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FY 2021 Budget a Mixed Bag for Cancer Research

After several months of uncertainty, congressional leaders agreed on both a $1.4 trillion Fiscal Year (FY) 2021 budget and $900 billion COVID-19 stimulus package. The House approved the bill in two portions with two strongly bipartisan votes on December 21, 2020, with the health-related provisions passing 359 to 53. Later that day the Senate voted 92-6 to pass the full agreement. The bill was signed by President Donald Trump on Sunday, December 27.

The legislative effort tied the $1.4 trillion FY 2021 budget to the $900 billion COVID-19 response legislation that has been debated since late spring. The FY 2021 budget completed major funding bills for the year including the Labor, Health and Human Services, Education, and Related Agencies portion, which was watched closely by the cancer center community. 

The final budget deal included a $1.25 billion increase in funding for the National Institutes of Health (NIH) and a $119.5 million increase to the National Cancer Institute (NCI). While the additional funding did not meet levels requested by AACI, the association is grateful for the significant additional support approved by legislators on both sides of the aisle. 

Beyond the $600 direct payments and enhanced unemployment provisions that have attracted most of the public’s attention, the 5,593-page COVID-19 response bill contains both good and bad news for cancer research. 

AACI and like-minded organizations advocated for $15.5 billion in funding for the NIH to address disrupted research and laboratory closures during the pandemic, but the bill includes no provision for such funding. AACI will continue to press the 117th Congress and the Biden administration for help in recouping cancer center budget shortfalls related to COVID-19.

On a positive note, the bill addressed three AACI public policy priorities:

The AACI-endorsed CLINICAL TREATMENT Act requires state Medicaid programs to cover routine patient costs for items and services connected with a qualifying clinical trial involving cancer or other life-threatening conditions. Medicaid insures nearly one-fifth of the U.S. population, most from underrepresented and lower-income groups. Before enactment of this law Medicaid was the only major payor not required by the federal government to provide coverage for routine costs of clinical trial participation. 

A second AACI-supported piece of legislation, the Removing Barriers to Colorectal Screening Act, was also included in the final package. Previously, Medicare waived coinsurance and deductibles for colonoscopies. However, when a polyp was discovered and removed, the procedure would be reclassified as therapeutic for Medicare billing purposes and patients were required to pay the coinsurance. The new act eliminates unexpected costs for Medicare beneficiaries, removing financial barriers to routine screenings and reducing the incidence of colorectal cancer.

The COVID-19 response package also targets surprise medical bills, which are issued when an out-of-network provider is unexpectedly involved in a patient’s care. AACI appreciates the bipartisan efforts of retiring Senator Lamar Alexander (R-TN) and Senator Patty Murray (D-WA) in tackling this issue.