Bills
| 3.23.22

Should Federal Research on Traumatic Brain Injuries Be Reauthorized? (H.R. 6615)

Do you support or oppose this bill?

What is H.R. 6615?

(Updated September 27, 2021)

This bill —  the Traumatic Brain Injury Program Reauthorization Act of 2018 — would reauthorize a national concussion surveillance system to determine concussions’ prevalence and incidence. This surveillance system would act under the authority of the Dept. of Health and Human Services (HHS) through the Centers for Disease Control and Prevention (CDC), providing $5 million in funds to carry out the national concussion surveillance system.

The bill would also provide for state grants for concussion rehabilitation, protection, and advocacy services, which would be handled by the Administration for Community Living (ACL). It would increase funding for state grants to improve access to both rehabilitation and other traumatic brain injury (TBI) services from $5.5 million to $7.321 million in fiscal years 2019 through 2024. Finally, it would increase state grant funding for TBI protection and advocacy services from $3.1 million to $4 million in fiscal years 2019 through 2024.

In total, the bill would authorize $23 million a year over the 2020-2023 period.

Argument in favor

Traumatic brain injuries affect 2.5 million high school students every year, in addition to elderly patients and athletes in contact sports. These injuries can have significant consequences, including death. Federal funding for both prevention and research are needed in this case.

Argument opposed

General taxpayer money shouldn’t be used to fund traumatic brain injury research. Instead, NFL games should be subject to a $1 excise tax per ticket, so those who support one of the main causes of traumatic brain injuries contribute to these injuries’ research and prevention.

Impact

Youth athletes; military; professional athletes; children; the elderly; state TBI protection and advocacy services; CDC; and ACL.

Cost of H.R. 6615

Based on the annual dollar amount to be authorized annually, the CBO estimates that this bill would cost $92 million over the 2020-2023 period.

Additional Info

In-Depth: Rep. Bill Pascrell, Jr. (D-NJ) introduced this bill to extend the federal TBI program through 2024 and authorize resources to boost the CDC’s efforts to launch a National Concussion Surveillance System as a means of filling longstanding data gaps and provide a better estimates of the TBI burden:

“I am proud to introduce this critical bipartisan, bicameral reauthorization of the Traumatic Brain Injury Act. For the last 18 years, I have fought to advance research and treatment for TBI because our athletes on the ballfield and our brave soldiers on the battlefield deserve more. While we have a long way to go, the advances in technology since Congress first started having this conversation can bring us closer to a world where no one must endure the consequences of a brain injury. This goal will take the right investments and partnerships, and this legislation does just that. For the first time, the Centers for Disease Control and Prevention will be able to implement a study to see how many people, both young and old, have sustained a brain injury, which will give us critical insight into this problem. This new TBI Act also modernizes how the government oversees TBI research, treatment, and prevention. And it provides an adjustment to account for the long overdue increase in funding for TBI that I fought to pass in the FY 2018 Omnibus last year. I look forward to working with my fellow Co-Chair of the TBI Task Force Congressman Tom Rooney, as well as Senators Casey and Hatch to ensure this legislation passes Congress and heads quickly to the President’s desk.”

Sen. Orrin Hatch (R-UT), who is sponsoring this bill in the Senate, adds that TBI affects millions of people, and is not sufficiently understood:

“The CDC has reported that this year alone, about 2.5 million children and adults will experience a traumatic brain injury. We know TBI is a serious problem, but we fail to grasp its severity and scope. Our bill will change that. By reauthorizing the TBI program, our legislation will extend important research, education, and advocacy efforts to help us better understand the nature of brain trauma and reduce the prevalence of these injuries going forward.”

TBI advocate Kim Archie proposes that TBI research be funded through a $1 federal excise tax on all National Football League (NFL) tickets, with all proceeds going directly to the government for concussion and TBI research, no strings attached. Archie point out, “There's already a $4 surcharge for parking at NFL games. Why not $1 for safety?"

Writing about this proposal, Vice Sports writer Aaron Gordon adds that Archie’s proposal makes sense on multiple levels, and would raise millions of dollars a year for TBI research:

“Philosophically speaking, it's wholly appropriate that the public should be funding research about public health issues, and not biased industries with an obvious desired outcome. Practically speaking, a per-ticket tax could raise plenty of money and remain trivial for any individual customer. The ongoing controversy between the NFL and the NIH involved a $16 million study. A $1 tax on all NFL tickets—a little more than one percent of the average price—would raise $17.5 million in a single regular season. Granted, the NFL could object to such a tax. They could even lobby against it. But doing so would put the league in an incredibly awkward public relations position. After all, the NFL clearly has no objection to making the public pay for its shiny things: local, state, and federal taxpayers currently subsidize stadiums and Super Bowls to the tune of billions of dollars, and the league routinely demands tax exemptions, too, whether it's regarding property taxes on new stadiums or even Super Bowl tickets… Oh, and if the NFL feels unfairly singled out on an issue that affects college football and the NHL as well? That's fine. Tax those sports, too… Perhaps fans will object to this idea. After all, they're the ones paying for it. But it only seems fair that the people who enjoy watching gigantic humans collide at full speed fund the research about what said collisions do to their brains. Those fans can continue to enjoy football at a minimal cost increase—$16 more a season, plus a few more bucks for preseason and playoff games, the cost of about two stadium beers—and perhaps do so with even less guilt than they may already have, knowing that a portion of their purchase is going toward finding the truth.”

This bill has been referred to the House Energy and Commerce Committee’s Subcommittee on Health with the support of two cosponsors, both of whom are Republicans. It also has the support of the Brain Injury Association of America (BIAA) and the National Association of State Head Injury Administrators (NASHIA).

The Senate version of this bill, S. 3657, the Traumatic Brain Injury Program Reauthorization Act of 2018, passed the Senate Committee on Health, Education, Labor & Pensions (HELP Committee) with increased funding (from $5,500,000 to $7,321,000 for 2020 through 2014). It had the support of two cosponsors, both Democrats.


Of Note: TBI is caused by abnormal movement to the head that disrupts the normal functioning of the brain. TBIs can vary from very mild to incredibly severe, with symptoms ranging from brief and subtle changes in mental state (such as mild confusion and disorientation) to drastic changes (such as loss of consciousness, amnesia, coma) or even death. Mild TBIs are often referred to as concussions. Approximately 2.8 million emergency department visits, hospitalizations, and deaths occurred in 2013 related specifically to TBI. The estimated cost of TBI in the United States is $76.5 billion.

The TBI Act of 1996, signed during the Clinton administration, was the first piece of legislation addressing TBI. It primarily addressed TBI prevention, research, and service through state grants. Since the TBI Act’s passage, all 50 states and the District of Columbia have adopted laws addressing TBI through prevention, accurate diagnosis, and treatment. These laws are largely a response to TBI caused by youth sports.

In 2017, 2.5 million high school students were affected by concussions or other forms of TBI, leading to a majority of the policies adopted by the states to focus on concussion education, athlete removal when a concussion is suspected, and evaluation by a health professional.Most recently, a series of new state laws have focused on TBI in military veterans, requiring treatment of veterans with TBI, and allocating money to programs specifically focused on TBI treatment.

The CDC recently released new diagnostic guidelines focused on treating children with mild TBI and concussions. These new guidelines are informed by years of CDC research aimed at accurately diagnosing and treating mild TBI in young adults and children. Additionally, the NIH, through the National Institute of Neurological Disorders and Stroke (NINDS), has a focus research group and awards grants specifically targeting TBI research.


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto / nikada)