New Federal Budget, Approved by Congress, a Mixed Bag for Cancer Research

Association of American Cancer Institutes (AACI)

Newswise — 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, with the health-related provisions passing 359 to 53. Later that day the Senate voted 92-6 to pass the full agreement. The bill awaits President Donald Trump’s signature.

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 to 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 the Association of American Cancer Institutes (AACI), the association is grateful for the significant additional support approved by legislators on both sides of the aisle.

“While we are pleased that Congress has moved beyond funding the government by continuing resolution, the marginal increases in the FY 2021 numbers keep pace with inflation but fall short of where we should be in prioritizing the agencies responsible for the health of the American people, particularly during this historic pandemic,” said AACI Executive Director Jennifer W. Pegher.

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 is wide-ranging and contains both good and bad news for cancer research.

AACI and many like-minded organizations fought for relief related to disrupted research during the pandemic. The financial impact of COVID-related laboratory closures and rebooting stalled research is immense. AACI advocated for $15.5 billion in funding to the NIH to cover these interruptions, 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 was included in the legislation. This provision 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 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. AACI appreciates the bipartisan efforts of retiring Senator Lamar Alexander (R-TN) and Senator Patty Murray (D-WA) in tackling this issue. According to the New York Times, surprise bills are most often issued when an out-of-network provider is unexpectedly involved in a patient’s care, such as when a patient is taken to an in-network hospital but then treated by an out-of-network physician. This issue has been a focus of AACI cancer centers in recent years.


AACI’s mission is to accelerate progress against cancer by enhancing the impact of North America’s leading academic cancer centers. For more information, please visit

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