Endocrine Insider
March 5,2009
President Obama released an overview of his proposed FY 2010 budget on February 26. As is typical for a new President’s first budget, Obama has provided very few details on the programs discussed in his budget overview and did not address all government programs in the overview. For instance, there was no discussion of overall funding for the National Institutes of Health in the overview, although the President did state his intention to provide $6 billion to the NIH for cancer research. Specific details will be provided when his full budget is sent to Congress in April. Given the top-line nature of the budget outline, a few of the President’s proposals relevant to Society members are described below.
Physician Payment Cuts
The overview outlines positive changes for the physician reimbursement system. Obama’s baseline budget assumes a $329.6 billion “fix” that is estimated to eliminate the 40 percent Medicare physician payment cuts scheduled to occur by 2017 and assumes a 1 percent physician payment increase per year. Additionally, the budget proposal indicates that the Administration is willing to consider changes to the sustainable growth rate (SGR), the complex formula that determines Medicare physician payment that has for years resulted in annual physician payment cuts, staved off at the last minute by Congress. The Administration states in the budget overview that “as part of health care reform, the Administration would support comprehensive, but fiscally responsible, reforms to the payment formula.”
In addition to physician payment changes, the Administration is proposing to establish a reserve fund that would set aside $633.8 billion over ten years for health care reform. Approximately half of these funds would be offset through program changes in Medicare and Medicaid, including, among other savings:
• $176.6 billion through a competitive bidding process for Medicare Advantage;
• $19.6 billion by increasing Medicaid prescription drug rebates, extending such rebates to Medicaid health plans, and applying rebates to new formulations of existing drugs;
• $9.2 billion by establishing a pathway for FDA approval of generic biologics;
• $8.1 billion through higher premiums required of higher-income Medicare Part D enrollees;
• $260 million through the use of radiology benefits managers.
Biomedical Research Funding
The budget outline also describes a strong commitment to science, though it gives very few actual numbers. In the budget request, President Obama highlighted a few areas of emphasis for research funding, including those listed below.
• $6 billion to the NIH to support cancer research. This is the first step in the President’s plan to double cancer research funding.
• Increased resources to detect, prevent, and treat HIV/AIDS domestically.
• $211 million in the Health and Human Services budget for research into the causes and treatments for Autism Spectrum Disorder, screening, public awareness, and support services.
• Doubling of funds for basic research over 10 years, beginning with $3 billion for the National Science Foundation (NSF) in the American recovery and reinvestment Act of 2009 and a 2010 Budget that increases NSF funding by $950 million over 2008 levels.
• Substantial increases for NSF’s Graduate research Fellowship and Faculty Early Career Development programs.
Please watch upcoming issues of Endocrine Insider for further information on fiscal year 2010 funding as more details are released by the White House.
