The 113th Congress, which is ending its first session in a matter of days, has been criticized for being the least productive Congress in recent memory.   In the race to adjourn for the year, Congress is seeking to complete action on a budget deal and to take initial steps toward reforming Medicare payments for services provided by physicians.

On Wednesday, December 11, House and Senate budget leaders announced a two-year plan governing federal spending.  The budget package, negotiated by House Budget Committee Chair Paul Ryan (R-WI) and Senate Budget Committee Chair Patty Murray (D-WA), would permit restoration of some of the cuts to domestic discretionary spending and defense spending that have been triggered by the budget sequestration order.

Although the budget deal has been described as a modest one and not the “grand bargain” that would have addressed  entitlement spending, taxes, and discretionary spending in comprehensive fashion, it prevents another government shutdown, represents an end to the legislative stalemate on budget matters, and permits the appropriators to debate and finalize spending bills according to regular Congressional procedures and consistent with the terms of the budget agreement.

Cancer advocates hope that the budget deal, by raising spending limits, will permit the appropriations committees to provide at least modest increases in funding to the National Institutes of Health (NIH) and certain other discretionary cancer programs.  It is unlikely that the NIH increase will be significant, but it should be adequate to allow NIH officials to fund more new research grants in the next two years, compared to the period of the sequester.  The budget package makes changes in federal retiree programs in order to pay for the restoration of discretionary funding.  The agreement would also extend the sequester cut of 2% that applies to mandatory programs into years 2022 and 2023.  The extension of the sequester would affect payments to Medicare providers, including those involved in care of cancer patients.  The 2% cut has been in effect since FY 2013 and will extend through 2023 under the terms of the budget package.