Figure 1. National Institutes of Health (NIH) Funding, FY1994-FY2019 Request

Program Level Funding in Current and Projected Constant (2019) Dollars

Sources: NIH Budget Office, Appropriations History by Institute/Center (1938 to Present), at http://officeofbudget.od.nih.gov/approp_hist.html. FY2017 and FY2018 enacted amounts are from the Explanatory Statement on the Consolidated Appropriations Act, FY2018 (H.R. 1625, P.L. 115-141), in the March 22, 2018 Congressional Record, pp. H2681, H2733-H2735. FY2019 request amounts are from Department of Health and Human Services, Fiscal Year 2019 Budget in Brief, Washington, DC, February 2018, p. 40FY2019 estimated program level is based on CRS analysis using figures from H.Rept. 115-952, pp. 573-575, and the Superfund recommendation from S.Rept. 115-276, p. 95. At the time of writing, full-year FY2019 appropriations had not been enacted for the Interior-Environment bill, which provides Superfund appropriations. Temporary appropriations for purposes funded under the bill have been provided through December 7 by a continuing resolution contained in Division C of P.L. 115-245. In the absence of final FY2019 Superfund appropriations, the lower Senate-recommended appropriations level of $78 million was used to estimate the NIH program level. Inflation adjustment reflects the Biomedical Research and Development Price Index (BRDPI), updated January 2018, https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.

Notes: By convention, program level totals include amounts "transferred in" pursuant to PHS tap, but do not include any amounts "transferred out" under this same authority. Program level includes all budget authority, including appropriations for the Global Fund to Fight AIDS, TB, and Malaria (FY2002-FY2011) that were subject to transfer-out. As of FY2012, NIH no longer receives appropriations for the National Institute of Allergy and Infectious Diseases (NIAID) identifying resources for the Global Fund; this responsibility was transferred to another federal agency. Totals include amounts "transferred in" pursuant to PHS Act transfer authority (evaluation tap), but do not exclude any amounts "transferred out" under this same authority. ARRA supplementary funding is from the American Recovery and Reinvestment Act of 2009, P.L. 111-5. In general, amounts provided to NIH for emergency requirements are excluded from these totals (e.g., FY2015 amount does not include $238,000,000 for the National Institute for Allergy and Infectious Diseases [NIAID]NIAID for research on Ebola that was provided in P.L. 113-235, Title VI of Division G). The FY2019 request level does not include NIH's proposed share ($750 million) of an additional $10 billion in HHS-wide opioid-related funding requested by the FY2019 President's budget.

The Public Health Service also includes the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Indian Health Service (IHS), and the Agency for Toxic Substances and Disease Registry (ATSDR).

For further information on NIH, see CRS Report R41705, The National Institutes of Health (NIH): Background and Congressional Issues.

Department of Health and Human Services, Fiscal Year 2018 Budget in Brief, Washington, DC, May 2017, p. 38.

Ibid.

Ibid.

NIH received a total of $10.4 billion in supplemental, one-time FY2009 appropriations in the American Recovery and Reinvestment Act (ARRA) of 2009 (P.L. 111-5). ARRA funds were made available for obligation for two years; $4.95 billion was obligated in FY2009, and $5.45 billion in FY2010. CRS Report R43304, Public Health Service Agencies: Overview and Funding (FY2010-FY2016).

Totals include amounts "transferred in" pursuant to PHS tap, but do not include any amounts "transferred out" under this same authority.

The FY2012 amount of $30.861 billion appears to be 0.2% below the FY2011 amount of $30.916 billion. However, the FY2011 amount includes $297.3 million that was subject to transfer-out for the Global Fund to Fight AIDS, TB, and Malaria.

At the time of writing, full-year FY2019 appropriations had not been enacted for the Interior-Environment bill, which provides Superfund appropriations. Temporary appropriations for purposes funded under the bill have been provided through December 7 by a continuing resolution contained in Division C of P.L. 115-245. In the absence of final FY2019 Superfund appropriations, the lower Senate-recommended appropriations level of $78 million was used to estimate the NIH program level.

See table in H.Rept. 115-952, pp. 573-575 for all amounts except for the Superfund related activities estimate, which is from S.Rept. 115-276, p. 95.

The House appropriations committee recommendations provide for an NIH program level total of $38.564 billion, calculated from figures in H.Rept. 115-952, pp. 573-575, and using the House Superfund appropriations recommendation of $80 million to NIEHS from H.Rept. 115-765, p. 82.

The Senate appropriations committee recommendations provide for an NIH program level total of $39.312 billion, calculated from figures in H.Rept. 115-952, pp. 573-575, and using the Senate Superfund appropriations recommendation of $78 million to NIEHS from S.Rept. 115-276, p. 95.

The FY2018 program level was calculated based on amounts shown in the Explanatory Statement on the Consolidated Appropriations Act, FY2018 (H.R. 1625, P.L. 115-141), in the March 22, 2018 Congressional Record, pp. H2681, H2733-H2735. Superfund amount provided by Division G of P.L. 115-141, the Department of the Interior, Environment, and Related Agencies Appropriations Act, 2018. Mandatory funds for type 1 diabetes research (under PHS Act §330B) provided by Section 50902 of P.L. 115-123 for FY2018 and FY2019.

NIH and other HHS agencies and programs authorized under the PHS Act are subject to a budget assessment called the PHS Program Evaluation Set-Aside, also called the evaluation tap. Section 241 of the PHS Act (42 U.S.C. §238j) authorizes the Secretary of HHS to use a portion of eligible appropriations to study the effectiveness of federal health programs. Although the PHS Act limits the evaluation tap to no more than 1% of eligible appropriations, in recent years the annual LHHS appropriations act has specified a higher amount (2.5% in FY2018) and directed specific amounts of funding from the evaluation tap for transfer to a number of HHS programs. The set-aside has the effect of redistributing appropriated funds for specific purposes among PHS and other HHS agencies. NIH, with the largest budget among the PHS agencies, has traditionally been the largest "donor" of program evaluation funds and, until recently, a relatively minor recipient. For more information, see the "PHS Evaluation Set-Aside" section of CRS Report R44505, Public Health Service Agencies: Overview and Funding (FY2015-FY2017). By convention, budget tables such as Table 1 do not subtract the amount of the evaluation tap from the donor agencies' appropriations.

The FY2019 request level does not reflect the proposal to allocate an additional $750 million to NIH for opioid-related activities from the $10 billion in requested HHS-wide funding. The FY2019 request level is as shown in HHS, Fiscal Year 2019 Budget in Brief, Washington, DC, February 2018, p. 40, https://www.hhs.gov/sites/default/files/fy-2019-budget-in-brief.pdf.

The first round of funding was provided by Section 194 of the Further Continuing and Security Assistance Appropriations Act, 2017 (CR, P.L. 114-254). The CR appropriated $352 million in the NIH Innovation account for necessary expenses to carry out the four NIH Innovation Projects as described in Section 1001(b)(4) of the Cures Act. The second round of funding was provided by the FY2018 omnibus (P.L. 115-141). The third round of funding is provided by the FY2019 Consolidated Defense, LHHS, and Continuing Resolution appropriations act (P.L. 115-245).

The index is developed for NIH by the Bureau of Economic Analysis of the Department of Commerce. It reflects the increase in prices of the resources needed to conduct biomedical research, including personnel services, supplies, and equipment. It indicates how much the NIH budget must change to maintain purchasing power. See "NIH Price Indexes," at https://officeofbudget.od.nih.gov/gbiPriceIndexes.html.