Science Policy Insider News

NIH Reorganization Bill Approved in Late-Night House-Senate Trade: Now What?

Compromise amendments to H.R. 6164, the National Institutes of Health (NIH) Reform Act of 2006, were approved by the U.S. Senate and House of Representatives by voice vote in the waning hours of the 109th Congress, clearing the bill for a presidential signature. The bill had not been expected to pass the Senate in the lame-duck session, since the Senate had held no independent hearings on the measure. However, outgoing House Energy and Commerce Committee Chairman Joe Barton (R-TX) bargained with the Senate to get the NIH bill passed in exchange for the House passing several bills the Senate wanted approved, including the Ryan White Act that funds community HIV/AIDS programs at the Centers for Disease Control and Prevention.

While most behavioral and medical research advocacy groups had not pressed for NIH to be reorganized, Chairman Barton and the Republican leadership on the House Energy and Commerce Committee spoke often of enhancing NIH's accountability for the large funding increases the agency received in the years 1998 through 2003. The purpose of the House-initiated bill was to streamline the management of the sprawling National Institutes of Health and to improve the coordination and transparency of research across its 27 institutes and centers. The NIH would be required to provide additional detailed reports about its research plans and progress in studying specific diseases.

The purpose of an authorization bill is to give Congress a periodic opportunity to adjust the structure and function of an agency, to allow or prohibit funding for specific programs, and to set spending ceilings. H.R. 6164 would allow an increase of up to 6% for the 2007 fiscal year and 8% for 2008, with no ceiling specified for 2009, which is when the authorization would expire. That provides room for NIH's budget to increase in real terms, if House and Senate appropriators approve the funds.

The NIH's spending growth has slowed since the budget doubling ended in 2003 and has actually fallen if adjusted for inflation, increasing competition for funds by scientists and lowering success rates (percentage of grants funded) at the institutes.

Provisions of the bill: H.R. 6164 codifies an NIH Director's common fund, after the example of the NIH Roadmap. The House dropped its demand that 50% of any NIH funding increase be applied to the common fund. In another compromise, the bill dropped the House-passed provision that would have allowed the NIH director to reconfigure, eliminate, or reorganize institutes and centers at NIH. Many groups expressed concern that so much authority should not be consolidated in the NIH director. Current law, which allows the HHS Secretary to reconfigure institutes and centers, would be maintained. Most groups are comfortable with that arrangement since the HHS Secretary has generally not acted upon that authority, and any reorganization at that level would be subject to a much more public process.

H.R. 6164 also modifies the provision that would allow individual institute and center directors to reconfigure and reorganize programs within their institute or center. The final bill calls for any institute or center director who wishes to initiate major changes to engage in a public process and receive input from the patient, scientific and other interested parties, and secure the approval of the director of NIH.

The bill establishes a Scientific Management Review Board to periodically review the configuration of the NIH and make recommendations to key officials every seven years. It also establishes a more comprehensive reporting system for the National Institutes of Health in terms of spending on various diseases, and the management of data and statistics. The NIH director must report to Congress on progress on key areas of health, but the bill includes a provision which would allow individual institutes and centers to report directly to Congress, as well.

How will behavioral research fare? APA, The Consortium of Social Science Associations, and other behavioral and social science organizations had encouraged the Senate not to pass the House version of the bill, but instead to take an independent look at authorizing NIH. In a letter, APA expressed several concerns, opposing the bill's provision to move the Office of Behavioral and Social Sciences Research to a new umbrella group in the Office of the Director, the Division of Program Coordination, Planning and Strategic Initiatives. The reorganization is not inherently good or bad for behavioral research, but how it is implemented is the key to whether behavioral initiatives will be more or less successful than in the current NIH organizational structure.

APA's Science Policy Office, along with our coalition partners, will carefully monitor the implementation of the NIH reorganization, and push for behavioral scientists or advocates of behavioral science to be represented on the various new advisory bodies created by the bill, including the Scientific Management Review Board.

Money at NIH is still a big issue. APA and coalition partners will also advocate that the new Congress increase funding for NIH. It remains to be seen if the agency will get substantive increases when Democrats assume control of Congress in January. Democrats, along with Republicans, have praised the agency's work, but they have also pledged to reduce the federal deficit and control spending. Overall, non-defense spending is expected to be under tight constraints when the new Congress convenes in 2007.