Considering the scarcity of research resources across the federal government, reports abound that early-career, American researchers are fleeing the lab to pursue more stable careers overseas or new professions altogether. In response to this flight, members of Congress are desperately seeking new ways to bolster funding at the National Institutes of Health (NIH) and attract young researchers back to American laboratories. In just the past year, bills have been introduced to provide mandatory funding to NIH and allow its budget to exceed austere spending caps, but none of these measures have prevailed.
As another effort to find funding for early-career scientists Representative Andy Harris (R-MD) has turned to the Public Health Service Evaluation Set-Aside, known informally as the “evaluation tap,” that is drawn in part from NIH and totals about $700 million per year. In his draft “YES to Cures Act” legislation currently being circulated for comment, Representative Harris proposes redirecting the evaluation tap funds back to NIH to support grants for emerging scientists as a way to spur medical innovation.
AcademyHealth agrees that it is important to fund young scientists in all research disciplines; in fact, one of AcademyHealth’s advocacy priorities is supporting the next generation of health services researchers and health policy analysts. However, if this bill were to pass, it would have severe, unintended consequences for health research and public health.
The evaluation tap was established in 1970 to fund cross-cutting and evaluative activities of the Department of Health and Human Services (HHS). In this capacity, the evaluation tap funds several agencies and their research, program evaluation, and data collection activities—each of which is critical to assessing and improving health. For example:
- The Agency for Healthcare Research and Quality (AHRQ) supports data collection and research activities to improve health care. Such evidence informs efforts to make health care safer, higher quality, and more accessible, equitable, and affordable. AHRQ’s appropriated budget is fully funded by the evaluation tap.
- The National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention (CDC) provides critical data on all aspects of our health—infant mortality and causes of death, chronic disease prevalence, emergency room use, rates of insurance, and teen pregnancy, to name a few. These data are used extensively in health research by NIH-funded scientists, among others. More than half of NCHS’s appropriated budget is supported through the evaluation tap.
- CDC’s National Immunization Survey is an essential tool for monitoring immunization coverage rates and identifying and reaching populations at greatest risk for vaccine-preventable diseases. The data collected through this survey drive CDC’s $560 million immunization program. The National Immunization Survey is fully funded by the evaluation tap.
- The National Library of Medicine, CDC’s National Institute for Occupational Safety and Health (NIOSH), and evaluative projects designed to assess the performance of federal programs across HHS are wholly or partially funded by the evaluation tap.
AcademyHealth fears that--in the absence of appropriated funding for these currently "tap-funded" programs--the use of NIH’s evaluation tap funds for grants for early-career scientists would ultimately come at the expense of many important programs designed to increase understanding and improve Americans’ health and well-being. Earlier this year, AcademyHealth, through the Friends of AHRQ and the Friends of NCHS, coordinated the “Mind the Tap” campaign to educate lawmakers and advocates about the important activities funded through the tap. AcademyHealth sent a letter to Representative Harris expressing these concerns, and urging him to reconsider his proposal.
AcademyHealth members who wish to share their concerns may also contact Representative Harris at his Washington office by calling 202.225.5311.