The House Appropriations Committee on Wednesday voted 30-21 in favor of passing a draft fiscal 2016 budget for HHS that would eliminate the agency responsible for supporting research on the effectiveness of medical practices.
The move is the latest in a series of budget measures proposed by GOP lawmakers in both the House and Senate that would significantly cut programs and agencies that provide evidence-based medicine research on patient outcomes.
The bill would eliminate the Agency for Healthcare Research and Quality, a $440 million unit that supports research designed to identify best clinical practices that improve patient quality and safety.
Bill supporters see eliminating AHRQ as a way to cut costs and concentrate limited funds on areas with more impact, like the National Institutes of Health, which got a $1.1 billion raise in fiscal 2016 over its budget allocation for fiscal 2015. The work of the NIH has been credited with decreasing heart disease and deaths from stroke and cancer. The Centers for Disease Control and Prevention would receive a $140 million increase over fiscal 2015 under the proposal, raising its budget to $7 billion for 2016.
“The funding in this bill is targeted to programs that are proven to produce results,” said House Appropriations Committee Chairman Hal Rogers in a statement. “In addition, great efforts were made to ensure none of the funding in the bill is spent wastefully or inappropriately. This includes terminating unnecessary programs, trimming back lower-priority areas, and preventing tax dollars from going toward extreme, intrusive regulations that have a net negative effect on this nation.”
But other measures within the bill stand to significantly cut other federal funding for healthcare. The Centers for Medicare and Medicaid Innovation would lose $7 billion under the proposed legislation, while $100 million would be cut from the Patient-Centered Outcomes Research Institute, the nongovernmental, independent organization created by the Affordable Care Act to support research that evaluates the efficacy of healthcare interventions.
The proposed cuts passed by the House Appropriations Committee on Wednesday come a day after the full House voted 244-154 in favor of repealing the Independent Payment Advisory Board, a much maligned 15-member panel of outside experts tasked with recommending ways to control Medicare costs. The body, also created by the ACA, has been criticized by both Republican and Democratic lawmakers who say it had the potential to limit patient care, even though the body has yet to convene.
“It's pretty disturbing that these important agencies have been singled out,” said Gerald Kominski, director of the Center for Health Policy Research at the University of California at Los Angeles. “We have an unwieldy healthcare system that does not function like other markets—innovation is slow, and the research effort helps to move that process from being so glacial.”
Kominski felt that in recent years, the number of staunchly conservative politicians in both the House and Senate has risen and led to efforts to defund research based on improving healthcare delivery. He believes the GOP is concerned that work would lead to health providers “rationing” healthcare out of concerns over costs.
“I think it's the idea that we don't want government placing any sort of restrictions on our ability to buy healthcare services even if they have no proven quality,” he said.
Others say the effort to defund such work runs counter to positions Republicans have held in the past. GOP leaders have previously advocated for funding initiatives that looked to arm physicians and patients with more data on the most effective clinical practices.
In an opinion piece published online Wednesday in the Washington Post, Eric Patashnik, a professor of public policy at the University of Virginia, wrote that the Republican shift was a result of the heightened politicization of healthcare since the implementation of the ACA.
“Federal investment in this research (although it predated the 2008 election) became closely tied to the Obama administration's healthcare reform agenda, because big funding increases were tucked into the 2009 stimulus legislation and the Affordable Care Act—two measures the GOP strongly opposed,” Patashnik wrote.