This was the first time that Congress allowed the program to lapse in its 20-year-history.
On February 9th, 2018, diabetes advocates finally could breathe a collective sigh of relief as news broke that funding for the Special Diabetes Program was included in a final bipartisan two-year budget deal passed by Congress. President Donald Trump signed the budget legislation into law shorty after the gavel came down in Congress in the early morning hours. The budget’s passage capped off several months of intense lobbying by diabetes advocates to save a beloved health program that has provided critical funding for research into new type 1 diabetes treatments and technologies.
Here’s what you need to know about the successful push to fund the Special Diabetes Program:
What is the Special Diabetes Program?
If we have to get formal, the program is actually called the Special Statutory Program for Type 1 Diabetes Research. It’s a fund administered by the National Institute of Diabetes Digestive and Kidney Diseases that provides money specifically for promising efforts to prevent diabetes and/or its complications. Since the program has come into existence in 1998, it has greatly increased the amount of money the National Institutes of Health can spend on type 1 diabetes research. This money is earmarked specifically for cutting-edge diabetes research projects; for example, Special Diabetes Program funding has greatly helped advance research into artificial pancreas technology.
It also provides some funding for programs designed to address the high rates of type 2 diabetes among American Indian and Alaska Native populations.
In comparison to many other appropriations in the final federal budget, the Special Diabetes Program is a financial drop in the bucket. In 2004, funding for the program was raised from $100 million to $150 million annually, and that figure has either stayed constant or dipped slightly, with no adjustment for inflation. Still, the money has been critical for getting many important type 1 diabetes research efforts off the ground.
So what happened?
Diabetes advocates from JDRF, the American Diabetes Association, and other organizations regularly roam the halls of Congress to talk up the value of the Special Diabetes Program, and in the past the program has enjoyed bipartisan support. That’s why it was a shock when the program’s funding was allowed to lapse during budget fights in late September. Congress provided a “patch” of funding to keep the program going for a few months, but legislators seemed powerless to provide long-term funding for even the most popular programs during a bitter budget battle that included a brief shutdown of the government.
Research efforts and health program need a steady stream of funding, and the uncertainty of continued funding invariably rattled researchers initiating new projects. JDRF, the American Diabetes Association, the Endocrine Society, and other diabetes-focused organizations sounded the alarm and stepped up their lobbying efforts for the program.
Over the past week, there were growing reports of a bipartisan budget being crafted in the Senate, and a similar bill was beginning to take shape in the House; both bills included restored two-year funding for the Special Diabetes Program.
However, there was uncertainty up until the last minute that the budget would survive a vote. Before it passed, the budget bill survived several filibuster-like attempts to derail it or call attention to its shortcomings from both liberal and conservative lawmakers. Even after the bill passed Congress, there was some concern as to whether President Trump would sign it into law; he had previously signaled that he would rather have a government shutdown than sign a budget bill that didn’t include substantial funding for his proposed wall on the border with Mexico. In the end, however, the president signed the bill into law, and the Special Diabetes Program funding was restored to a tune of $300 million over two years.
Why diabetes advocates shouldn’t rest easy
This is the first time that renewal for the Special Diabetes Program was allowed to lapse. It isn’t the only popular health program that has been disrupted by budget disputes and growing rancor between the two major political parties.
Funding for the popular Children’s Health Insurance Program, also known as CHIP, also recently lapsed before Congress voted to renew the program for another decade. Since President Trump took office, there also have been several unsuccessful attempts to either repeal or radically restructure the Affordable Care Act, also known as Obamacare. In addition, the Trump Administration is now allowing states to require some state Medicaid programs to impose work requirements for Medicaid recipients.
If the recent budget battles are any indication, health care advocates won’t be able to take the continued funding of any popular program for granted in the coming years. The uncertainty surrounding the Special Diabetes Program may be a sign of things to come for health care policy budget fights.