Senate Appropriations Committee Releases Draft FY 2020 Health and Human Services (HHS) Appropriations Bill

The Senate Appropriations Committee released the draft FY 2020 Labor, Health and Human Services, and Education (LHHS) appropriations bill (and accompanying report) on September 18, 2019. The LHHS appropriations bill includes funding for U.S. global health programs provided to the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).

Key highlights are as follows (see table for additional detail):

  • Funding provided to CDC for global health totaled $596 million, an increase of $100 million above the FY19 enacted level ($496 million), $139 million above the President’s FY20 request, and $65 million above the FY20 House level ($530.8).[i] This includes:
    • $128.4 million for global HIV/AIDS, matching the FY19 enacted and FY20 House levels and $58.9 million above the FY20 Request ($69.5 million).
    • $7.2 million for global tuberculosis (TB) through a shift in TB funding historically provided under the “HIV/AIDS, Viral Hepatitis, STD and TB Prevention” account to the “Center for Global Health” at CDC. This funding matches the FY19 enacted and FY20 Request levels, but is $10 million below the FY20 House level ($17.2 million).
    • $226 million for global immunization, matching the FY19 enacted and FY20 House levels and $20 million above the FY20 Request ($206 million). Within this total are the following:
      • Funding for polio totals $176 million, matching the FY19 enacted and FY20 House levels; the President’s FY20 request did not specify a funding amount for polio at CDC.
      • Funding for CDC’s other global vaccines/measles program totals $50 million, matching the FY19 enacted and FY20 House levels; the President’s FY20 request did not specify a funding amount for other global vaccines/measles at CDC.
  • $26 million for parasitic diseases and malaria, matching the FY19 enacted and FY20 House levels and $2 million above the FY20 Request ($24 million).
  • $208 million for the global public health protection program, $100 million above the FY19 enacted level ($108 million), $58 million above the President’s FY20 Request ($150 million), and $75 million above the FY20 House level ($133 million). This includes:
    • $198 million for the global disease detection and emergency response program, $100 million above the FY19 enacted level ($98 million) and $75 million above the FY20 House level ($123 million).
    • $9.8 million for the global public health capacity development program matching the FY19 enacted and FY20 House levels.
  • Funding for the Fogarty International Center (FIC) at NIH totaled $82 million, a $4 million increase above the FY19 enacted level ($78 million), $15 million above the President’s FY20 request ($67 million), and $3 million below the FY20 House level ($85 million).

Resources:

  • FY2020 Labor, Health and Human Services, and Education Appropriations Bill
  • FY2020 Labor, Health and Human Services, and Education Appropriations Report

The table (.xls) below compares global health funding in the FY 2020 Senate LHHS appropriations bill to the FY 2019 enacted funding amounts as outlined in the “Consolidated Appropriations Act, 2019” (P.L. 116-6; KFF summary here), the President’s FY 2020 request (KFF summary here), and the House FY 2020 LHHS bill (KFF summary here).

Table: KFF Analysis of FY20 Senate HHS Funding for Global Health
Department / Agency / Area FY19
Enactedi
(millions)
FY20
Requestii
(millions)
FY20
House
(millions)
FY20
Senate
(millions)
Difference
(millions)
FY20 Senate
– FY19 Enacted
FY20 Senate
– FY20 Request
FY20 Senate
– FY20 House
Health & Human Services (HHS)
Centers for Disease Control & Prevention (CDC) – Total Global Health $495.8 $457.0 $530.8 $595.8 $100
 (20.2%)
$138.9
 (30.4%)
$65
 (12.2%)
Global HIV/AIDS $128.4 $69.5 $128.4 $128.4 $0
(0%)
$58.9
(84.7%)
$0
(0%)
Global Tuberculosisi $7.2 $7.2 $17.2 $7.2 $0
(0%)
$0
(0%)
$-10
(-58.1%)
Global Immunization $226.0 $206.0 $226.0 $226.0 $0
(0%)
$20
(9.7%)
$0
(0%)
Polio $176.0 Not specified $176.0 $176.0 $0
(0%)
$0
(0%)
Other Global Vaccines/Measles $50.0 Not specified $50.0 $50.0 $0
(0%)
$0
(0%)
Parasitic Diseases $26.0 $24.5 $26.0 $26.0 $0
(0%)
$1.5
(6.3%)
$0
(0%)
Global Public Health Protectionii $108.2 $149.8 $133.2 $208.2 $100
(92.4%)
$58.4
(39%)
$75
(56.3%)
Global Disease Detection and Emergency Response $98.4 Not specified $123.4 $198.4 $100
(101.6%)
$75
(60.8%)
of which Global Health Security (GHS) $50.0 $99.8 Not specified Not specified
Global Public Health Capacity Development $9.8 Not specified $9.8 $9.8 $0
(0%)
$0
(0%)
National Institutes of Health (NIH) – Total Global Health $880.2 $760.1 Not specified Not specified
HIV/AIDS $590.1 $511.1 Not specified Not specified
Malaria $212.0 $182.0 Not specified Not specified
Fogarty International Center (FIC) $78.1 $67.0 $84.9 $82.3 $4.2
(5.4%)
$15.3
(22.9%)
$-2.6
(-3%)
Notes:
i – CDC global health program totals have been adjusted to include the transfer of tuberculosis funding from the “HIV/AIDS, Viral Hepatitis, STI and TB Prevention” account at CDC. In FY20, the administration proposed to formally transfer $7.2 million from the “HIV/AIDS, Viral Hepatitis, STI and TB Prevention” account to “Global Tuberculosis” activities. The report accompanying the draft Senate FY20 appropriations bill states that the $7.2 million provided through the “HIV/AIDS, Viral Hepatitis, STI and TB Prevention” account for tuberculosis activities is shifted under this bill to the “Center for Global Health.”
ii – In the CDC FY20 congressional justification, this funding line is titled “Global Disease Detection and Other Programs”. The full breakdown in funding for “Global Public Health Protection,” which includes “Global Disease Detection and Emergency Response,” “Global Health Security,” and “Global Public Health Capacity” is not yet known for the draft House FY20 bill. However, the draft bill includes $99.8 million for “global public health protection,” and the committee report specifies $123.4 million for “Global Disease Detection and Emergency Response.” These totals will be updated as more information becomes available.
Posted: September 19, 2019

[i] CDC global health program totals have been adjusted to include the transfer of tuberculosis funding from the “HIV/AIDS, Viral Hepatitis, STI and TB Prevention” account at CDC. In FY20, the administration proposed to formally transfer $7.2 million from the “HIV/AIDS, Viral Hepatitis, STI and TB Prevention” account to “Global Tuberculosis” activities. The report accompanying the draft Senate FY20 appropriations bill states that the $7.2 million provided through the “HIV/AIDS, Viral Hepatitis, STI and TB Prevention” account for tuberculosis activities is shifted under this bill to the “Center for Global Health.”