“NO” on the 21st Century Cures Act (H.R. 6)

Later this week, the House will consider the 21st Century Cures Act (H.R. 6).  Sponsored by Rep. Fred Upton (R-MI) 39% and Rep. Diana DeGette (D-CO) 13%, the bill would create a new mandatory funding stream outside the Budget Control Act (BCA) caps and make a number of changes to the National Institutes of Health (NIH) and the Food and Drug Administration (FDA).

Conservatives are rightly concerned about the amount of the federal budget that is classified as “mandatory” (also known as “direct” or “autopilot” spending). Many budget reform ideas put forward by conservatives throughout the years have sought to incorporate more of the federal budget into the normal, annual, discretionary budget process, so that spending programs have to re-justify themselves every year and so Congress must re-prioritize spending as new information and priorities present themselves. H.R. 6 moves in the opposite direction.

What’s more, the NIH already has a standard discretionary funding stream, and Congress can decide to increase spending to those accounts within the BCA caps. In fact, both the relevant House and Senate Appropriations Committees bills contain spending increases for NIH as part of bills that cut spending elsewhere in order to maintain overall spending reductions from FY15.  That represents Congress making necessary spending choices – the exact kinds of spending choices this bill would allow future appropriators to avoid making.

While some may be tempted to dismiss the mandatory-discretionary argument, it is impossible to ignore woefully insufficient offsets that are meant to mask the very real and immediate spending increases contained in H.R. 6.  A fraction of the offsets are small administrative changes to Medicare and Medicaid payments to providers — these are not the structural or behavioral changes the programs need. Worse, however, the vast majority (about $7 billion out of $9.2 billion, or roughly 75%) of the offset comes from tapping the Strategic Petroleum Reserve (SPR), starting in 2018. The SPR is not a piggy bank for lawmakers to use to offset their desire for immediate spending increases. If and when it becomes appropriate to tap the SPR, those savings should go towards deficit reduction – not more spending.

There is no excuse for evading the BCA caps. The House could pass the NIH and FDA reforms in this bill and give appropriators the ability to further prioritize the NIH and FDA within the BCA caps. By choosing to bypass the BCA caps, H.R. 6 represents a dangerous precedent for other authorizing Committees and an ominous foretaste of Congress’s willingness to abide by the BCA caps.

Heritage Action opposes H.R. 6 and will include it as a key vote on our legislative scorecard.