FY 2021 Budget Proposals Impacting Rehabilitation and Disability
Peter W. Thomas, JD, Principal, Powers Pyles Sutter & Verville, PC
The Trump administration’s FY 2021 budget proposals impact a wide variety of programs that affect rehabilitation and disability providers and consumers, although perhaps more indirectly than some of the proposals involving Medicare, such as Post-Acute Care (PAC) payment reform and prior authorization in the fee-for-service program. Following is a summary of some of the many rehabilitation and disability-related proposals the administration has put forward for Congressional consideration. While many of these proposals will not survive the appropriations process, the administration has significant regulatory authority to proceed with its agenda without congressional approval and the budget serves as a roadmap for the administration’s intentions. Rehabilitation and Disability Research and Services This year’s budget would be more alarming if the administration were proposing its domestic (non-defense) funding levels for the first time. The fact is that the Trump administration has proposed many significant cuts to a wide variety of federal rehabilitation and disability programs in the last three years only to be overridden by Congress. While many proposed funding levels continue to be gravely concerning, they are (again this year) not likely to be enacted into law as the onus now shifts to Congress to determine funding levels for agencies and program for the coming fiscal year, which begins on October 1, 2020.
Joseph Nahra, Legislative Director, Powers Pyles Sutter and Verville, PC
The FY 2021 budget proposes a $2.9 billion cut to the National Institutes of Health, bringing the total NIH budget from nearly $42 billion down to $38.7 billion, a huge cut on a percentage basis that would eliminate a wide variety of grants. The National Institute of Child Health and Human Development (NICHD) is slated for a $140 million cut in funding, bringing its budget down to $1.41 billion. NICHD houses the National Center for Medical Rehabilitation Research (NCMRR) which receives a 6.5 percent set-aside of the NICHD extramural research budget and, therefore, rehabilitation research would also be negatively impacted. These cuts would wipe out the $2.7 billion increase in funding Congress and the president just enacted in December 2019. In sum, it is highly unlikely that Congress will reverse course on its recent bipartisan support for increases in NIH funding and there will be plenty of stakeholders making that case. The National Institute for Disability, Independent Living and Rehabilitation Research (NIDILRR) is housed in the Department of Health and Human Services’ Administration for Community Living (ACL). NIDILRR supports applied research and data collection in the rehabilitation and disability areas. It has funded the Traumatic Brain Injury, Spinal Cord Injury and Burn Model Systems for years as well as investigator-initiated research in the areas of rehabilitation, disability, and independent living. NIDILRR has received increases to its budget of $3 million for each of the last two years, bringing its total budget this year to $112 million. However, the FY 2021 budget proposes to slash NIDILRR funding by $22
10 AMRPA Magazine / March 2020
