When members of Congress passed legislation to fund the government for an additional three weeks this Monday, they left unaddressed a widely praised program that experts say supports diabetes research.
That program, known formally as the Special Diabetes Program or SDP, now faces an increasingly uncertain future as those same experts fear lawmakers may simply move on to flashier, more contentious battles.
“We are extremely disappointed and concerned that Congress has failed to renew its funding, letting it expire for the first time ever,” said Cynthia Rice, the senior vice president of advocacy and policy at Juvenile Diabetes Research Foundation. “With strong bipartisan support, there is no reason why SDP should not be fully funded. If Congress doesn’t renew SDP and support critical diabetes research, then they are abandoning the millions of children and adults with diabetes who need more of the life-saving treatments and technologies SDP has funded—and who are hoping, one day, for a cure.”
The story of Congress’ failure to fully fund the SDP is, in many ways, the story of the modern day appropriations process, in which government functions often get financial support either on auto-pilot, in times of crisis, or not at all. The SDP began in 1997 as a widely hailed bipartisan program that would backstop both the administration of health care and research into diabetes cures and therapies vis-a-vis the National Institutes of Health. And it costs relatively little compared to other federal expenditures. Today, the program relies on a $300 million, two-year authorization for each of its two components.
So how was it allowed to lapse?
In the end of September, Congress failed to re-authorize the SDP as well as CHIP, the federal children’s health care program, as their attention remained fixated on repealing and replacing Obamacare. Instead, they kept the Special Diabetes Program for Indians—the portion of the SDP that deals with health services—going on a piecemeal basis and pledged to tackle the full re-authorization at a later date.
In December, lawmakers got around to funding the research portion of the SDP, but only to the tune of a $37.5 million payment. This Monday, as lawmakers voted to re-open the government, they finally addressed a long-term reauthorization for CHIP, passing a six-year extension. But, once more, SDP was put off.
Those in the research community warn that parceling out small amounts of funding enables the program to tread water but makes it virtually impossible to logically administer grants and support sustained research. One can’t develop technologies to combat Type 1 diabetes if operating off sporadic and uncertain spurts of financial support.
No lawmaker disputes this. Nor is there any elected official who is openly opposed to fully funding the SDP. Just days after Congress passed the three-week funding deal that didn’t include an authorization for the program, House Majority Leader Kevin McCarthy (R-CA) listed it among the items he wanted to address going forward. Other lawmakers have pledged to hold town halls on the topic.
But political support was something that the SDP never lacked. Today, there are 75 senators and 356 members of the House who say they support its funding. What it has lacked, its champions insist, is widespread recognition about the direness and uncertainty of its future.
“Nearly 1.25 million Americans live with Type 1 diabetes and failing to reauthorize this important program, which has broad bipartisan support, disregards the real needs and concerns of American families,” said Sen. Jeanne Shaheen (D-NH), co-chair of the Senate Diabetes Caucus. “I will continue to advocate for domestic priorities to remain front and center in the negotiating process. The urgency to reauthorize the Special Diabetes Program, as well as funding to combat the opioid epidemic and support community health centers, cannot be ignored.”