Senate Releases FY 2024 Labor-HHS Bill

The Senate last week released its fiscal year 2024 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations spending bill and the accompanying report. The Senate Appropriations Committee approved the bill, in a 26-2 vote, on July 27.

While the Society for Women’s Health Research (SWHR) is disappointed to see that needed investments were not provided across the full research continuum and believes the bill falls short in providing the investments that are needed to improve the health of the nation, the Senate Labor-HHS bill was much more favorable to public health and research agencies than the House’s version of the bill, which was released on July 13. The Senate’s report also included several provisions specific to women’s health.

The Senate bill provided $117 billion in discretionary funding for the U.S. Department of Health and Human Services (HHS) in fiscal year 2024, more than $13 billion more than the amount proposed by the House. Within HHS, the bill calls for:

• $49.224 billion for both the National Institutes of Health (NIH) and the newly established Advanced Research Projects Agency for Health (ARPA-H), which would include a $100 million increase for Alzheimer’s disease research, a $60 million increase for cancer research, and a $10 million increase for the IMPROVE initiative for research on maternal mortality.
  • As reported by the Ad Hoc Group for Medical Research, “The total includes $47.724 billion for NIH, including $407 million in funding from the 21st Century Cures Act and $678 million in emergency funding to restore a scheduled cut to Cures funding in FY 24; the net increase for the agency would total $265 million (0.6%).”
• A $3 million cut to the Agency for Healthcare Research and Quality (AHRQ).
• Just under $9.2 billion for the Centers for Disease Control and Prevention (CDC), a $20 million cut from the fiscal year 2023 level.

According to the bill summary, the bill also includes $1.2 billion for the core Maternal and Child Health programs and $350 million for Public Health Infrastructure and Capacity to bolster public health infrastructure and rebuild the workforce at the state and local level to respond to emerging public health threats.

Within the report, which provides more detailed guidance to departments and agencies, the Committee included several notable provisions related to women’s health issues, including:

• $76,480,000 for the NIH Office of Research on Women’s Health (ORWH), which represents flat funding from the fiscal year 2023 level.
  • Within that amount, the Committee provides $7 million, an increase of $2 million above the fiscal year 2023 enacted level, to expand ORWH’s Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) program.
• ORWH Grant Making Authority. The Committee reiterated that the Consolidated Appropriations Act, 2022 noted that “funding for ORWH be made available for direct grant making to address women’s health research needs that are not being addressed by Institutes and Centers.”
• Office of Autoimmune Disease Research (OADR). The Committee recognized the important role of OADR within ORWH and encouraged the Office to seek input from external stakeholders, particularly patient advocacy organizations that represent the populations affected by autoimmune and immune-mediated diseases.
  • Note: While the fiscal year 2023 report language provided $10 million within ORWH to establish the Office of Autoimmune Disease Research, the fiscal year 2024 report does not mention a specific amount to be allocated to the new Office. 
• Common Data Elements (CDEs). The Committee expressed the need to develop CDEs in disease areas where they currently do not exist, particularly in complex autoimmune and immune mediated conditions. The report says, “The Committee encourages the Office of Data Science Strategy to collaborate with the ORWH and Institutes and Centers that oversee research on autoimmune and immune-mediated conditions to prepare a roadmap for developing CDEs for these conditions.”
• $235,500,000 for the provision of breast cancer screening and diagnostic services to uninsured and underinsured women.
• $155,105,000 for CDC’s Heart Disease and Stroke Prevention Program and the continuation of CDC’s WISEWOMAN program to increase the number of low-income, uninsured and underinsured women who are assessed and connected to resources.
• Link Between Obesity and Endometrial Cancer. For the National Cancer Institute, the Committee requested an update in the fiscal year 2025 congressional justification on collaborative research efforts across NIH, other NIH-supported extramural research projects, and research efforts focusing on the link between obesity and endometrial cancer.
• Endometriosis. The Committee encouraged NIH to advance research to increase earlier detection and develop more accurate diagnostics and for education to inform health care providers and their patients regarding diagnosis and treatment of endometriosis.
• Women’s Reproductive Health Research (WRHR) Program. The Committee requested that additional WRHR scholars be funded by the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD).
• Alzheimer’s Clinical Trial Diversity. The Committee recommended that NIH fund or conduct Black/African American-, Latino/Hispanic- and women-only research studies to better understand the underlying etiology of cognitive impairment and dementia in these groups that have disproportionately higher prevalence of disease.

With Congress out on August recess, there are very few working days remaining before the end of the fiscal year on September 30. Some members, including senior Republican appropriator Steve Womack (R-AR), have expressed concern over a government shutdown, which will occur if Congress does not reach an agreement on fiscal year 2024 spending bills or pass a continuing resolution to keep the government funded at current levels by the fiscal year deadline.

For questions, please contact SWHR Chief Advocacy Officer Lindsey Horan.