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President Obama's FY 2016 Budget Request

On February 2, the President sent his FY 2016 Budget Request to Congress requesting approximately $4 trillion to fund the federal government in the next fiscal year.  The Budget Request would “fully reverse” the sequester by increasing discretionary spending to $74 billion above the present spending caps, with a total of $530 billion designated for non-defense discretionary spending and $561 billion for defense spending. However all increases are offset with cuts and revenues, including $320 billion in new revenues.

Highlights from the Budget Request include:

Investing in Innovative Research and Development: The Budget provides a 6% increase for R&D, including significant investments in basic research and advanced manufacturing technology. The Budget invests in biomedical research—like the BRAIN initiative, which is developing tools and technologies to offer new insight into diseases like Alzheimer’s, and Precision Medicine, which can improve health outcomes and better treat diseases. It also emphasizes agricultural research, looking at climate resilience and sustainability.

NIH: The Budget provides $31.3 billion, an increase of over $1 billion, to support biomedical research at NIH, providing over10, 000 new NIH grants that will help us better understand the fundamental causes and mechanisms of disease. The Budget provides increased resources for Alzheimer’s, cancer and other diseases that affect millions of Americans and enhanced support for the BRAIN initiative that is helping to revolutionize our understanding of the human brain. It also includes $215 million to launch a Precision Medicine initiative that will accelerate our ability to develop prevention, diagnostic and treatment approaches tailored to individual patients.

NSF: The Budget Request for NSF is $7.724 billion, an increase of $379.34 million (5.2 percent) over the FY 2015 Estimate.  This request includes $292 million for the Social, Behavioral, and Economic Sciences Directorate. 

Department of Energy Office of Science: The FY 2016 Budget Request provides $5.34 billion for Science, $272 million above the FY 2015 Enacted level, to continue to lead basic research in the physical sciences and develop and operate cutting-edge scientific user facilities while strengthening the connection between advances in fundamental science and technology innovation.

ARPA-E: The FY 2016 Budget requests $325 million for the Advanced Research Projects Agency-Energy (ARPA-E), $45 million above the FY 2015 Enacted level, to fund additional early-stage innovative programs as well as to exploit the technological opportunities developed in previous ARPA-E programs, leading to transformational energy technologies.

NASA: The President’s FY 2016 Budget provides $18.5 billion in discretionary funding for the National Aeronautics and Space Administration (NASA) to extend humanity’s reach in space and strengthen America’s leadership here on Earth.

Building Evidence and Encouraging Innovation : The Budget invests in developing and testing effective practices, recruiting social and behavioral sciences experts, and providing better information on what works in key areas ranging from improving college completion to creating greater accountability for job training programs to improving the data available on Indian Country.\

Addressing Viral Hepatitis: Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation in the United States. An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected. In addition to causing substantial morbidity and mortality, viral hepatitis infection has adverse economic consequences. The Budget includes $63 million for CDC’s Viral Hepatitis program, an increase of $32 million over FY 2015 to focus on controlling the emerging epidemic of hepatitis C virus infection in young people, working to eliminate mother-to-child transmission of hepatitis B virus infection, and decreasing premature death resulting from chronic viral hepatitis infection. These priorities are aligned with the HHS Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis.

Bringing Mental Health Out of the Shadows: Mental and physical health comorbidity results in decreased length and quality of life, and increased functional impairment and cost. Patients diagnosed with a serious mental illness die 25 years earlier than other Americans, and they are also among the least likely to seek treatment. The Budget includes an increase of $58 million, to total $185 million, within the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration for the President’s Now is the Time initiative to make sure students and young adults get treatment for mental health issues, and provide nationwide data to better understand how and when firearms are used in violence deaths and inform future research and prevention strategies.  Additional funds will be used to increase workforce capacity across the nation by expanding an existing partnership with HRSA that addresses the number of licensed behavioral health professionals available.  The Budget also proposes the elimination of Medicare’s 190-day lifetime limit on inpatient psychiatric facility services, removing one of the last obstacles to behavioral health parity in the Medicare benefit

Organ Transplantation:  The Budget Request includes $23,549,000 for HRSA’s Division of Transplantation, the same as the FY 2015 Enacted level. Included in this total is $5.4 million to operate the OPTN.  The OPTN is a critical system necessary to facilitate the matching of individuals needing an organ transplant and donor organs. Organ allocation policies developed by the OPTN prioritize the allocation of deceased donor organs to individuals waiting for an organ. The policies are under continual review and refinement to achieve the best outcomes for patients. Given the critical shortage of organs, these policies strive to achieve the maximum benefit for the recipient as well as make the best use of donor organs, consistent with the policy development requirements of the OPTN final rule (42 CFR §121). The costs of operation of the OPTN are funded with appropriated funds and revenues generated by patient registration fees collected by the contractor under authority of 42 CFR §121.5(c).

Republican Response: Not surprisingly, Republican leadership response to the budget proposal is not a favorable one.  House and Senate Budget Committee Chairmen Tom Price and Mike Enzi released a joint statement declaring “…it is so disturbing that President Obama has submitted yet another budget proposal that is focused on the same tired agenda that has failed to deliver for American families. The president is advocating more spending, more taxes and more debt. As we have seen over the past several years that approach will yield less opportunity for the middle class and a crushing burden of debt that threatens both our future prosperity and our national security. A proposal that never balances is not a serious plan for America’s fiscal future. Especially when we have to borrow money just to afford the programs we already have.” 

“We are ready to move past the new normal of President Obama’s budget and in a new direction. We want to make government more efficient and accountable to hard-working taxpayers by lifting the regulatory burden on families and job creators, and by embracing the innovative spirit that drives American entrepreneurship and success. This is how we as a nation can lay the foundation for a healthy economy and a responsible federal budget.”

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