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June 24, 2022

House of Representatives Passes Bills on Mental Health, ARPA-H

Credit: Association of American Medical Colleges, Sinead Hunt, Christa Wagner

On June 22, the House of Representatives passed two bills to authorize programs to bolster mental health and biomedical research innovation. These bills, the bipartisan Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666), which would reauthorize key federal mental health programs, and the bipartisan Advanced Research Project Agency-Health (ARPA-H) Act (H.R. 5585), which would establish ARPA-H as a new entity within the Department of Health and Human Services (HHS), were recently approved by the House Energy and Commerce Committee during a May 18 markup [refer to Washington Highlights, May 20].

Members of the House debated 17 amendments to the Restoring Hope for Mental Health and Well-Being Act, which were offered as two en bloc proposals. The first group of amendments included an addition by Reps. Ami Bera, MD, (D-Calif.) and Brian Fitzpatrick (R-Pa.) to add the House-passed Helping Emergency Responders Overcome Act (HERO Act, H.R. 1480). They also included a provision from Reps. John Katko (R-N.Y.), Grace Napolitano (D-Calif.), Don Beyer (D-Va.), Jamie Raskin (D-Md.), Tony Cárdenas (D-Calif.), and Fitzpatrick adding the House-passed Suicide Prevention Lifeline Improvement Act of 2021 (H.R. 2981) to the legislation, enhancing funding for the National Suicide Prevention Lifeline. These amendments were agreed to by a 387-32 vote.

The second group included an amendment from Reps. Rodney Davis (R-Ill.), Gus Bilirakis (R-Fla.), Tom O’Halleran (D-Ariz.), Ann Wagner (R-Mo.), and Ann Kuster (D-N.H.), which added text from the House-passed Opioid Prescription Drug Verification Act (H.R. 2355), incentivizing states to expand their prescription drug monitoring programs. In addition, it included an amendment from Reps. David Trone (D-Md.), Kelly Armstrong (R-N.D.), and Mikie Sherrill (D-N.J.) authorizing the State Opioid Response and Tribal Opioid Response grants for five years at $1.75 billion per year. These amendments were agreed to by a 366-51 vote.

The House agreed to the amended legislation in a 402-20 vote. Following passage, House Energy and Commerce Committee Chair Frank Pallone Jr. (D-N.J.) and House Energy and Commerce Health Subcommittee Chair Anna Eshoo (D-Calif.) released a joint statement, noting, “As our nation continues to confront the mental health and substance use disorder crises, the House took decisive action today to help restore hope to millions of Americans… We’re grateful for the collaborative work of our colleagues on this bill to address these dual crises and look forward to swift action in the Senate.” In a separate statement, Ranking Member Cathy McMorris Rodgers (R-Wash.) added, “I am grateful for all my colleagues who led on many solutions in this bill, and for the strong bipartisan work that led to today’s passage in the People’s House. Our goal is to continue to build on this for stronger families, stronger communities, and a brighter future for all.”

Members of the House debated one amendment to the ARPA-H Act, which was introduced by Eshoo and Health Subcommittee Ranking Member Brett Guthrie (R-Ky).The amendment, which was agreed to by a 381-40 vote, would limit the amount of money the agency may allocate towards its own administrative expenses, remove the requirement that the ARPA-H director be confirmed by the Senate, and modify language regarding grantees to prohibit funding to entities in Russia, China, Iran, and North Korea. The House agreed to the amended ARPA-Act by a 336-85 vote.

Following passage, McMorris Rodgers and Guthrie issued a statement, noting, “Today, the People’s House passed the ARPA-H Act … with a clearly defined targeted mission. It fosters the development of transformative health technologies by supporting high-risk, high-reward biomedical projects not being met by existing Federal programs or the private sector. It places strong transparency and accountability safeguards on the agency to make sure its top and only priority is high-risk breakthrough innovations in health and medicine.”

In their own statement, Pallone and Eshoo added, “We are pleased by the broad bipartisan support this legislation received in the House today and urge its passage in the Senate, so that this agency can quickly embark on fulfilling its promise to achieve breakthroughs to conquer deadly diseases and healthier patient outcomes.”

Prior to the House vote on the two bills, the AAMC submitted a June 22 letter to Pallone and Rodgers highlighting the urgent need to expand access to mental and behavioral health care, particularly for children and youth. In addition, the association emphasized opportunities to maximize the potential of ARPA-H and the necessity of sustained support for the NIH and foundational science research.

The AAMC expressed appreciation for the Restoring Hope and Mental Health Well-Being Act’s reauthorization of vital mental and behavioral health programs and inclusion of the Mainstreaming Addiction Treatment (MAT) Act (H.R. 1384), while encouraging the committee to continue its focus on the nation’s ongoing mental health crisis. The letter highlighted the AAMC-endorsed Strengthen Kids’ Mental Health Now Act (H.R. 7236), which aims to expand access to care by increasing Medicaid reimbursement rates for pediatric mental health services, as another bill the committee should advance.

The AAMC’s letter also commented on several provisions of the ARPA-H Act, including recommendations to include representatives from academic medicine in convenings with stakeholders from federal agencies to advise the newly established agency, and to modify language regarding the sharing of facilities and administrative cost rates to align with already established requirements for agencies and awardees. In addition, the letter reiterated the association’s longstanding commitment to the National Institutes of Health (NIH) and foundational science research, emphasizing that any additional support for ARPA-H should supplement, rather than supplant, the NIH budget.

The path forward for these bills in the Senate is not yet determined. The Senate Health, Education, Labor, and Pensions Committee passed its own version of the ARPA-H Act in March [refer to Washington Highlights, March 18].