The Obama Administration announced its 2015 budget proposal, dedicating $77.1 billion to HHS discretionary spending, as well as an outline for 2015 health-related expenditures including continued support of new health reform programs, specific distribution of the budget between health agencies, and additional increases for certain initiatives. The budget explanation with respect to the HHS apportionment specifies the use of the funds to continue support of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) through the operation of health insurance Marketplaces and the implementation of subsidies. While some agencies, such as the National Institute of Health (NIH), are scheduled to receive increased funding under the proposal, others, such as the CDC, will have their budgets cut. Finally, the 2015 health budget includes increased funding for certain specific initiatives, including the Early Head State Child Care Partnership (Head Start) and a program to implement health care provider training.
While the $77.1 billion request for HHS discretionary spending is $800 million less than the 2014 apportionment, HHS total spending would still top one trillion dollars in 2015. The administration claimed that the 2015 proposal “prioritizes core services and programs and makes targeted investments in training and support of health care providers, innovative biomedical research, food and drug safety, mental health services, healthcare for American Indians and Alaska natives, early childhood programs, and services for other vulnerable programs.” Specifically, the HHS budget explanation introduces the Opportunity, Growth, and Security Initiative, which emphasizes child care partnerships, long term public health improvements, and the construction of two new Indian Health Services facilities. In all, the health budget outline projects a savings of $402 billion over the next decade resulting from savings attributed to health programs and initiatives.
The White House identified the “continue[d] historic progress in slowing health care cost growth” as the first aspect of fiscal responsibility in the overview of the 2015 budget, stating that the 2015 budget builds on the reforms and savings initially implemented by the ACA apportionment. The 2015 budget contains $600 million in new funds to continue the enactment of ACA provisions. According to comments by Ellen Murray, the HHS Assistant Secretary for Financial Resources, this amount represents the required $1.8 billion for continued implementation of the ACA less the $1.2 billion in taxes and fees that are built into the provisions of the ACA. While the budget outlay for the ACA is described as providing continued support for health insurance Marketplaces, premium tax credits, and cost-sharing assistance programs, the administration also asserts that it has been projected that the ACA will reduce the deficit by $100 billion in its first decade of operation and by over $1 trillion in the second decade.
The budget proposal also includes the specific distribution of funds to health- related government agencies such as the CDC, the FDA, and the NIH. Under the 2015 parameters, the NIH is set to receive a $30.36 billion share, which represents a slight increase from the 2014 NIH budget and is meant to encourage innovative and high-risk research. Meanwhile, the CDC budget has been cut by 6 percent in comparison to last year’s funding.
Several notable initiatives have received more attention in the Obama Administration’s 2015 budget in the form of increased funding including doctor training, “Head-Start”, mental health programs, and antibiotic resistance research. Specifically, the budget contains $14.6 billion to be dedicated to “implement[ing] innovative policies to train new health care providers and ensure the future health care workforce is prepared to deliver high quality and efficient health care services.” The Head Start program is set to receive $650 million from the base budget and an additional $800 million from the Opportunity, Growth, and Security Initiative to provide over 100,000 toddlers and infants with high-quality health care.
For the exact allocations to each agency, initiative and health program, see the 2015 budget summary tables.