Democrats' Agenda May Stifle Efforts for More Ca Funding

WASHINGTON—With the Democrats taking control of the House and Senate in January, expectations have escalated for budget increases for biomedical research, especially at the National Cancer Institute (NCI), and a change in the restrictive policies governing embryonic stem cell research. But whether and to what extent the next Congress can turn these expectations into reality remains an open and contentious question.

Democratic leaders in the House and Senate have outlined a bold legislative agenda for the new Congress but also emphasized they plan to reduce the annual budget deficit that has soared in recent years. Given their broad list of spending plans, the deficit reduction goal will likely stifle spending for a number of domestic programs. Moreover, although Democrats may pass many of their priority bills in the coming 2 years, President Bush still retains veto power.

Power of the Veto

During the first 6 years of his administration, the President rarely needed to do more than threaten to veto a piece of legislation to block its passage because the Republicans held the majority of votes in both houses. Democrats will have a 51-to-49 voting edge in the Senate and a comfortable but not overwhelming majority in the House. Thus, without strong support from Republicans, the Democrats would have no chance of over-riding any presidential veto. Further, winning votes from the GOP will be more difficult than in recent years, since a number of moderate Republicans lost their seats in the November elections, including Sen. Lincoln Chafee (RI), Rep. Jim Leach (Iowa), Rep. Nancy L. Johnson (Conn), and Rep. Charles Bass (NH).

Other Costly Plans

Dealing with the war in Iraq and its consequences ranks high on the Democrats' legislative agenda. Senate Majority-Leader-elect Harry M. Reid (D-Nev) said shortly after the election that Democrats in the incoming Congress will seek to boost the military budget by $75 billion to strengthen the combat readiness of military units depleted by the war. And one month before the November elections, a confident Rep. Nancy Pelosi (D-Calif), now Speaker of the House-elect, said she envisioned enacting all of the recommendations of the commission that investigated the Sept. 11, 2001, terrorist attacks, another costly initiative.

But several issues important to cancer researchers, clinicians, and advocates also rate high among the wish lists of many Democrats—including requiring Medicare to negotiate medication prices with the drug industry, decreasing research restrictions on embryonic stems cells, and stabilizing or increasing the NCI budget. However, the first two priorities, if passed by Congress, appear dead on arrival at the White House.

Six days after the election, for example, Health and Human Services (HHS) Secretary Mike Leavitt declared that the Administration would not support any effort to authorize the Centers for Medicare & Medicaid (CMS) to negotiate the price Medicare pays for drugs, which is a standard procedure at the Department of Veterans Affairs. "The idea of the government negotiating drug prices really isn't about the government negotiating drug prices," Mr. Leavitt told reporters. "It's a surrogate for a much larger issue, which is really government-run health care." And President Bush has repeatedly expressed his strong opposition to expanding research on embryonic stem cells beyond the restrictions he set shortly after taking office.

Any legislation loosening these limits that makes its way through Congress will almost certainly face a veto. But some members of Congress have higher hopes for restoring at least some of the cancer dollars lost by the National Institutes of Health (NIH), especially at NCI.

The first year of the Bush Administration was also the final year of a 5-year effort that Capital Hill leaders had once envisioned doubling the annual appropriations for NIH. In fact, the years of sizeable increases fell a bit short of that goal, but NCI did see an 80% increase in its budget over the 5 years. Each year since then, however, the money that NCI has actually had to spend has been lower than the previous year.

Until President Bush's last budget proposal, the NCI had received a slight budget increase each year. The cuts in actual available funds resulted from inflation and because the Administration and Congress deducted significant sums from approved appropriations to pay for other expenditures. At NIH, for example, all of its components, including NCI, had to contribute to help finance the agency's "Road Map," its long-term, biomedical-research planning process.

For fiscal year 2007, the President's budget request called for NIH funding to remain flat while NCI suffered a small but symbolically significant cut of 0.8%.

In the 109th Congress, Rep. Brian Higgins (D-NY) planned to introduce an amendment to the Labor, Health and Human Services Appropriations Bill to add $240 million to NIH's fiscal year (FY) 2007 budget, to restore the money for cancer research lost in recent years. Largely because of unrelated politics, that funding bill never came to the floor, but Rep. Higgins plans to introduce similar legislation in the next Congress. "Progress in cancer assumes future funding to continue research," he told ONI. "Right now, promising researchers are being discouraged from pursing their careers."