now and December 11th favors an effort to lump all or many of the bills into an omnibus measure, which is a group of several bills.

November 4, 2020 - Senate Majority Leader Mitch McConnell (R-KY) said that Congress should approve a coronavirus relief package before the end of the year. He stated that a coronavirus relief package and government funding past the December 11, 2020 deadline will be top priorities for the Senate.

 

October

October 1, 2020 - Legislators passed, and President Trump signed into law a stopgap spending measure to continue government funding.  The short-term continuing resolution, H.R. 8337, keeps federal agencies operating through Dec. 11th. Work on the 12 regular appropriations bills will remain stalled until after the election. This bill includes a provision which would extend the availability of funding for certain multiyear NIH research grants that were interrupted by COVID-19. The bill also includes several temporary “health extenders” such as ongoing authorization for health centers, the National Health Service Corps, and teaching health centers, and support for disproportionate share health care providers. Here is a summary of H.R. 8337.

October 1, 2020 - The House passed its updated $2.4 trillion HEROES legislation along party lines. The House is scheduled to leave for recess and not return until after the election, but odds are that if a bipartisan deal is reached before the election, then legislators would return to Washington, pass a bill, and send it to the president. The revised House HEROES (H.R. 8406) legislation is very similar to the previous HEROES bill but reduces the overall price by shortening the length of time for certain benefits and initiatives. The new HEROES legislation does contain improved provisions for non-profit relief by expanding the eligibility for benefits to more non-profits regardless of their size, and other improvements. More information on H.R 8406 is available here, and a summary by the House Committee on Appropriations is available here.

 

September

 

September 22, 2020 -After negotiations with the White House, the House of Representatives passed H.R. 8337. This stopgap measure has bipartisan support, and will keep federal agencies funded through December 11th. The Senate is expected to follow suit and pass the bill before the September 30th end of the current fiscal year. While the bill keeps agencies level-funded, the relatively “clean” CR does include a provision which would extend the availability of funding for certain multiyear NIH research grants that were interrupted by COVID-19 and set to expire on September 30th. Here is a summary of the continuing resoltion, and more information on the bill.

September 11, 2020 - The White House and legislators have agreed to work to advance a stopgap continuing resolution (CR) to fund federal agencies from Oct. 1 until after the November election. Political considerations are being weighed by both Democrats and Republicans. Republicans want the CR to last until sometime after the election, but expire before the end of the calendar year so they can work with the existing set of congressional and administration players to finish off the process. Democrats, are pressing for a CR that lasts into calendar year 2021.

 

August

August 14, 2020 - As September 30 marks the end of FY 2020, a continuing appropriations resolution (CR) is expected. This will provide funding for government agencies through the fall, until regular appropriations measures can be enacted.

The House and Senate are both expected to halt negotiations on the HEROS Act and HEALS Act COVID-19 legislation until after the August recess has concluded.

August 7, 2020 - House and Senate appropriators are poised to begin negotiations on the spending details of the COVID-19 stimulus bill. Scientific, patient, provider, and academic groups are encouraging the House and Senate leadership to adopt a funding level of $15.5 billion for National Institutes of Health in the upcoming COVID-19 spending package. This funding would support coronavirus research and support research that was halted or otherwise negatively impacted by the pandemic situation.

 

July

HEALS Act

July 31, 2020 - Senate Republicans issued the HEALS Act—their $1 trillion alternative to the House-passed $3 trillion HEROES legislation addressing COVID-19. The HEALS Act takes a more limited approach, but does contain important economic stimulus, spending, and healthcare access provisions. Notably absent in the Senate package is a COVID-19 National Testing Plan mandate, and meaningful relief for large and mid-sized not-profits. Senators will continue working towards a complete COVID-19 package, which will require bipartisan cooperation.

Fiscal Year (FY) 2021 Appropriations

July 27, 2020 - House Appropriations Committee Chairwoman Nita Lowey (D-NY) worked another major spending bill through the full House of Representatives the week of July 27th, rolling six annual FY 2021 appropriations measures into one package that cleared the House on July 31st. The minibus includes the annual funding bills for 1) Labor-HHS-Education; 2) Defense; 3) Energy and Water; 4) Commerce, Justice and Science; 5) Financial Services; and 6) Transportation, Housing, and Urban Development. See the House Appropriations Committee Press Release here. The full bill text is available here.

July 10, 2020 - Beginning in July, the House Appropriations Committee considered and passed its Fiscal Year (FY) 2021 appropriations bills for the departments of Labor, Health and Human Services, Education, and Related Agencies (L-HHS), Defense, Military Construction, Veterans Affairs, and Related Agencies, Agriculture, Rural Development, Food and Drug Administration, and Related Agencies, Interior, Environment, and Related Agencies, and State, Foreign Operations, and Related Programs. These bills are the first significant movement of the FY 2021 appropriations process and may be voted on in the full House of Representatives in the coming weeks.

Labor-HHS bill key provisions:

$96.4 billion for the Department of Health and Human Services, an increase of $1.5
billion above the FY 2020 enacted level.

  • $7.2 billion for Health Resources Services Administration (HRSA), an increase of $157 million above the 2020 enacted level.

    • $8 billion for Centers for Disease Control and Prevention (CDC), an increase of $232 million above the FY 2020 enacted level.

    • $9 billion in emergency supplemental funding for public health and emergency response activities.

    • $1.31 billion for Chronic Disease Prevention and Health Promotion, a proposed increase of $66.5 million over FY 2020.

      • $3 million for a new Chronic Disease Education and Awareness Program, a
        proposed increase of $3 million over FY 2020.

  • $ 47 billion for the National Institutes of Health (NIH), $5.5 billion above the FY 2020 enacted level.

    • Within the total, the bill provides $42 billion in annual appropriations (including the full $404 million provided in FY 2021 through the Innovation Account established in the 21st Century Cures Act for specific initiatives), an increase of $500 million above the 2020 enacted level (1.2%), as well as $5 billion in emergency appropriations available through FY 2025. The $5 billion in emergency funding may be used “to offset costs related to reductions in laboratory productivity resulting from interruptions or shutdowns of research activity” in FY 2020, and would be provided to the Office of the Director, with the requirement that at least $2.5 billion be distributed across NIH proportionate to each institute and center’s FY 2020 funding level.
  • $2.27 billion for the National Institute of Diabetes and Digestive and Kidney Diseases, a proposed increase of $154.24 million over FY 2020.
  • $893.65 million for the National Center for Advancing Translational Sciences, a proposed increase of $60.76 million over FY 2020.
  • $4.61 billion for the Office of the Director, a proposed increase of $2.4 billion over FY 2020.
    • $631.9 million for the Common Fund, a proposed increase of $5.4 million over

      FY 2020.

  • $6 billion for Substance Abuse and Mental Health Services Administration (SAMHSA) an increase of $96 million above the FY 2020 enacted level.
  • $343 million for the Agency for Healthcare Research and Quality (AHRQ), an increase of $5 million above the FY 2020 enacted level.
  • $4 billion for Centers for Medicare and Medicaid Services (CMS) administrative expenses, an increase of $315 million above the FY 2020 enacted level.

$73.5 billion in discretionary appropriations for the Department of Education, an increase of $716 million above the FY 2020 enacted level.

Defense Bill key provisions:

$33.3 billion for the Defense Heath Program (basically level-funding from FY2020), including $1.02 billion for congressionally directed medical research activities.

Military Construction/VA Bill key provisions:

$840 million is proposed for the VA Medical and Prosthetic Research Program, an increase of $40 million above the FY 2020 enacted level.

Agriculture-FDA Bill key provisions:

$3.212 billion in discretionary funding for the Food and Drug Administration (FDA), an increase of $40.8 million above the FY 2020 enacted level.



June

June 5, 2020 - House Appropriations Committee Chairwoman Nita Lowey (D-NY) issued a “Dear Colleague” letter to House members announcing the committee’s plans to hold all subcommittee and full committee markups of FY 2021 bills during the weeks of July 6 and 13th. The bills are then expected to be on the House floor the weeks of July 20th and 27th.

 

May

House Resolution 965 - Authorizing remote voting by proxy in the House of Representatives and providing for official remote committee proceedings during a public health emergency due to a novel coronavirus, and for other purposes, was passed on May 15th. Remote voting is allowed for 45 days with the possibility of extending this period by another 45 days or shortening it, depending on the status of the public health emergency. The new remote voting rules require committees to hold a few hearings and practice deliberations before advancing legislation.

A House Appropriations Committee spokesperson advised the media that the committee would be holding off on FY 2021 markups until after the COVID-19 (HEROES) legislation is finalized. The committee staff is working hard to be prepared to move forward with markups when they do occur.

 

March 2020

House and Senate Labor-HHS appropriations subcommittees held hearings on February 27th with Health and Human Services Secretary Azar. Congress is prepared to spend emergency funding to respond to needs identified by health officials. On March 5th, President Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) allotting $8.3 billion in emergency spending to respond to the outbreak.

 

February 2020

The House and Senate are both holding subcommittee hearings in the beginning of March to examine the proposed budget of the National Institutes of Health for FY 2021. These links will provide upcoming hearing information for the House and Senate appropriations subcommittees.

House and Senate Labor-HHS appropriations subcommittees held hearings on February 27th with Health and Human Services Secretary Azar. Much of the time at the hearing was dedicated to discussing questions about the coronavirus and the adequacy of the administration’s request for supplemental funding to respond to the public health threat. Congress is preparing to spend emergency funding to respond to needs identified by health officials. Read Secretary Azar's oral testimony to the House Committee on Ways and Means here.

 

 

FY 2021 Appropriations

The President's administration budget proposal for FY 2021 was issued to Congress on February 10. These funding recommendations do not conform to the two-year budget deal released last year. Congress will now examine this budget proposal and develop the twelve annual appropriations bulls based on funding levels provided by the two-year budget deal. Find the entire budget document here.

  • $6.21 billion for FDA, a proposed increase of $265 million above FY 2020.

    • $2.02 billion for Human Drugs at FDA, a proposed increase of $49 million over FY 2020. 

    • $1.12 billion in Prescription Drug User Fees at FDA, a proposed increase of $52 million over FY 2020.

    • $526 million in Generic Drug User Fees at FDA, a proposed increase of $10 million over FY 2020.

    • $425 million for Biologics at FDA, a proposed increase of $6 million over FY 2020. 

    • $43 million in Biosimilar User Fees at FDA, a proposed increase of $1 million over FY 2020.

  • $7 billion for CDC, a proposed decrease of $693.29 million below FY 2020.

    • $813 million for Chronic Disease Prevention and Health Promotion at CDC, a proposed decrease of $427 million from FY 2020. 

  • Individual chronic disease programs are consolidated into a new proposed block grant program.

  • $38.69 billion for NIH, a proposed decrease of $2.99 billion below FY 2020.

      • $2.01 billion for the National Institute of Diabetes and Digestive and Kidney Diseases at NIH, a proposed decrease of $191 million from FY 2020.

      • $788 million for the National Center for Advancing Translational Sciences at NIH, a proposed decrease of $45 million from FY 2020.$2.1 billion for the Office of the Director at NIH, a proposed decrease of $148 million from FY 2020.

      • $788 million for the National Center for Advancing Translational Sciences at NIH, a proposed decrease of $45 million from FY 2020.

    $2.1 billion for the Office of the Director at NIH, a proposed decrease of $148 million from FY 2020.

FY 2020 Appropriations

Congressional leaders and administration officials have agreed on a comprehensive package for Fiscal Year (FY) 2020 spending which includes all 12 annual appropriations bills that are lumped into two minibus spending measures. Find a press release from the House Committee on Appropriations containing a full summary and the minibus text here.

 

Key spending highlights of the bills include:

  • $95 billion in discretionary spending for the Department of Health & Human Services, an increase of $4.4 billion above FY 2019.
  • $7.3 billion for the Health Resources and Services Administration, an increase of $177 million above FY 2019.
  • $8 billion for the Centers for Disease Control and Prevention, an increase of $636 million above FY 2019.
  • $41.7 billion for the National Institutes of Health, an increase of $2.6 billion above FY 2019.
  • $5.9 billion for the Substance Abuse and Mental Health Services Administration, an increase of $140 million above FY 2019.
  • $338 million for the Agency for Healthcare Research and Quality, level-funded with FY 2019.
  • $73 billion in discretionary spending for the Department of Education, an increase of $1.3 billion above FY 2019.
  • $800 million for the VA Medical and Prosthetic Research Program, an increase of $20 million above FY 2019.
  • $34 billion for the Defense Health Program, level-funded with FY 2019.
  • $5.77 billion including user fees and $3.16 billion in discretionary funding for the Food and Drug Administration, an increase of $91 million above FY 2019.

 

January 2020

Retiring House Appropriations Committee Chairperson Nita Lowey (D-NY) is expected to push the FY 2021 bills out of committee during her last year in office, and there is similar optimism in the Senate for swift committee action.

 

For FY 2021, the expectation is that appropriators will hit the ground running in February once the administration’s budget proposal is issued (on the 10th). The recent overarching budget deal covers both FY 2020 and FY 2021, so there is relatively little holding back the FY 2021 process. Retiring House Appropriations Committee Chairperson Nita Lowey (D-NY) is expected to push the FY 2021 bills out of committee as expeditiously as possible during her last year in office, and there is similar optimism in the Senate for swift committee action.

 

 

 

 

Senate Republicans issued the HEALS Act—their $1 trillion alternative to the House-passed $3 trillion HEROES legislation addressing COVID-19. The HEALS Act takes a more limited approach, but does contain important economic stimulus, spending, and healthcare access provisions. Notably absent in the Senate package is a COVID-19 National Testing Plan mandate, and meaningful relief for large and mid-sized not-profits. See the attached DDNC memo for a more detailed look. Senators will try again next week to find a path forward on the COVID-19 package, which will require bipartisan cooperation.

Earlier this week, the Senate released draft versions of its Fiscal Year (FY) 2021 appropriations bills and corresponding committee reports. The measures, known as “Chairman’s Marks,” because they were not advanced through the official committee markup process, are intended to facilitate negotiations with the House in an effort to craft final, compromise FY 2021 funding bills. At this time, both the House and Senate have expressed an interest in completing the FY 2021 appropriations process before the current continuing resolution expires on December 11th (or at least by the end of the year).   Highlights of the FY 2021 Senate bills and their corresponding committee reports include: Labor-Health and Human Services-Education (L-HHS) ●$96.4 billion for the Department of Health and Human Services (HHS), an increase of $1.5 billion above the FY 2020 enacted level. ●$7.1 billion in programmatic funding for the Health Resources and Services Administration (HRSA), a proposed increase of $67.28 million over FY 2020 and $90 million less than the House proposal.  ●$7.82 billion in programmatic funding for the Centers for Disease Control and Prevention (CDC), a proposed increase of $130 million over FY 2020 and $100 million less than the House proposal.  ●$43.46 billion for the National Institutes of Health (NIH), a proposed increase of $2 billion over FY 2020 and $3.5 billion less than the House proposal. ●$6 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA), a proposed increase of $117 million over the FY 2020 enacted level and the same allocation that was proposed by the House. ●$256.7 million for the Agency for Healthcare Research and Quality (AHRQ), a proposed decrease of $81.24 million from FY 2020 and $86.24 million less than the House proposal.   ●$76.86 billion for the Department of Education, a proposed increase of $490.63 million over FY 2020 and $283 million less than the House proposal.  Department of Defense (DoD) ●$33.2 billion for the Defense Health Program, basically a proposal of level-funding from FY 2020 and essentially the same level as the House proposal.  Military Construction, Veterans Affairs, and Related Agencies (MilCon-VA) ●$800 million for the VA Medical and Prosthetic Research Program, a proposal of level-funding from FY 2020 and $40 million less than the House proposal.  Agriculture, Rural Development, Food and Drug Administration, and Related Agencies (Ag-FDA) ●$3.21 billion for the Food and Drug Administration (FDA), excluding user fees, a proposed increase of $40 million over FY 2020 and essentially the same allocation that was proposed by the House.  Interior, Environment, and Related Agencies (Int-Env) ●$9.1 billion for the Environmental Protection Agency (EPA), a proposed increase of $28 million over FY 2020 and roughly $290 million less than the House proposal.  Of specific interest to the DDNC, the bills include: Health Resources and Services Administration (HRSA) ●$5.71 billion for Community Health Centers, a proposed increase of $87 million over FY 2020.○$137 million for Ending the HIV Epidemic initiative, a proposed increase of $87 million over FY 2020. ●$2.44 billion for the HIV/AIDS Bureau at HRSA, an increase of $60 million over FY 2020 ○$28.55 million for Organ Transplantation, a proposed increase of $1 million over FY 2020 ●$5.5 million for the National Living Donor Assistance Center, a proposed increase of $1 million over FY 2020 Centers for Disease Control and Prevention (CDC) ●$1.28 billion for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, an increase of $5 million over FY 2020○$39 million for Viral Hepatitis, level funded with FY 2020 ●$994.71 billion for Chronic Disease Prevention and Health Promotion at CDC, a proposed increase of $9.8 million over FY 2020 ○$1 million for Inflammatory Bowel Diseases, level funded with FY 2020 ●$382 million for Cancer Prevention and Control, a proposed increase of $1 million over FY 2020 ○$43.29 million for Colorectal Cancer, level funded with FY 2020 National Institutes of Health (NIH) ●$6.54 billion for the National Cancer Institute, a proposed increase of $282.22 million over FY 2020 ●$2.17 billion for the National Institute of Diabetes and Digestive and Kidney Diseases, a proposed increase of $53.9 million over FY 2020 ●$6.14 billion for the National Institute of Allergy and Infectious Diseases, a proposed increase of $266.35 million over FY 2020 ●$890 million for the National Center for Advancing Translational Sciences, a proposed increase of $57.12 million over FY 2020 ●$2.38 billion for the Office of the Director, a proposed increase of $138.27 million○$646.3 million for the Common Fund, a proposed increase of $19.79 million Department of Defense (DoD) ●$115 million for the Peer-Reviewed Cancer Program, a proposed increase of $5 million over FY 2020  Committee Recommendations Centers for Disease Control and Prevention Hepatitis B Vaccination.—The Committee is concerned that despite the availability of an effective hepatitis B virus [HBV] vaccine, only approximately one quarter of adults age 19 and older were vaccinated. Therefore, the Committee is pleased that CDC is evaluating new universal HBV vaccination recommendations including a comprehensive plan to increase adult HBV vaccinations. The Committee urges CDC to promote awareness about the importance of hepatitis B vaccination among medical and health professionals, communities at high risk, and the general public. The Committee directs CDC to submit a report to the Committees on Appropriations of the House of Representatives and the Senate within 180 days of enactment detailing how CDC can increase the rate of HBV adult vaccination to the levels necessary to eliminate new infections of hepatitis B in the United States, and to improve collaboration and coordination across CDC to achieve this goal.  Infectious Diseases and the Opioid Epidemic.—The Committee provides $15,000,000, an increase of $5,000,000, to CDC to strengthen efforts to conduct surveillance to improve knowledge of the full scope of the burden of infectious diseases (including viral, bacterial, and fungal pathogens) associated with substance use disorders. CDC is encouraged to take into account risk factors for hepatitis B and C, HIV, and morbidity and mortality related to substance use disorder among other factors when distributing funding. Interventions may include increasing capacity for State and local health departments; expanding access for syringe exchange programs; fully implementing national HIV, hepatitis B, and hepatitis C screening guidelines; and expanding surveillance and data collection on infectious diseases related to opioid use.  Inflammatory Bowel Diseases [IBD].—The Committee commends CDC for investing in research on the epidemiology of IBD, as well as on disparities in treatment patterns and overall health outcomes within minority populations and underserved communities. The Committee encourages CDC to continue supporting this research and to develop a plan to reduce the time for persons from underserved communities to receive a diagnosis, including by increasing understanding and awareness of IBD among these populations and the healthcare providers who serve them. Nutrition, Physical Activity, and Obesity.—Evidence shows that physical activity and nutrition help control weight; reduce risk of cardiovascular disease, diabetes, and some cancers; and improve other quality of life factors. The Committee recognizes CDC’s efforts through Active People, Healthy Nation, which aims to help 27,000,000 million Americans become more physically active by 2027, and encourages CDC to continue evidence-based strategies that promote physical activity.  National Institutes of Health  Deadliest Cancers.—For fiscal year 2020, Congress directed NCI to develop a scientific framework using the process outlined in the Recalcitrant Cancer Research Act of 2012 (Public Law 112–239) for stomach and esophageal cancers. The Committee expects that outlining the state of the science and foremost research questions for both of these diseases will provide a roadmap for future research. The Act defined ‘‘recalcitrant cancers’’ as those for which the 5 year survival rate is below 50 percent. According to NCI, the 5 year survival rates for stomach and esophageal cancers are 32 and 20 per cent, respectively. The Committee expects to be kept informed of NCI’s efforts, alongside the research and advocacy communities, to convene working groups of experts to develop scientific frameworks for both cancers; and to be kept informed of ways in which NCI is supporting research into all recalcitrant cancers. The deadliest cancers, which also include cancers of the brain, liver, lung, ovary, pancreas, and mesothelioma, among others, account for nearly half of all U.S. cancer deaths. While steady advances have made it possible to reduce the overall rate of cancer deaths for more than 2 decades, there has been little progress reducing mortality for these diseases. The Committee recognizes that advances in treating what were once thought of as incurable diseases has previously occurred in unexpected ways, and is encouraged by NCI’s continued support for research related to the deadliest cancers. In particular, the Committee notes the promising focus on diagnostics to make earlier identification possible when successful treatment might still be possible. Given the toll all recalcitrant cancers exact on society and the lack of diagnostic and treatment resources currently available to help patients, the Committee directs NCI to provide an update on its work over the past year for each of the seven deadliest cancers in the fiscal year and to identify future goals for each in the fiscal year 2022 CJ. Liver Cancer.—The Committee notes that liver cancer is a devastating cancer with a 5 year survival rate of only 20 percent. The Committee commends NCI for the creation of a Specialized Center of Research Excellence focused on liver cancer and encourages NCI to continue to support research opportunities for investigators that focus on a better understanding of the biology of liver cancer and new therapeutic targets. Additionally, the Committee commends NCI for its support of the inter-Institute effort to develop the NIH Strategic Plan to Cure Hepatitis B. In view of the well-established fact that up to 60 percent of global liver cancer cases are caused by the hepatitis B virus, NCI is encouraged to continue close collaboration with NIAID and NIDDK and as active participants in the Director’s Trans-NIH Hepatitis B Working Group. The Committee requests an update on NCI’s activities in these areas in the fiscal year 2022 CJ.  Pancreatic Cancer.—The Committee appreciates NCI’s recent submissions of the 5 year Review and Update report required by the Recalcitrant Cancer Research Act of 2012 (Public Law 112– 239). This year, the Committee looks forward to the report on the effectiveness of the scientific framework, including research efforts on improvements in pancreatic cancer prevention, detection, diagnosis and treatment. While progress has been made, the Committee encourages NCI to continue to support research efforts to advance discoveries and improve treatment options for patients diagnosed with pancreatic cancer Inflammatory Bowel Diseases [IBD].—The Committee recognizes NIDDK’s leadership in supporting research into Crohn’s disease and ulcerative colitis. The Committee also recognizes the importance of patient-centered, bedside-to-bench approaches to understand complex, chronic diseases such as IBD, and the need to better understand the impact of diet on IBD. The Committee directs NIDDK to pursue research on the interactions among food, the gut, and the brain/nervous system in people with IBD and other chronic gastrointestinal diseases. The Committee notes that this bedside-to-bench approach has been successful in other disease areas, including type 2 diabetes and oncology, and encourages NIDDK to use a similar approach focused on IBD.  Celiac Disease.—The Committee includes sufficient funding for NIH to devote focused research to the study of Celiac disease, including the autoimmune causation underpinning the affliction. Today, the only known treatment for this disease is a gluten-free diet; however, recent public and private sector research has revealed that such a ‘‘treatment’’ is insufficient for many who suffer from Celiac disease. Therefore, the Committee urges NIAID to support new research on celiac disease to better coordinate existing research and focus new research efforts toward causation, and ultimately, a cure of this disease. The Committee encourages NIAID to coordinate with other Institutes and Centers including NIDDK as appropriate and to submit its plan for coordination and execution of this research to the Committees on Appropriations of the House of Representatives and the Senate no later than 90 days after enactment of this act. Food Allergies.—The Committee recognizes the serious issue of food allergies which affect approximately 8 percent of children and 10 percent of adults in the United States. The Committee commends the ongoing work of NIAID in supporting a total of 17 clinical sites for this critical research, including seven sites as part of the Consortium of Food Allergy Research. The Committee encourages NIAID to expand its clinical research network to add new centers of excellence in food allergy clinical care and to select such centers from those with a proven expertise in food allergy research.   Hepatitis B.—The Committee applauds NIAID for its leadership of the inter-Institute initiative to develop a NIH Strategic Plan for Trans-NIH Research to Cure Hepatitis B released in December 2019. It is noted that infection with the hepatitis B virus [HBV] is a serious public health threat and that 1 in 20 Americans has been infected while more than 2,000,000 Americans are chronically infected, increasing by 70,000 a year. This serious public health threat results in over 780,000 worldwide deaths each year. The Committee appreciates the Institute’s use of contracts, program announcements, and research resources initiatives to stimulate new research applications and facilitate ongoing work. The Committee urges NIAID to issue new targeted calls for research through Program Project, R01, and U01 Cooperative Research Agreements, such as those successfully used to discover cures for hepatitis C. The Committee also urges NIAID to consider cooperative research to implement the Strategic Plan and the ‘‘Roadmap for a Cure,’’ reported from the Hepatitis B Foundation, to close the gap in our understanding of HBV and hepatitis delta virus molecular biology and develop effective therapeutics. The Committee notes that the Trans-NIH Strategic Plan was specific enough to provide guidance for program announcements without stifling innovation. The Committee requests that NIAID submit, within 90 days of enactment of this act, a specific plan to pursue a cure for hepatitis B in coordination with the Trans-NIH Hepatitis B Working Group.  Centers for Medicare and Medicaid Services CT Colonography.—Due to the proven life and cost savings of preventive screening for colorectal cancer, the Committee encourages CMS to consider covering CT Colonography as a Medicare-covered colorectal cancer screening test under section 1861(pp)(1) of the Social Security Act.  Sepsis.—The Committee is pleased that CMS and the National Quality Forum plan to update the SEP–1 measure. A CMS study published in February reported an alarming 40 percent increase in the number of Medicare patients hospitalized with sepsis over the past 7 years. The Committee encourages CMS to issue a Request for Information as part of the update to the SEP–1 measure review to collect broad stakeholder input to help ensure the new SEP–1 measure improves health outcomes. The Committee requests an update on these activities in the fiscal year 2022 CJ.  Total Parenteral Nutrition Cancer Access.—The Committee requests that CMS provide the Committees on Appropriations of the House of Representatives and the Senate an update 180 days after enactment on its plans to revise the Durable Medical Equipment local policies to allow for parenteral nutrition as first line therapy for patients with head, neck, and gastrointestinal cancers.  Department of Defense Peer-Reviewed Medical Research Program.—The Committee recommends $370,000,000 for the Peer-Reviewed Medical Research Program. The Committee directs the Secretary of Defense, in conjunction with the Service Surgeons General, to select medical research projects of clear scientific merit and direct relevance to military health. Research areas considered under this funding are restricted to: Alzheimer’s arthritis, autism, burn pit exposure, cardiomyopathy, congenital heart disease, diabetes, Duchenne muscular dystrophy, eating disorders, emerging viral diseases, epidermolysis bullosa, familial hypercholesterolemia, fibrous dysplasia, focal segmental glomerulosclerosis, food allergies, Fragile X, frontotemporal degeneration, gulf war illness, hemorrhage control, hepatitis B, hydrocephalus, hypertension, inflammatory bowel diseases, lupus, malaria, metals toxicology, mitochondrial disease, multiple sclerosis, myalgic encephalomyelitis/chronic fatigue syndrome, myotonic dystrophy, neurofibromatosis, non-opioid therapy for pain management, nutrition optimization, Parkinson’s, pathogen-inactivated blood products, peripheral neuropathy, plant-based vaccines, platelet like cell production, polycystic kidney disease, pressure ulcers, reconstructive transplantation, respiratory health, rheumatoid arthritis, sleep disorders and restriction, suicide prevention, sustained release drug delivery, tick-borne diseases, trauma, tuberous sclerosis complex, vision, and women’s heart disease. The Committee emphasizes that the additional funding provided under the Peer-Reviewed Medical Research Program shall be devoted only to the purposes listed above.  Peer-Reviewed Cancer Research Programs.—The Committee recommends $130,000,000 for the peer-reviewed breast cancer research program, $70,000,000 for the peer-reviewed prostate cancer research program, $30,000,000 for a peer-reviewed melanoma research program, $10,000,000 for the peer-reviewed ovarian cancer research program, $17,500,000 for a peer-reviewed rare cancers research program, and $115,000,000 for the peer-reviewed cancer research program that would research cancers not addressed in the aforementioned programs currently executed by the Department of Defense. The funds provided in the peer-reviewed cancer research program are directed to be used to conduct research in the following areas: bladder cancer; blood cancers; brain cancer; esophageal cancer; kidney cancer; liver cancer; lung cancer; neuroblastoma; pancreatic cancer; pediatric brain tumors; pediatric, adolescent, and young adult cancers; and stomach cancer. The funds provided under the peer-reviewed cancer research program shall be used only for the purposes listed above. The Committee directs the Assistant Secretary of Defense (Health Affairs) to provide a report not later than 18 months after the enactment of this act to the congressional defense committees on the status of the peer-reviewed cancer research program. For each research area, the report should include the funding amount awarded, the progress of the research, and the relevance of the research to servicemembers.  Veterans Affairs VA Cancer Moonshot Contribution.—The Committee supports the Department’s contribution utilizing advances in genomic science to provide targeted treatment to veterans. The Department has identified prostate cancer, triple-negative breast cancer, and colorectal cancer as areas of priority. Due to the prevalence of various skin cancers among servicemembers, the Committee directs that skin cancer be included as well.  Gulf War Illness Studies.—The Committee urges the Department to consistently utilize the term, ‘‘Gulf War illness.’’ The Committee recommends that the Department continue to conduct epidemiological studies regarding the prevalence of Gulf War illness, morbidity, and mortality in Persian Gulf War veterans, and directs the Department to publish disease-specific morbidity and mortality data related specifically to Persian Gulf War veterans. The Committee urges the Department to focus on recent Gulf War illness treatment research findings and ongoing Gulf War illness treatment research direction to expedite development and clinical implementation of effective treatments, preventions, and cures for Gulf War illness. Furthermore, the Committee encourages VA to strengthen the training of primary, specialty, and mental healthcare providers on Gulf War illness, its clinical manifestations, and promising potential treatments. The Committee directs the Department to submit a report to the Committees on Appropriations of both Houses of Congress no later than 180 days after enactment of this act on the progress of research related to the incidence and prevalence of brain cancer in Gulf War veterans.  Food and Drug Administration Gluten Free Labeling.—The Committee urges the FDA to prioritize publication of the final rule entitled ‘‘Food Labeling: Gluten-Free Labeling of Fermented or Hydrolyzed Foods’’ to provide certainty for food manufacturers and ensure people with celiac disease or other forms of gluten intolerance receive accurate information from hydrolyzed or fermented food products labeled as gluten-free.  Hepatitis B Drug Development.—The Committee appreciates the FDA’s commitment to patient-focused drug development and its interest in an Externally-Led Patient-Focused Drug Development meeting focusing on the treatment-related needs and challenges of individuals infected with the Hepatitis virus to help inform the focus of new drug development and future clinical trials. The Committee urges the FDA to continue focusing on this issue Medical Foods.—The Committee recognizes the unique role medical foods play in the nutritional management of inborn errors of metabolism and encourages a flexible regulatory process that would enhance access to safe medical foods for individuals with serious or life-threatening inborn errors of metabolism. The Committees encourages the FDA to continue focusing on this issue. 

 

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2020-Gastroparesis: Quality of Life and Symptom Burdens for Patients
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2019-IFFGD recognizes December as Constipation Awareness Month with the launch of Animated Patient’s Guide to Constipation
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2019-IFFGD Raises Awareness for Gastroparesis Awareness Month to Encourage “Education”
2019-0516 IFFGD Announces 2019 Research Recognition Awards Recipients
2019-0328 IFFGD Encourages Patients to Share "What I Wish People Understood About My IBS" for IBS Awareness Month
2018-1205 IFFGD Marks Constipation Awareness Month with Launch of Education Campaign
2019-0213 IFFGD Sheds a Light on the Daily Impact of Rare Digestive Disorders for Rare Disease Day 2019
2018- 1107 IFFGD Celebrates #GivingTuesday
2018-1101 Have You Heard? It Could Be GERD!
2018-0801 IFFGD Raises Awareness for Gastroparesis Awareness Month to “Make Patient Voices Heard”
2018-0529 IFFGD Presents 2018 Research Recognition Awards at DDW
2018-0402 Social Taboos, Lack of Awareness May Prevent Diagnosis & Treatment of IBS
2018-0212 IFFGD Raises Awareness for Rare Disease Day 2018
2017-1114 Holiday Heartburn or Something More?
2017-0802 Research Survey Reveals Unmet Needs of People with Gastroparesis
2017-0403 IFFGD Encourages People to See Their Doctor for Symptoms of IBS
2016-1115 GERD is More Than Simple Heartburn
2016-0801 Learn the Facts About Gastroparesis
2016-0405 Think You Have IBS? Find Out For Sure Before Starting a Treatment
2015-1123 Is it More than Simple Heartburn? Ask Your Doctor.
2015-7-30 Gastroparesis is a Hidden Medical Condition for Many
2015-0330 Online Survey Looks to Help Improve Outcomes for those with IBS
2014-1119 Persistent Heartburn May Be a Sign of GERD
2014-0826 Lack of Awareness of Gastroparesis May Impact Medical Care
2014-0326 IFFGD Marks IBS Awareness Month with Launch of Mobile App
2014-0225 IFFGD Research Grants to Study Gastroparesis
2013-1106 15 Tips for GERD Awareness Week
2013-0626 New DHA.org
2013-0412 IFFGD Presents 2013 Research Awards
2013-0401 Turning Attention to Returning Vets
2012-1109 Banish Frequent Heartburn by Burning More Calories
2012-0321 April is IBS Awareness Month: A Serious Issue for Veterans
2011-1130 Is Your Child's Reflux/Spitting Up A Point of Concern?
2011-0412 IFFGD Research Award Winners
2011-0329 IBS Signs You Should Not Ignore
2010-1118 GERD Difference
2010-1001 Heartburn or GERD?
2010-0517 US House Resolution for IBS
2009-1109 GERD at Night
2009-0417 IFFGD Research Award Recipients
2008-0331 Dealing with Digestive Disorders
2007-1118 When Is Simple Heartburn Not So Simple?
2007-0718 Proposed FDA Funding Applauded
2007-0401 IBS Myths
2006-1116 GERD & Holidays
2006-0418 Natl Commission
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2005-1125 GERD Costs
2005-0412 IBS Awareness
2004-1125 Heartburn & Heartache
2004-0929 Norton Honored
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2004-0101 IFFGD Conference
2003-1117 GERD Treatment
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2001-1119 Heartburn or Heart Attack
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Advocate for Change

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What it means to be an advocate – someone who speaks out and works with others to create meaningful, positive change. Let your voice be heard.

Taking Action for Digestive Health

The Functional GI and Motility Disorders Research Enhancement Act

Make Your Voice Heard