The President released his budget proposal for FY2010 to Congress this week, as you've no doubt heard in the news.

Here's what I've been able to make of it, as far as it relates to MD research - if anybody else is following it and has a different take, or more info, I'd love to hear from you.

Looks like he's asking for discretionary funding at the Department of Health and Human Services at $76.8 billion for FY2010. This actually represents a decrease from 2009. But, that doesn't include money from the economic stimulus package, which the budget says is $22.4 billion. Out of that $22 billion, NIH got more than $10 billion, and that was a huge win.

Looking out at the next 5 years, the budget shows an increase of about 13% for HHS (less than 3% per year). Some departments show very large increases over the 5 years, notably the State Department (and other international programs) which would increase 89%, or the Department of Education, which would increase 56%. These numbers are all for discretionary spending authority.

The budget outline released on Thursday doesn't get into many specifics, so we don't know what this means for the amounts for NIH or CDC yet. Apparently there will be a more detailed budget proposal submitted in April, and this whole thing is going to be subject to debate the likes of which we haven't seen in quite some time, I'd say.

The President did make specific proposals regarding cancer research. His proposal included $6 billion for cancer in FY2010, on the way to a doubling of cancer research over 5 years. For comparison purposes, NIH spending on all forms of muscular dystrophy totalled $56 million under the new NIH accounting method in FY2008 ($22 million on D/BMD). Cancer was at $5.5 billion.

I think our message remains the same. Appropriate more money to NIH. I personally was hoping that this President would put forward larger increases to HHS. But, I think the comittment he made to more funding for NIH for cancer (and the increases for NSF and DOE, for that matter) indicates he's pro-research. Let's hope his detailed budget calls out an increase for NIH research for all diseases, not just cancer, and that the Congressional budget and appropriations committees are of the same mindset.

On another note, the FY2009 appropriations bill (HR.1105) cleared the House last Wednesday, and at least one source I read said it included a 3% increase for NIH. The bill includes $31 billion more total spending than the previous year. I would not be surprised at all if the Senate Republicans took some kind of stand over the bill, it has a lot of earmarks. I saw zero coverage of the bill in the mainstream media, and the House only debated it for one hour. Among other things, it includes $40 million just to complete the Capital Hill visitor's center. That single item alone is nearly as much as the government spent on DMD research over the last two years.

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I'm more concerned about the cap on deductions for charitible spending. Some of the large, bulk gifts to charities that help our sons could disappear. That is not good news at all. We need to advocate against that part of his tax plan.
For anyone not up on the details, the cap on deductions that Jerry refers to would limit the income tax deduction that families making over $250,000 could take for a charitable donation. The proposal would limit the tax rate for the deduction to 28%, whereas today you can deduct it at whatever bracket you're in, which if you're in that income level, can be as high as 35% today, and the President proposes to return the top rate to 39.6%.

Many charities are against this, since for many of them, much of their funding comes from donors that would be impacted by this. Good article on the subject here.

I'm thinking this one has a good chance of falling by the wayside, because every non-profit in the country will be lobbying hard against it - especially higher education, and they're a key constituency of the Democrats.
Attempts to reduce the FY2009 appropriations bill in the Senate have all but failed, and a vote looks likely for Friday at the latest.

The bill includes $30.3 billion for the National Institutes of Health (NIH), which is a $938 million increase above the FY08 funding level, or 3.2%. CDC got a 3.8% increase. Good, right?

Well, the inflation rate in 2008 was 3.8%, so the FY2009 appropriations are another year of no increase in buying power for the most important government agencies involved in disease research and education. This is disappointing, to say the least, since the FY2009 appropriations represent an 8.3% increase in discretionary spending, "the largest percentage increase in decades", according to this article.

Our elected officials are failing us. Less than 1% of the federal budget is spent at the NIH. Please get everyone you know to send in the "Take Action Now" e-letter on the main PPMD site and let them know we want more funding at the NIH.
It took longer than expected, but the FY2009 budget passed the Senate tonight and is expected to be signed by the President tomorrow.

If you want to look at the nearly 8,000 or so earmarks in the bill, totalling more than $7.7 billion dollars (none of which appears to have gone to anything MD specific as far as I can tell) - including which elected officials requested the earmark - there's a good spreadsheet on this webpage.
The House and Senate passed seperate versions of the FY2010 budget this week.

The House bill reads " The discretionary resources for Function 550 (health) for 2010 match the
President’s 2010 request... enabling support of the President’s priorities for cancer research, food safety, and other important programs." The Senate version is similar, from the news accounts, anyway.

Those, such as myself, that were hopeful that this new administration and Congress would bring us substantially increased government funding for biomedical research are on a path to being disappointed. At a 3% growth rate, it probably won't even keep up with rates of inflation we'll likely see during an economic recovery. Even in last year's declining economy we had inflation of 3.8%.

It will be very interesting to see how this progresses during appropriations. Maybe NIH will get more than the 3% increase that the overall health function is going to be budgeted. It probably will, to accommodate the doubling of cancer research. Hopefully there's money allocated to increase research for all diseases, not just cancer.

If you haven't already, make your voice heard. Ask your elected officials to sign the funding letters being circulated. More info on how to get involved here on the main PPMD site.
The House Labor, HHS, Education subcommittee, which will determine NIH's budget for FY2010, has a markup hearing scheduled for this Friday, 7/10. The Chairman of the full committee, wants to complete work on all 12 of the appropriations measures before the month long recess which begins August 3rd.

I'm expecting we'll see an increase at NIH in the 3% range. It will be interesting to see if the appropriations tie increased funding to cancer research as the President requested.

Better than nothing, but incredibly disappointing with a Democratically controlled House, Senate, and White House, and an overall budget that's skyrocketing.

Just last week, the Senate Armed Services Committee approved $1.75 billion to build seven F22 fighter jets, a measure opposed by the committee chair, Carl Levin (D), and ranking member, John McCain (R).

$1.75 billion for seven aircraft. That's 76 times the amount to be spent on DMD research this year. The money from just one less plane could have increased DMD research by more than tenfold.
The markup was completed by the House subcommittee, and, as far as I can tell, approved by the full appropriations committee this week.

In the House bill, NIH's budget for discretionary programs is increasing for 2010 by $942 million. That's a 3.1% increase. Not bad, but considering total Federal budget outlays for 2010 will increase by more than 15% - not great. More money is more money, though, and certainly better than the alternative.

There's two important takeaways for anyone that's interested in advocacy.

First, the subcommittee increased funding for NIH by $500 million over the President's request. They more than doubled the amount of increase that the President wanted to send to NIH.

Second, the subcommittee removed the disease specific funding for cancer that the President wanted. As the Chair, David Otey put it "rejecting the Administration’s targeted funding approach and ensuring that all institutes and centers receive funding to offset biomedical research inflation". This is big, because the President's plan would have sent a significant portion of any new NIH funds to cancer.

Time spent lobbying our elected officials to sign on to the appropriations letter was time well spent. There's $500 million dollars more available for NIH than there would have been, and most of this year's increase would have gone to another disease, if the subcommittee had not intervened. That's good news.
Hi Keith,

I appreciate your input with whats going on in DC. Staying on top of politicians and policy is like watching sports. For those of us who aren't sports oriented having your input makes things much easier to follow. This most recent post is really great news!! Something we all could use a little more of,
cheryl
Thank you for this update. Definitely a positive news, especially removing the constraint to target significant chunk to cancer ... all FATAL conditions are important and need equal attention.
Common sense prevailed today on the defense spending issue I mentioned on 7/6. The Senate voted to remove the seven jets from the defense appropriations bill. Another interesting tidbit on that was that even the Defense Department didn't want them - Sec'y Gates was against it. 44 more of them are already on order - this was just over adding another seven. The jets are super advanced, very costly to operate, and haven't flown at all in Iraq or Afghanistan. The House bill approved 12 additional jets, so the issue isn't closed yet. News story here.

Don't let anybody tell you there's no room in the budget for more biomedical research...

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