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President Approves FY 2015 Spending Package

Revised December 18, 2014—President Obama Dec. 16 signed the Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) after the House approved it, 219-206, on Dec. 11 and the Senate approved it, 56-40, on Dec. 13. The so-called “CRomnibus” spending bill includes a continuing resolution (CR) providing funding for the Department of Homeland Security through Feb. 27, 2015, and complete versions of the remaining 11 fiscal year (FY) 2015 spending bills to fund government agencies and programs through the end of September.

In addition, the package includes $5.4 billion in emergency supplemental funding to address the Ebola epidemic domestically and internationally. While the funding falls short of the administration’s $6.2 billion request, the funding does not need to be offset and therefore does not affect funding available for discretionary programs (see related story).

The AAMC supported passage of H.R. 83.  In a Dec. 10 statement, AAMC President and CEO Darrell Kirch, M.D., urged quick action by Congress and the president “to ensure that vital medical research and public health functions can continue without interruption.”

In a Dec. 11 Statement of Administration Policy, the White House supported House passage of H.R. 83, but objected “to the inclusion of ideological and special interest riders in the House bill.” The White House also expressed disappointment with the three-month CR for the Department of Homeland Security, saying, “Short-term continuing resolution funding measures are disruptive, create uncertainty, and impede efficient resource planning and execution.”

National Institutes of Health (NIH): The budget agreement provides $30.084 billion, an increase of $149.7 million (0.5 percent) over the FY 2014 comparable.  Adding the $238 million in Ebola funding , the agreement provides a total of $30.322 billion for NIH in FY 2105, an increase of $387.7 million (1.3 percent).

The agreement distributes the increases proportionately among NIH’s institutes and centers, with an additional $25 million for the National Institute on Aging (NIA) for the Alzheimer’s disease research initiative throughout NIH, and additional funds to several institutes to support the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative.

The agreement:

  • reforms the Public Health Service (PHS) evaluation transfer or “tap” so that NIH, while still subject to the transfer, now will receive $715 million from the tap;

  • retains the cap on extramural salaries at Executive Level II;

  • includes legislative language mandating NIH “to submit to Congress a 5-year scientific strategic plan”;

  • provides at least $273.3 million for the Institutional Development Award (IDeA) program; and

  • provides $545.6 million for the Common Fund, including $12.6 million authorized by the recently enacted Kids First Act to support the first year of the 10-year Pediatric Research Initiative.

The agreement includes report language instructing NIH “to develop a new approach with actionable steps to reduce the average age at which an investigator first obtains R01 funding.” NIH is to provide a plan to Congress within 120 days on the steps it will take, measurement methods, and a senior level IC Director monitoring plan. The plan also “should include an analysis of the role of the universities in this effort.”

Report language also requests “NIH review the grant success rates for early stage investigators in their first two grant submissions to consider whether the grant applications submitted by all early stage investigators, regardless of whether they successfully achieved their first submission, should compete against other early stage investigators instead of all submissions as a whole.”

With regard to reproducibility of research, report language instructs NIH to “develop incentives for scientists to undertake confirmation studies, best practice guidelines that would facilitate the conduct of replicable research and guidelines to encourage research transparency in the reporting of methods and findings.” In addition, the report “expects an NIH-wide policy and trans-NIH oversight to address the replication concerns.”  NIH is to report in its FY 2016 budget request on the activities it has on-going toward this effort, the annual measure and amount of resources spent or estimated each year toward this effort.

Health Professions: The bill provides $486.6 million for the Health Resources and Services Administration (HRSA)’s Title VII health professions and Title VIII nursing workforce development programs, a $17.4 million (3.7 percent) increase over the FY 2014 level.

Within this total, the bill provides $255 million for Title VII health professions programs, a $9.6 million (3.9 percent) increase above the FY 2014 levels. Despite the Senate Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Subcommittee proposal to eliminate the Title VII Centers of Excellence (COE), the Title VII Health Careers Opportunity Program (HCOP), and the Title VII faculty loan repayment program, the bill funds all three diversity pipeline programs at their FY 2014 levels [see Washington Highlights, June 13]. The bill also rejects the president’s proposal to eliminate the Title VII Area Health Education Centers (AHEC) program and provides funding at essentially the FY 2014 enacted level [see Washington Highlights, March 7].

Several Title VII programs receive increases, including Scholarships for Disadvantaged Students, primary care medicine, oral health training, public health and preventive medicine, and mental and behavioral health programs.

For Title VIII nursing workforce development programs, the bill provides $232 million, a $7.8 million (3.5 percent) increase over the FY 2014 levels. Several Title VIII programs receive increases over their FY 2014 enacted levels, including Advanced Education Nursing (3.2 percent); nurse education, practice and retention (5 percent); comprehensive geriatric education (3.2 percent), and the nursing faculty loan program (7.9 percent).

A funding chart detailing the levels for each of the Title VII and Title VIII is available here.

Children’s Hospitals Graduate Medical Education (CHGME):The bill maintains funding for the CHGME program at the FY 2014 level of $265 million, rejecting the administration’s proposal to eliminate the program’s discretionary appropriation in FY 2015 [see Washington Highlights, March 7].

National Health Service Corps (NHSC): The bill does not provide an appropriation for the NHSC; however, the NHSC Fund established by the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) provides $310 million in mandatory funding for the program in FY 2015. The NHSC Fund expires at the end of FY 2015.

Agency for Healthcare Research and Quality (AHRQ): The agreement continues funding for AHRQ at the FY 2014 level of $363.7 million in base discretionary spending, $30 million more than the president requested. Unlike past years, the spending package provides the funding through a direct appropriation, thereby eliminating the agency’s reliance on the PHS evaluation “tap” and granting AHRQ budget authority. Additionally, the agency is scheduled to receive a transfer of approximately $106 million from the Patient-Centered Outcomes Research Trust Fund (PCORTF), bringing the total AHRQ budget to $470 million in FY 2015. This funding level represents an increase of approximately $6 million (1.3 percent) over the comparable FY 2015 level. However, the spending agreement does not continue a $7 million transfer from the Prevention and Public Health Fund (PPHF) that AHRQ had received in FY 2014 and past years to administer the U.S. Preventive Services Task Force.

340B Drug Discount Program: The spending package includes report language that requires HRSA “to make 340B ceiling prices available to covered entities through a secure Web site.” Additionally, the report indicates that “the program should examine its ability to ensure patients’ access to 340B savings for outpatient drugs,” and “work with covered entities to better understand the way these entities support direct patient benefits from 340B discounted sales.”

Centers for Disease Control and Prevention (CDC): The bill provides a total of $6.926 billion in for the CDC, a $21.4 million (0.3 percent) increases above the FY 2014 enacted level. This total includes $6.023 billion in appropriated funds, a transfer of $887 million from the PPHF and a transfer of $15 million from the Public Health and Social Services Emergency Fund (PHSSEF). The CDC does not receive funding from the PHS evaluation tap in FY 2015.

Prevention and Public Health Fund (PPHF):The bill allocates the PPHF, which totals $927 million after sequestration. The House Appropriations Committee summary notes that allocating the fund blocks it from being used to fund the Affordable Care Act (ACA).

Hospital Preparedness Program: The omnibus maintains funding for the Hospital Preparedness Program at the FY 2014 level of $254.6 million, as requested by the president. The legislation also provides additional funding to the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) to bolster domestic preparedness for and response to Ebola.

Department of Veterans Affairs (VA): The bill includes $209 million to help address new costs related to the Veterans Access, Choice, and Accountability Act of 2014 (P.L. 113-146) such as hiring medical staff and expanding facility capacity. The measure includes $589 million for VA Research, a $3.2 million (0.6 percent) increase above the FY 2014 level, matching the president's budget. The bill also provides $58.7 billion in advanced FY 2016 funding for VA medical care.

National Science Foundation (NSF): The bill provides $7.344 billion for NSF, a $172 million (2.4 percent) increase over the FY 2014 level and $90 million (1.2 percent) more than the president’s budget request. Within this total, the bill provides $5.933 billion for research and related activities.

Food and Drug Administration (FDA):The bill provides $2.588 billion in base budget authority for FDA, a $36.6 million (1.5 percent) increase above the FY 2014 level. The FDA budget is supplemented by industry user fees, which are expected to generate $1.855 billion in FY 2015. This brings the FDA’s total budget to $4.443 billion, a $96.7 million (2.2 percent) increase over the FY 2014 level. Report language notes the FDA has grown 60 percent in the last 5 years and expresses concern that “oversight of FDA has not kept pace with growth in the agency’s regulatory authority or funding.” The bill therefore adds $1.5 million for the HHS Office of the Inspector General and requests they submit a plan to Congress regarding the additional oversight activities planned for FDA.


Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559

Alexandra Khalife
Legislative Analyst
Telephone: 202-828-0418

Alexandra Khalife
Legislative Analyst
Telephone: 202-828-0418

Matthew Shick, JD
Director, Gov't Relations & Regulatory Affairs
Telephone: 202-862-6116


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Jason Kleinman
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Telephone: 202-903-0806