The White House March 18 released the remaining volumes of the president’s fiscal year (FY) 2020 budget proposal and other related materials. This follows the March 11 release of select portions of the budget, which proposes significant decreases in federal spending overall, including a 12% reduction to the Department of Health and Human Services (HHS); deep cuts to Medicare, graduate medical education (GME), and Medicaid; and reduced funding for the National Institutes of Health (NIH), the Veterans Affairs (VA) Medical and Prosthetic Research, and health workforce programs [see Washington Highlights, March 15].
Additional details describing the proposed budget cuts are outlined in the Major Savings and Reforms document, including details regarding the proposed reduction of nearly $5 billion to the NIH. According to the document, the “Administration believes NIH can improve efficiencies to maximize the return of its investments” and proposes changes that “would enable funding to be better targeted toward supporting the highest priority research on diseases that affect human health while making research institutes less reliant on Federal dollars.”
The request proposes to lower the current HHS salary cap from Executive Level II ($189,600 in 2019) to Executive Level V ($154,300), as the Administration has proposed in its last two budget requests. In the accompanying congressional justification document, the NIH also outlines what it characterizes as a complementary “administrative policy” to “reduce the direct cost of research by capping the percentage of an investigator’s salary that can be paid with NIH grant funds at 90 percent.” The policy is similar to a proposal the administration requested legislative language for in its FY 2019 request.
The president’s FY 2020 request also notes that “For the past two years, NIH has been prohibited by law from reducing grantee administrative costs” and proposes eliminating the prohibition.
Along with the additional materials posted regarding the president’s FY 2020 proposal, HHS also posted updated projections for the Biomedical Research and Development Index (BRDPI), expecting BRDPI to grow at 2.7% for FY 2019 through FY 2024.
The budget request also provides details on significant proposed cuts to the Health Resources and Services Administration (HRSA) Title VII health professions and Title VIII nursing workforce development programs. In the accompanying congressional justification document, the administration proposes to cut geriatric programs, diversity pipeline programs, and primary care training and enhancement programs.
While the budget proposes to eliminate most Titles VII and VIII programs, Mental and Behavioral Health ($36.916 million) and Behavioral Health Workforce Education and Training Programs ($75 million) are proposed to receive the same amount of funding in FY 2020 as was enacted in FY 2019. The full budget proposal also eliminates funding for HRSA GME grants for public medical schools.