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Washington Highlights

Congress Approves Omnibus Spending Package

December 18, 2015—The Senate Dec. 18 approved, 65-33, legislation that combines a $1.15 trillion omnibus spending package and a $6.8 billion tax extenders package (see related story). The measure (H.R. 2029) now goes to the president, who has said he will sign it.

Earlier in the day, the House of Representatives approved the spending provisions, 316-113. A total of 150 Republicans joined with 166 Democrats to vote yes, while 95 Republicans and 18 Democrats voted no. The House separately passed the tax extenders portion of the package, 318-109, on Dec. 17.

Negotiators reached agreement late Dec. 15 on the spending package, which combines all 12 regular fiscal year (FY) 2016 spending bills.

To avert a potential government shutdown, President Obama Dec. 16 signed a five-day continuing resolution (CR) to extend funding through midnight, Dec. 22.

In a Dec. 16 statement, AAMC President Darrell Kirch, M.D., urged Congress to pass the legislation without delay. Dr. Kirch commended congressional negotiators for increasing funding for the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality (AHRQ), Veterans Affairs (VA) medical research, and for the Health Resources and Services Administration’s (HRSA) health professions education programs. The legislation did not include an AAMC-supported technical correction to address the recently passed hospital outpatient department site-neutral payment policy (see related story).

The following is a brief summary of the major provisions of interest to academic medicine.

National Institutes of Health (NIH): The omnibus provides $32.1 billion for NIH, a $2 billion (6.6 percent) increase. This includes:

  • $200 million for the president’s Precision Medicine Initiative (PMI);

  • a total of $936 million (an increase of $350 million) for Alzheimer’s disease research;

  • $150 million for the BRAIN Initiative (an increase of $85 million);

  • an increase of $100 million to National Institute for Allergy and Infectious Diseases (NIAID) for antimicrobial resistance research; and

  • $675.6 million for the Common Fund in the Office of the Director – this includes $130 million for PMI and $12.6 million for the Gabriella Miller Kids First Research Act.

The omnibus retains the limit imposed on extramural researchers funded by the Department of Health and Human Services (HHS) at Level II of the Executive pay scale ($183,300 in 2015).

The conferees expect NIH to support the number of National Research Service Awards and other training grants “in proportion to at least the general IC level funding increase. The agreement expects NIH to provide a stipend level and inflationary increases to grantees that is at least consistent with any fiscal year 2016 Federal employee pay raise.”

The conference agreement provides $500 million for the Clinical and Transitional Science Awards (CTSA) program, an increase of $25.3 million (5.3 percent) above FY 2015, to implement the recommendations from the 2013 IOM report. In report language, the conferees support the goal of using CTSA to build networking capacity and support for innovative collaborative projects.  Additional funding is included to allow the program to retain its merit-based CTSA funding to institutions while expanding the network capacity to conduct multi-site clinical studies and collaborative projects.

The conference agreement includes bill language that states the funding for the Institutional Development Awards (IDeA) program is “not less than” $320.8 million.

Department of Veterans Affairs (VA): The omnibus provides $630.7 million for VA Research, a $41.8 million (7.1 percent) increase over FY 2015 in line with Senator Dick Durbin (D-Ill.)’s American Cures Act (S. 2115). The VA Medical and Prosthetic Research increase was championed earlier this year by Senator Durbin as an amendment on the Senate Floor to the Mil.Con.-VA spending bill [see Washington Highlights, Nov. 20] and by Rep. David Price (D-N.C.) as an amendment in the House VA Committee markup [see Washington Highlights, April 24].

Conrad 30 Reauthorization: The measure includes a one-year clean extension of the State Conrad 30 J-1 visa waiver program, which was set to expire with the continuing resolution. The extension puts on hold a more permanent reauthorization (S. 1189) introduced by Senators Amy Klobuchar (D-Minn.), Jerry Moran (R-Kan.), Susan Collins (R-Maine) and Heidi Heitkamp (D-N.D.) that would have expanded the size of the program in addition to programmatic reforms. AAMC has endorsed the measure [see Washington Highlights, July 31].

Title VII and Title VIII Health Professions Program: The omnibus provides $491.9 million for Titles VII and VIII, which is a $5.3 million (1.1 percent) increase over FY 2015.

  • Title VII Health Professions programs receive $262.4 million, which is a $7.5 million (2.9 percent) increase, including continued funding for the diversity pipeline program the Health Careers Opportunity Program (HCOP) at the FY 2015 level. The Senate Committee-approved bill had proposed eliminating HCOP.                                                

  • Title VIII Nursing Workforce Development programs receive $229.5 million, which is a $2.2 million (0.9 percent) decrease below FY 2015.

The omnibus also consolidates under Title VII funding for the Title VII geriatric education programs with the Title VIII nursing Comprehensive Geriatric Education program, citing HRSA’s combined competition for the programs in FY 2015.

Agency for Healthcare Research and Quality (AHRQ): The omnibus provides $334 million for AHRQ, a $29.7 million (-8.1 percent) decrease below FY 2015. This funding level includes $74.3 million for patient safety research, with $10 million directed to Combating Antibiotic-Resistant Bacteria. AHRQ also is expected to receive a transfer from the Patient-Centered Outcomes Research Trust Fund in FY 2016, which the agency’s congressional justification earlier this year projected to be $115.6 million. The House Committee had proposed eliminating the agency, while the Senate Committee had proposed a 35 percent cut.

Children’s Hospitals Graduate Medical Education (CHGME): The omnibus provides $295 million for CHGME, a $30 million (11.3 percent) increase over FY 2015.

Hospital Preparedness Program (HPP): The spending bill maintains funding for the HPP program, administered by the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), at the FY 2015 level of $254.6 million.


Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525

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


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806