As reported by the Senate Committee on Health, Education, Labor, and Pensions on July 25, 2018
S. 2465 would authorize the Secretary of Health and Human Services, through the Centers for Disease Control and Prevention (CDC), to conduct research, surveillance and public health activities related to sickle cell disease (SCD) and other heritable blood disorders. In addition, the bill would authorize grants for the prevention and treatment of complications from sickle cell disease.
In fiscal year 2018, CDC received about $15 million for activities related to blood disorders including hemophilia and thalassemia. The bill would require CDC to continue to conduct research and surveillance on the incidence and prevalence and the health outcomes and complications of those blood disorders. CBO estimates those activities would cost $65 million over the 2019-2023 period assuming appropriation of amounts consistent with 2018 levels. In addition, it would authorize CDC to conduct surveillance activities on sickle cell disease. Based on historical spending patterns and information from the agency, CBO estimates those activities would cost about $39 million over the 2019-2023 period, assuming appropriations of the necessary amounts. The bill would also authorize the appropriation of about $22 million over the 2019-2023 period for grants related to the prevention and treatment of complications from SCD. Previous funding for those grants in the American Jobs Creation Act of 2004 totaled $10 million per year but expired in 2009. There has been no explicit funding for those grants since 2009. Based on historical spending for similar activities, CBO estimates that implementing those grant programs would cost about $18 million over the 2019-2023 period, assuming appropriation of the specified amounts. In total, implementing the bill would cost $123 million over that period, CBO estimates.
Enacting S. 2465 would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. CBO estimates that enacting S. 2465 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2029.
S. 2465 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.
On September 22, 2017, CBO transmitted a cost estimate for H.R. 2410, the Sickle Cell Disease Research, Surveillance, Protection, and Treatment Act of 2017, as ordered reported by the House Committee on Energy and Commerce on June 7, 2017. CBO’s estimates of the budgetary effects of implementing both pieces of legislation are different. CBO’s estimated cost for this estimate is higher over 5 years because it includes spending for activities related to other heritable diseases, in addition to SCD.