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Top GOP health appropriator: Congress will reject White House cuts to NIH, CDC

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Top GOP health appropriator: Congress will reject White House cuts to NIH, CDC

If there was any question about whether Republicans on Capitol Hill would back President Donald Trump's plan to cut about $5 billion from the National Institutes of Health, Rep. Tom Cole, R-Okla., set the administration straight: The White House is on its own.

Cole is the top Republican on the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies.

At a March 13 hearing, Cole said Trump's plan for the massive NIH reductions, which the administration proposed in its fiscal 2020 budget request to Congress two days earlier, would "send the wrong signals to young scientists."

The Oklahoma Republican also said the administration's proposal to slice about $1 billion from the Centers for Disease Control and Prevention's spending "is literally a risky mistake."

The CDC's funding is "every bit as much as a defense budget" as anything at the Department of Defense, Cole said. "We're much more likely to die of pandemics than a terrorist attack. This is really the front line of defense, I think, for the American people. In an era of Ebola and Zika and goodness knows what else, I think this is not a place that we would want to be reducing spending."

Cole said he expected his congressional colleagues — Republicans and Democrats — to reject Trump's proposed cuts to the NIH and the CDC.

But the lawmaker gave Health and Human Services Secretary Alex Azar a break, telling the health chief "I know the budget numbers were not of your own making" and belonged more to the White House Office of Management and Budget.

But Rep. Nita Lowey, D-N.Y., chairwoman of the full House Appropriations Committee, was not so forgiving, slamming her fist on her desk, while telling Azar the administration was "absurd" for wanting to cut the NIH while proposing $8.6 billion in new funding for a border wall between the U.S. and Mexico.

It was Trump's demand for border wall funding that resulted in the recent 35-day shutdown of 25% of the U.S. government, including much of the U.S. Food and Drug Administration.

Rep. Rosa DeLauro, D-Conn., the subcommittee's chairwoman, was also not ready to let Azar off the hook, despite praising HHS' $291 million proposal to fund an initiative for federal agencies to work more collaboratively to end HIV/AIDS in the U.S. by 2030 — a program that builds on an initiative launched during the Obama administration.

The Connecticut lawmaker said the initiative conflicted with the administration's plan to cut the President's Emergency Plan for AIDS Relief, or PEPFAR, by 22% for fiscal 2020 and slash the budget for Medicaid by $1.5 trillion over 10 years.

DeLauro noted it was Azar's former boss, President George W. Bush, who started PEPFAR in 2003 with an unprecedented $15 billion investment from U.S. taxpayers to target 15 foreign nations that are the hardest hit by HIV/AIDs.

Both PEPFAR and Medicaid — the U.S. government's health insurance program for low-income Americans — are vital to ending HIV in the U.S. and abroad, DeLauro said.

When later questioned by Rep. Barbara Lee, D-Calif., about the PEPFAR cuts, Azar suggested some of the countries may have achieved a level of infrastructure where they can "walk and run" at the same time.

Much of what Trump proposed for fiscal 2020 are "retreads of bad ideas that Congress has already rejected on a bipartisan basis," DeLauro said.

She also confronted Azar about the $385 million in fiscal 2019 funds he diverted from the NIH, the CDC and other U.S. programs involved in the nation's HIV response to use instead to address the growing number of migrant children HHS is charged with caring for under the Trump administration's border policy.

Not all bad news

The hearing was the second day Azar was on Capitol Hill to defend Trump's fiscal 2020 budget. The secretary was grilled on March 12 by the House Energy and Commerce Health Subcommittee.

Azar is scheduled for a third round of questions before the Senate Finance Committee on March 14.

But at the House appropriations subcommittee hearing, Azar tried to emphasize that even though it was a "tough, tough budget," which calls for a 12% reduction in HHS' overall spending for fiscal 2020, it also has some health areas where the White House wants to increase funding.

One area that would receive a slight boost is the Strategic National Stockpile — a cache of drugs and medical equipment deployed to areas of the U.S. in the event of a manmade or natural disaster or other emergency.

The stockpile, which HHS recently administratively transferred from the CDC to the Office of the Assistant Secretary for Preparedness and Response, would get a $10 million increase under Trump's plan. The new funds would support the addition of a recently FDA-approved antiviral to treat smallpox, SIGA Technologies Inc.'s Tpoxx.

Smallpox was declared eradicated in 1980, but health officials have raised concerns the disease could re-emerge as a bioterrorism agent.

The new funds would also support a supply of a new thermal burn bandage for the stockpile, Azar added.

DeLauro, however, noted that the administration had proposed cutting $120 million from funding intended to address antimicrobial resistance, despite data showing at least 2 million Americans become infected every year with bacteria that are resistant to antibiotics, with about 23,000 of those people dying from their infections.