What do the opioid legislation, the Zika legislation and Cures/Innovations bills have in common, other than that they are “hot button” issues? In each case, Congress has done its best to seriously consider healthcare problems facing our nation and managed to find compromises in order to reach consensus. Also — significantly — the three pieces of legislation are stalled by funding issues.
Some Members of Congress (mostly Democrats) think that action on these three topics is so pressing that the legislation should contain enough mandatory funding so that they can be implemented as soon as possible. Other Members of Congress (mostly Republicans) agree on the importance of the three issues, but feel strongly that funding should be left to the appropriations committees. For the moment, the three bills are deadlocked, but it is money, not substance, that is holding them back.
One or more of the three bills may move next week or in September or (possibly) during a lame duck session. But then again, there is no guarantee that they aren’t deadlocked for the year because of the funding issues.
Meantime, the appropriations process seems to be facing a similar fate. There is some compromise and consensus baked into the current set of bills, but also lots of “poison pill” amendments and games-playing. Analysts are still predicting either a continuing resolution or an omnibus bill.
Heading into a presidential election and a difficult transition (regardless of who wins), it is already clear that the most important issue next year, as this year, will be money to fund programs. Under the existing budget agreements, there is not enough domestic discretionary spending to meet high priority needs, no less to handle emergency situations (like Zika and opioids). Under the circumstances, it is hard to say where the money will come from to pay for the new administration’s initiatives. The primacy of funding concerns will occur regardless of which party controls the House and the Senate.
None of this is good news for FDA or any of the public health service agencies. As the foremost advocate for FDA funding, the Alliance will continue to tell Congress about the broad mission and ever-increasing responsibilities on FDA. It will take all of us to make a dent against so much downward funding pressure.
Note: This week’s Analysis and Commentary was written by Steven Grossman, the deputy executive director of the Alliance for a Stronger FDA.