On March 11, the Biden administration released the fiscal year (FY) 2025 president’s budget request. Following the release of the budget proposal, the AAMC released a statement expressing appreciation for the administration’s attempts to preserve funding for federal programs and initiatives key to improving the nation’s health, but with concern that the budget underinvests in the nation’s health and public health infrastructure.
Proposed funding levels and policies for programs of interest to academic medicine, based on the materials that have been released to date, including the Department of Health and Human Services (HHS) Budget in Brief, are below. Since FY 2024 funding for most academic medicine priorities has not been finalized by Congress, the budget request compares proposed levels to FY 2023.
The budget proposes a total of $48.3 billion in discretionary funding for the National Institutes of Health (NIH), including an estimated $871.5 million (1.8%) increase for NIH’s base budget compared to the final FY 2023 enacted levels, with additional mandatory funding requested for cancer research and biodefense research. Additionally, the budget proposes flat funding for the Advanced Research Projects Agency for Health, providing $1.5 billion in FY 2025, the same level that Congress provided in FY 2023. The Ad Hoc Group for Medical Research, which the AAMC convenes, issued its March 11 statement on the budget proposal, noting that while appreciative of the request, it lags behind biomedical inflation and would force the NIH to reduce its capacity to support medical research nationwide.
For the Health Resources and Services Administration Title VII health professions programs and Title VII nursing programs, the president proposed a combined $956.7 million in funding, a $77 million (8.8%) increase compared to FY 2023 funding levels. The proposal continues the mandatory investment for the Teaching Health Center Graduate Medical Education Program and National Health Service Corps. The Children’s Hospital Graduate Medical Education program and the Rural Residency Program would receive flat discretionary funding compared to FY 2023 funding levels.
The president’s proposal requests modest increases for the Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality, while the request for the Department of Veterans Affairs research program would decrease funding below the recently enacted FY 2024 level of $943 million. Similar to the FY 2024 budget request, the administration also proposes new mandatory investments for pandemic preparedness initiatives across HHS agencies available for five years, including for the NIH, the Administration for Strategic Preparedness and Response, the Food and Drug Administration, and the CDC.
The budget proposal demonstrates the administration’s ongoing commitment to promoting health care affordability. It would build upon policies included in the Inflation Reduction Act (IRA, P.L. 117-169) by increasing the number of drugs subject to the newly established Medicare Prescription Drug Negotiation Program and extending cost-sharing protections to individuals with commercial insurance. The budget request also proposes to increase access to affordable health insurance coverage by making permanent the enhanced premium tax credits originally established under the American Rescue Plan Act of 2021 (P.L. 117-2), providing “Medicaid-like” coverage to individuals living in non-expansion states, and requiring states to extend postpartum Medicaid coverage to 12 months. The budget proposal also includes a provision that would ban the use of “facility fees” for telehealth and certain outpatient services in commercial insurance. It would also replenish the No Surprises Act (P.L. 116-260) implementation fund and extend surprise billing protections to ground ambulances.
The budget justification for the Health Resources and Services Administration also includes several proposals to strengthen the agency’s oversight of the 340 Drug Pricing Program.