Congress returned from the truncated August recess, but the Senate did not immediately begin the process to markup its nine remaining Fiscal Year (FY) 2022 appropriations bill. While the House has advanced its version of the FY 2022 Labor-HHS-Education spending measure, which funds the National Institutes of Health along with other medical research and public health programs, that is one of the measures still awaiting parallel action in the Senate. With the Fiscal Year set to end on October 1^st, Congress is preparing to enact a continuing appropriations resolution (CR) to keep the government funded at FY 2021 levels and operating until final FY 2022 appropriations bills can be prepared. There is talk about lifting the debt ceiling through the legislative package prepared for the CR (and addressing other timely issues), and urgent negotiations are underway between both parties and both chambers.

In lieu of further work on the appropriations process, Democrats in Congress continue to hammer out a comprehensive budget reconciliation package to advance a number of germane policy priorities. In the House, both the Energy and Commerce Committee and the Ways and Means Committee prepared provisions for further consideration, while moderate push back on drug pricing provisions has slowed down the overall process. A summary of key items from the Energy and Commerce Committee and the Ways and Means Committee is included below (these are no final provisions, but reflect the current phase of the legislative process).

• Establishing the Advanced Research Project Agency for Health (ARPA-H) and authorizing $3 billion in initial funding. The ARPA-H language makes clear that the new agency should not subsume or displace any NIH activity or funding but leaves open the question of where the agency will be located.
• Changing the Orphan Drug Tax Credit to make the benefit less generous and widely-available.
• Making the enhanced advance premium tax credits permanent and expanding the availability of health insurance coverage to low-income individuals in states that have not yet adopted expanded Medicaid eligibility through the Affordable Care Act.

The National Center for Advancing Translational Science (NCATS) at NIH continued to release balkanized funding opportunity announcements for the CTSA program. Please see below for additional information.

Limited Competition: NCATS Clinical and Translational Science Award (CTSA) Program Research Education Grants Programs (R25 - Clinical Trial Not Allowed)
https://www.grants.gov/web/grants/view-opportunity.html?oppId=335751

Limited Competition: High Impact Specialized Innovation Programs in Clinical and Translational Science for UM1 CTSA Hub Awards (RC2 Clinical Trials Not Allowed)
https://www.grants.gov/web/grants/view-opportunity.html?oppId=335764

Limited Competition: Mentored Research Career Development Program Award in Clinical and Translational Science Awards (CTSA) Program (K12 Clinical Trial Optional)
https://www.grants.gov/web/grants/view-opportunity.html?oppId=335743