Congress Unveils FY2023 Omnibus Spending Bill

Early Tuesday morning, Congress released the text of the fiscal year (FY) 2023 omnibus spending legislation, the Consolidated Appropriations Act, 2023 (H.R. 2617). The package includes all 12 FY2023 spending bills, emergency supplemental funding for recent natural disasters and weather events, and resources for Ukraine.

There are several notable provisions within the omnibus for public health and health research, and women’s health specifically.

The bill provides a total of $120.7 billion for the U.S. Department of Health and Human Services (HHS), an increase of $9.9 billion above the FY2022 enacted level. Within this, the bill includes:

• $47.5 billion for the National Institutes of Health (NIH), an increase of $2.5 billion above the FY2022 level, with an increase of “no less than 3.8 percent for each Institute and Center” (IC) as well as targeted investments in several high-priority areas, including the National Cancer Institute ($7.3 billion), Alzheimer’s disease and related dementias research ($3.7 billion), and universal flu vaccine research ($270 million)
• $9.2 billion for the Centers for Disease Control and Prevention (CDC), an increase of $760 million above the FY2022 enacted level, which includes targeted investments in public health infrastructure and other public health efforts (e.g., an $108 million investment for safe motherhood and infant health)
• $373.5 million for the Agency for Healthcare Research and Quality (AHRQ), a $23.1 million increase above the FY2022 level
• $187 million for the National Center for Health Statistics (NCHS), a $7 million increase above the FY2022 level
• $9.7 billion for the Health Resources and Services Administration (HRSA), in increase of $852 million above FY2022, which includes $823 million (an $87 million increase) for the Maternal and Child Health Block Grant, including $55 million for State Maternal Health Innovation Grants and $7 million for the Maternal Mental Health Hotline

Additionally, the bill includes authorizing language for the Advanced Research Projects Agency for Health (ARPA-H), a new agency proposed by the Biden administration that will seek to speed the development of medical treatments by funding “high-potential, high-impact biomedical and health research that cannot readily be accomplished through traditional research or commercial activity.” The bill provides the agency with $1.5 billion, which would be available through fiscal year 2025, and places it separately within the NIH. The appropriated funding for ARPA-H is in addition to the $47.5 billion provided to the NIH. (Where the agency will be located has yet to be determined.)

Within the FY2023 bill text and accompanying report language are also several promising women’s health provisions:

First, the bill provides $76.5 million to the NIH Office of Research on Women’s Health (ORWH), an increase of $17 million above the FY2022 enacted level. Notably, this includes:

• $10 million to establish the Office of Autoimmune Disease Research (OADR) within the the ORWH. Establishing this new Office within NIH was a recommendation of a recent National Academies of Sciences, Engineering, and Medicine (NASEM) report, Enhancing NIH Research on Autoimmune Disease. The agreement directs OADR to: (1) coordinate the development of a multi-IC strategic research plan with concrete, meaningful milestones to set priorities; (2) as part of the internal and external outreach for the strategic plan, identify emerging areas of innovation and research opportunity; (3) coordinate and foster collaborative research across ICs; (4) annually evaluate the autoimmune research portfolio to determine progress made across NIH; (5) provide resources to support planning, collaboration, and innovation; and (6) develop and oversee a publicly accessible central repository for autoimmune disease research. The agreement directs ORWH and OADR to brief the Committees within 150 days of enactment of this Act on NIH’s efforts to stand up OADR and the status of the aforementioned directives.
  *The Society for Women’s Health Research endorsed the creation of OADR within its 2022 Autoimmune Policy Agenda.
• $2 million to contract with NASEM to conduct a study on the gaps present in women’s health research across all NIH ICs, and specifically to determine the proportion of research on conditions that are more common or unique to women, establish how these conditions are defined, and ensure that it captures conditions across the lifespan, evaluates sex differences and racial health disparities, and determine the appropriate level of funding that is needed to address gaps in women’s health research at NIH.

Within the NIH Office of the Director (OD), the bill “directs the ICs, in coordination with OD and the Office of Research on Women’s Health, to support research to assess whether sex, race, and other differences play a role in [COVID-19] study outcomes.”

The Senate could vote as soon as today, December 21, on the omnibus before the House takes up the measure. The legislation must be signed into law by the time the current continuing resolution expires (midnight on December 23) to avert a government shutdown.

More resources on the FY2023 omnibus text are included below. For questions, please contact SWHR Chief Advocacy Officer Lindsey Horan.

• FY2023 Omnibus Bill Text
• Division H – Labor, HHS, Education, and Related Agencies Report Language
• Summary of Appropriations Provisions by Subcommittee
• Press Releases
  • Senate Majority
  • Senate Minority
  • House Majority