Impact of Obama’s Budget

Congress Must Act on Medicare Physician Payment by March 31; Cost of SGR Repeal Increases Making Permanent Fix Unlikely in the Coming Year

The Congress has until March 31 to pass legislation to avert a 21% Medicare physician payment cut. As Congress moves forward in considering options to replace the sustainable growth rate (SGR) formula, a $30.5 billion increase in the cost of repeal may make a temporary patch the only option for the coming year. Last November, the Congressional Budget Office estimated that the cost of repealing the SGR would be $144 billion; however, revised projects now indicate that this cost has risen to almost $175 billion. While there is much agreement on an alternative payment system with which to replace the SGR, the lack of agreement on how to pay for such repeal will likely preclude Congress from passing a permanent fix in the coming year.

The continued delay of a permanent fix to the SGR results in increased cost for repeal each year. The Endocrine Society and other medical societies are urging Congress to pass a permanent solution to this ongoing and increasingly problematic payment system. However, if Congress cannot agree on how to pay for a permanent repeal, the Society would approve of a temporary patch as long as there was meaningful work toward a permanent solution.

TAKE ACTION: Join the Endocrine Society’s online advocacy campaign at www.endocrine.org/advocacy to tell your Congressman to pass a permanent solution to the SGR before March 31.

President Obama Proposes FY 2016 Budget, Precision Medicine Initiative

On February 2, President Barack Obama released his fi scal year (FY) 2016 budget, providing more detail about his policy priorities.

The president’s budget proposes to reverse the pending sequestration cuts for defense and nondefense programs. A summary of the Obama request notes that “in the absence of congressional action, nondefense discretionary funding in 2016 will be at its lowest level since 2006, adjusted for infl ation.” The president replaces sequestration with alternative spending cuts, tax increases, and enhanced efforts to reduce waste, fraud, and abuse in government programs.

Under the Obama proposal, the National Institutes of Health (NIH) would receive $31.3 billion, a $1 billion or 3.3% increase over FY 2015. All of the federal science agencies would receive funding increases as well. A summary of the NIH budget notes that “in establishing funding priorities, NIH must maintain strong, diverse investments in basic science; the development of eff ective diagnostics, treatments, and preventative measures for common and rare diseases; and the need to sustain a vital and cuttingedge workforce and scientific infrastructure.”

The agency also states that a “significant portion of the $1 billion increase will be devoted to raising the number of new and competing research project grants (RPG).” The NIH estimates that the FY 2016 budget will support:

• 10,303 competing RPGs, an increase of 1,227
above the projected FY 2015 total;
• A total of 35,447 RPGs, an increase of 1,241
above the projected FY 2015 total;
• An average cost of $461,000 for new and competing
RPGs, similar to the FY 2015 level.

Obama’s request expands funding for several other areas of the NIH budget, including:

• A $23 million increase for research and training to support an additional 204 full-time training positions;
• A 2% increase above the FY 2015 level for trainee stipends;
• A $95 million increase for intramural research.

As outlined in the State of the Union speech, the NIH will also receive a total of $215 million to implement the new Precision Medicine Initiative. This includes $130 million to launch a national research cohort of more than one million individuals who will voluntarily share their genetic information to improve the understanding of health and disease. Another $70 million will be directed to the National Cancer Institute to expand ongoing cancer genomics research and develop more effective treatments for specific types of tumors.

President Obama’s proposal is just a starting point for the congressional debate over the budget and appropriations. Th e Society is pleased that the administration’s FY 2016 budget request restores the harmful cuts to nondefense discretionary programs, including the NIH. By replacing sequestration with a balanced approach to defi cit reduction, the President provides $37 billion to make new strategic investments in education, public health, science, and infrastructure. Importantly, the President’s budget also recognizes that both defense and nondefense programs contribute equally to the American way of life, and that each deserves equal relief from sequestration. However, the Society remains concerned that funding for biomedical research and other important discretionary health programs remains too low under the Budget Control Act.

TAKE ACTION: Join the Society’s on-line advocacy campaign at www.endocrine.org/advocacy to urge your congressional delegation to support NIH.

Members of Congress Introduce Various Bills to Support NIH Funding

As the Congress begins debate on the budget, several champions of medical research have introduced legislative proposals to bolster funding for the National Institutes of Health (NIH).

Senator Dick Durbin (D-IL) introduced the American Cures Act to support the future of research at the NIH, the Centers for Disease Control (CDC), the Department of Defense Health Program (DHP), and the Veterans Medical & Prosthetics Research Program. Senator Durbin fi rst introduced this legislation during the previous Congress last year after meeting with former Society President Teresa K. Woodruff . Senator Durbin attended ICE/ENDO last June to receive the Society’s Champion of Biomedical Research Award. He urged Society members to advocate for research funding.

The American Cures Act would reverse the decline in grant funding by setting a steady growth rate in federal appropriations for biomedical research conducted at the NIH, CDC, DHP, and the Veterans Medical & Prosthetics Research Program. Each year, the bill would increase funding for each agency and program at a rate of GDP-indexed inflation plus 5%.

The America Cures Act is co-sponsored by Senators: Sherrod Brown (D-OH), Amy Klobuchar (D-MN), Barbara Boxer (D-CA), Edward J. Markey (D-MA), Ben Cardin (D-MD), Al Franken (D-MN), and Bob Casey (D-PA).

In addition, Senators Elizabeth Warren (D-MA), Ben Cardin (D-MD), Sherrod Brown (D-OH), and Tammy Baldwin (D-WI) introduced the Medical Innovation Act, a bill that would boost funding for critical medical research. Congressman Chris Van Hollen (D-MD) plans to introduce the Medical Innovation Act in the House of Representatives with Representatives Jan Schakowsky (D-IL), Peter Welch (D-VT), and Kathy Castor (D-FL). Th e legislation would require large pharmaceutical companies that break the law and settle with the federal government to reinvest a small percentage of their profits into the NIH. If the policy had been in place, over the past five years, the NIH would have had nearly $6 billion more every year to fund thousands of new grants to scientists and universities and research centers around the country — almost a 20% increase in NIH funding.

The Society will continue to monitor this legislation and apprise the membership of developments.

Meet the Guideline Experts Sessions to be Launched at ENDO 2015

Attendees at ENDO 2015 will have the opportunity to meet and talk with the authors of the Society’s newest clinical practice guidelines. Come to the Endocrine Society booth from 1:30 to 2:30 pm each day to have your questions answered by those that know the guidelines the best.

• Thursday: Treatment of the Symptoms of Menopause — 1:30 to 2:30 pm
• Friday: Acromegaly — 1:30 to 2:30 pm
• Saturday: Pharmacological Management of Obesity — 1:30 to 2:30 pm

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