On Dec. 19, Congress averted a government shutdown by reaching a $1.4 trillion bipartisan deal and passing all 12 of the fiscal year 2020 (FY20) spending bills in two minibuses, H.R. 1865 and H.R. 1158, that will permanently fund the government until Sept. 30, 2020. This legislation comes after two continuing resolutions were passed for the FY20 budget year after Congress failed to pass a spending package in late September. The agreement includes increased funding for medical research and additional health care measures, and punts other top agenda items addressing surprise medical billing and issues related to high medical costs into next year.

Medical Research Funding and Disease Prevention

The spending package provides funding increases for medical research and disease prevention programs at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). Most of ACC's FY20 appropriations priorities will receive increased funding levels in FY20: the NIH received $41.7 billion in funding or a $2.6 billion increase over fiscal year 2019 (FY19); the National Heart, Lung, and Blood Institute (NHLBI) received a $0.2 billion increase over FY19 at $3.6 billion; the CDC Division for Heart Disease and Stroke Prevention saw a $2 million increase at $142 million; the CDC WISEWOMAN program received the first increase in several years of $5 million for a total funding level of $26.1 million; and the CDC Office on Smoking and Health received a $20 million increase for a total funding level of $230 million.

Other notable medical research entities received substantial support in the spending package, as the Agency for Healthcare Research and Quality (AHRQ) was provided level funding at $338 million and the Patient Centered Outcomes Research Institute was reauthorized until 2029.

The bill's report language also includes a provision encouraging the CDC to support education and awareness activities that promote the early diagnoses of peripheral arterial disease (PAD). The College cosponsored a PAD Hill briefing in October with the American Heart Association and WomenHeart.

Tobacco 21

As a result of the sharp rise in e-cigarette use among young people, passing legislation to raise the legal tobacco age was a bipartisan and bicameral priority this year in Congress. The spending deal includes language that would prohibit the sale of tobacco products – including cigarettes and e-cigarettes – to anyone under the age of 21. The measure does not include a ban on flavored e-cigarettes. Tobacco 21 was one of ACC's top legislative priorities during this year's Legislative Conference.

"The ACC is celebrating a major leap forward in the fight against tobacco use among young people. In passing Tobacco 21 and raising the age to legally buy tobacco and nicotine products to 21 years old, America is finally drawing a line in the sand on this critical public health issue and protecting the well-being of our youth," said ACC President Richard J. Kovacs, MD, FACC. "Smoking is the most preventable cause of early death in the U.S. and the second leading cause of heart disease, yet the 2019 National Youth Tobacco Use Survey found 31.2 percent of high school students reported current use of a tobacco product, including e-cigarettes. The ACC stands with Congress, the House of Medicine and all stakeholders in the fight against tobacco use by utilizing all available resources to end the youth tobacco epidemic," said ACC President Richard J. Kovacs, MD, FACC.

Unique Patient Identifier

An appropriations bill rider prohibiting the Department of Health and Human Services (HHS) from using funds to adopt a unique patient identifier has been included annually since 1998, but for the first time, the House of Representatives voted to repeal the prohibition earlier this summer. The FY20 spending deal excludes a provision that would have lifted the ban on a national patient identifier and allowed public funds to be used to investigate patient matching technology. Instead, the bill's report language encourages HHS to offer technical assistance to private sector-led initiatives in patient matching. Earlier this year, ACC signed a coalition letter asking Senate Appropriators to allow HHS to explore patient identification solutions.

Gun Research

For the first time in more than 20 years, Congress has appropriated money towards studying gun violence. The legislation includes $25 million for firearms prevention research, with $12.5 million going towards the CDC and NIH equally. ACC has expressed support for and partnership with other medical societies in efforts to advance gun violence research through the CDC and other entities.

Repeal of Health Care Taxes

Congress agreed to permanently repeal three health industry taxes originally enacted with the Affordable Care Act in 2010, including the Cadillac Tax on expensive employer plans, a 2.3 percent tax on medical devices and a health insurance fee.

Drug Pricing

The only drug pricing provision tacked on to the spending deal, the CREATES Act, aims to help expedite generic products coming to the market and is expected to save the government about $4 billion over a decade.

Keywords: ACC Advocacy, Electronic Nicotine Delivery Systems, Public Health, Drug Costs, National Institutes of Health (U.S.), Tobacco Products, Centers for Disease Control and Prevention, U.S., Cardiology, Biomedical Research

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