Tomorrow, the House Subcommittee on Labor, Health and Human Services, Education and Related Agencies will mark up its FY 2017 spending bill. In a victory for the #SaveAHRQ campaign, the Agency for Healthcare Research and Quality (AHRQ) is sustained in the bill – a vast improvement from last year’s proposed termination and the first time in four cycles that the House has preserved any funding for the agency at all.
Unfortunately, the House like the Senate, has proposed cuts for AHRQ which are not acceptable. The bill as written cuts AHRQ by just under $54 million (16 percent), bringing its discretionary budget to $280.24 million. Any of these cuts would be on TOP of the $30 million cut AHRQ sustained in FY 2016. The bill also decimates funding for the Center for Medicare and Medicaid Innovation (CMMI); rescinds significant funding for the Patient-Centered Outcomes Research (PCOR) Trust Fund – which compounds AHRQ’s cuts; and prohibits funding for any patient-centered outcomes research with appropriated dollars across the Department of Health and Human Services (HHS).
Taken together these cuts would be a significant blow to federally funded health services research and our nation’s ability to research and produce information on whether and how different interventions work for different patients in different settings. The cuts will make it harder for health care delivery organizations, policymakers, and the people they serve to make informed decisions about how to get the best, safest care while addressing costs and protecting patient safety.
As an advocate for the health services and policy research community and all the users of their findings in the public and private sectors, AcademyHealth is extremely disappointed with the proposed funding level for AHRQ and strongly opposed to the cuts at CMMI, the claw back of the PCOR Trust Fund, and the prohibition on discretionary funding for PCOR more generally. While we recognize that Congress is under extreme pressure to fund competing priorities whilst doing its best to keep the federal budget in check—reducing our ability to make health care safer, less complex and less costly is simply a foolish decision.
As noted above, AHRQ sustains a pretty hefty cut of just under $54 million (16 percent) in the House bill, bringing its discretionary budget to $280.24 million. The last time AHRQ’s base budget was close to this low was 2001, at $270 million (not adjusted for inflation). As a reminder, the Senate proposed a $10 million cut (3 percent). The agency’s current discretionary budget is $334 million.
Any proposed cuts in FY 2017 would be in addition to the $30 million cut AHRQ sustained in FY 2016.
The House “Labor-HHS” bill also rescinds $150 million from the PCOR Trust Fund. As mandated by the Affordable Care Act, up to 20 percent of the amount in the PCOR Trust Fund shall be used to support research capacity building and dissemination activities and of this amount, 80 percent may be used by AHRQ and 20 percent may be used by the Secretary of HHS.
AHRQ received approximately $90 million from the PCOR Trust Fund in FY 2016 in addition to its base discretionary budget. So the cut to the PCOR Trust Fund has additional implications for AHRQ’s program level budget, as well as that of the Patient Centered Outcomes Research Institute (PCORI).
Finally, the Labor-HHS bill prohibits the use of any discretionary funding to support patient-centered outcomes research, which would impact the portfolio of the National Institutes of Health, and it rescinds $7 billion from the Center on Medicare and Medicaid Innovation or CMMI.
What Happens Now
AcademyHealth encourages the health services research (HSR) community, the myriad users of HSR findings, and the Friends of AHRQ to contact their representatives on the House Subcommittee on Labor, Health and Human Services, Education and Related Agencies Appropriations to advocate for increased funding for AHRQ, the restoration of funding for CMMI and the PCORTF, and the removal of the ban on PCOR discretionary funding.
While funding for all health research is crucial, AcademyHealth believes that health services research is uniquely capable of helping the nation address the rising costs of health care and transform how we approach health and health care in this country. Every cut reduces our capacity to ensure patient safety, address waste and inefficiency, and ensure access groundbreaking treatments and prevention.
You can find a toolkit of resources to assist in educating policymakers about the important contributions of AHRQ on our website.
AcademyHealth will be following appropriations developments in the House and Senate closely, and stand ready to act on behalf of our members and the field. As we look to the future, we look not only to preserve AHRQ, but to save the critical health services research that can measurably improve health and healthcare in the nation.