HHS FY2015 Budget in Brief

Department of Health and Human Services
Overview

ADVANCING THE HEALTH, SAFETY, AND WELL–BEING OF THE NATION

The Department of Health and Human Services enhances the health and well-being of Americans by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services.

FY 2015 President’s Budget for HHS

(Dollars in millions)

Category 2013 2014 2015
Budget Authority 873,535 962,554 1,020,284
Total Outlays 886,472 958,077 1,010,479
Fulltime Equivalents (FTE) 74,992 77,457 79,540


 $1010 billion in outlays

General Notes

Detail in this document may not add to the totals due to rounding. Budget data in this book is presented “comparably” to the Fiscal Year (FY) 2015 Budget, since the location of programs may have changed from prior years or may be proposed for change in FY 2015. This approach allows increases and decreases in this book to reflect true funding changes.

The FY 2013 figures herein reflect final levels post sequestration and transfers. The FY 2014 and FY 2015 mandatory figures reflect current law and mandatory proposals reflected in the Budget.

Introduction

The Budget for the Department of Health and Human Services (HHS) improves the economic opportunity of all Americans by providing critical investments in scientific research, health care, disease prevention, social services, and children’s wellbeing, to support healthier families, stronger communities, and a thriving America.

The President’s fiscal year (FY) 2015 Budget for HHS includes investments needed to support the health and wellbeing of the nation, and legislative proposals that taken together would save an estimated $355.6 billion over 10 years. The Budget totals $1 trillion in outlays and proposes $77.1 billion in discretionary budget authority, a reduction of $1.3 billion from FY 2014. With this funding HHS will continue to improve health care and expand coverage, create opportunity, give children the chance to succeed, protect vulnerable populations, promote science and innovation, protect the nation’s public health and national security, and focus on responsible stewardship of taxpayer dollars.

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Strengthening Health Care

Continuing Effective Implementation of the Affordable Care Act

Expanding Health Insurance Coverage. As of January 1, 2014, millions of Americans gained access to new health insurance options previously not available to them. The Marketplaces provide improved access to insurance coverage, creating a new private health insurance market in which those in need of coverage are more easily able to purchase health insurance. The Marketplaces have enrolled 4 million individuals. New premium tax credits and rules ensuring fair premium rates are making private coverage more affordable for consumers. The Budget supports continued operations in the federally-facilitated Marketplaces, as well as oversight and assistance to state-based and Partnership Marketplaces.

The Affordable Care Act provides full federal funding to cover newly eligible adults in states that expand Medicaid up to 133 percent of the federal poverty level for three years starting in 2014 and covers no less than 90 percent thereafter. The Affordable Care Act also simplified Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment processes and aligned them with Marketplaces.  As a result, millions more low-income people have been determined eligible for Medicaid or CHIP.  The Centers for Medicare & Medicaid Services (CMS) continues to work with states and other partners to advance state efforts that promote health, improve the quality of care, and lower health care costs.

Also beginning in 2014, consumers will benefit from a number of new protections in the private health insurance market. Non-grandfathered health plans will no longer be allowed to charge more or deny coverage to people because of pre-existing conditions. These new protections will also prohibit non-grandfathered plans from putting annual dollar limits on benefits and from varying premiums based on gender or any factor other than age, tobacco use, family size, or geography. In addition, new plans in the individual and small group market will be required to cover a comprehensive package of items and services known as Essential Health Benefits that must include items and services within ten benefit categories. Finally, most individuals choosing to participate in clinical trials will not face limits in health insurance coverage. This protection applies to all clinical trials that treat cancer or other life-threatening diseases. 

Health Centers. Health centers will continue to be a vital source of primary care for uninsured and medically underserved patients seeking a quality source of care in FY 2015. The Budget requests $4.6 billion for health centers, of which $3.6 billion is funded by the Affordable Care Act’s Community Health Center Fund, to serve approximately 31 million patients in FY 2015. These resources will support the establishment of 150 new health centers in areas of the country where they do not currently exist, enhance quality, and support capital development and facility improvements at currently existing health centers, all of which will improve health center capacity to provide quality primary and preventive health services to existing patients and expand access to new patients.

Health Care Workforce.  The Budget makes new and strategic investments in our nation’s health care workforce to ensure rural communities and other underserved populations have access to doctors and other providers. In total, $14.6 billion will be invested in three key initiatives: $4 billion in expanded funding for the National Health Service Corps, $5.2 billion for a new Targeted Support for Graduate Medical Education program, and $5.4 billion for enhanced Medicaid reimbursements for primary care.  

The $4 billion in new mandatory resources from FY 2015 through FY 2020 is in addition to $100 million in discretionary funding and $310 million in current law funding for FY 2015 for the National Health Service Corps.  Corps clinicians serve in medical facilities in high-need areas of the country, including rural areas and federally funded health centers, where access to care is limited and where shortages of health care professionals often persist.  The proposed investment by the Health Resources and Services Administration (HRSA) is projected to support a field strength of 15,000 providers in FYs 2015–2020 and serve the primary care needs of more than 16 million patients.

HRSA will also invest in our nation’s health workforce through the new Targeted Support for Graduate Medical Education program.  Between FY 2015 and FY 2024, $5.2 billion in total mandatory funding is requested for this effort, to be distributed through a new competitive grant program to teaching hospitals, children’s hospitals, and community-based consortia of teaching hospitals or other health care entities.  The focus of the targeted support program will be to support ambulatory and preventive care, in order to advance the Administration’s goals of higher-value health care that reduces long-term costs. This investment will support 13,000 residents over 10 years.

Concurrent with these efforts at HRSA, CMS will devote $5.4 billion to extend enhanced reimbursements to states for primary care through the end of calendar year 2015, expand eligibility for reimbursements to midlevel providers, including physician assistants and nurse practitioners, and exclude emergency room codes to better target primary care.

Protecting Vulnerable Populations

Programs that Serve American Indians and Alaska Natives. Over the past year, the Indian Health Service (IHS) has actively consulted with tribes and engaged with the White House Council on Native American Affairs to ensure IHS is providing services that both align with tribal priorities and are coordinated with other agencies within the federal government.  The FY 2015 Budget funds IHS at $6 billion, an increase of $228 million over FY 2014.  The Budget prioritizes funding to reduce health disparities in tribal communities by increasing resources for health care services provided by both IHS and tribes and for critical health services purchased outside of these health systems.  It also provides staffing and operating costs for new and replacement facilities that expand both IHS and tribal capacity to provide health care services to American Indians and Alaska Natives.  Additionally, the Budget fully funds estimated contract support costs, which assist tribes in administering their own health plans to ensure appropriate decisions about local health care needs are made by those in the best position to make those decisions.

Elder Justice. The FY 2015 Budget proposes $25 million in the Administration for Community Living (ACL) to protect vulnerable older adults by combating the rising scourge of elder abuse, neglect, and exploitation in America.  This effort builds on the findings and recommendations of the Elder Justice Coordinating Council, a consortium of federal partners established by the Elder Justice Act of 2009 and led by the HHS Secretary. In response to the recommendations of the Council, ACL will begin developing a national Adult Protective Services data system and provide funding for key research.  This investment will help states improve the quality and consistency of their Adult Protective Services programs.

Ryan White HIV/AIDS Program. Serving over half a million low-income people with HIV/AIDS annually, the Ryan White HIV/AIDS Program plays a critical role in supporting patients across the HIV/AIDS continuum and ensuring care across all life stages, genders, and ages. The Budget requests $2.3 billion in FY 2015 to continue linking patients to care, engaging and retaining patients, prescribing and improving adherence to antiretroviral medicine, and achieving viral suppression. The Administration is committed to working with state and local governments, grantees, clients, and other key stakeholders to implement the program in a manner that is responsive both to the impact of expanded insurance coverage and the current demands of the epidemic. 

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Advancing Scientific Knowledge and Innovation

Promoting Global Health Security. Epidemic threats to national security arise at unpredictable intervals and from unexpected sources. Because these threats do not recognize national borders, the health of people overseas directly affects America’s safety and prosperity, with far-reaching implications for economic security, trade, the stability of foreign governments, and the well-being of United States citizens at home. The FY 2015 Budget includes an increase of $45 million for global health security activities in the Centers for Disease Control and Prevention (CDC) to strengthen the capacity to prevent the introduction and spread of global health threats. CDC will help other nations build capacity to manage emerging threats, enhance early disease detection, improve disease confirmation, and effectively respond to epidemics and other public health catastrophes before they reach our borders. 

Combating Antibiotic Resistance. While antibiotic resistance is not a new phenomenon, the current magnitude of the problem and the speed in which new resistance is developing pose the possibility of a future without effective treatment options. The Budget includes an increase of $30 million for CDC’s Detect and Protect Against Antibiotic Resistance initiative, which will enhance surveillance and laboratory capacity at local, state, and national levels to characterize domestic threats and protect patients from imminent danger.

In FY 2015, the Budget also includes $29 million for the Food and Drug Administration (FDA) to advance the protection of human and animal health through integrated monitoring of antimicrobial resistance. The Budget supports an increase within the FDA food safety program specifically to conduct research to better understand antimicrobial drug use practices in animals and the public health impacts of bacteria. 

In addition, the Biomedical Advanced Research and Development Authority (BARDA) anticipates spending $79 million on its Broad Spectrum Antimicrobials program in FY 2015. Throughout the next several years, BARDA plans to build a portfolio in this area of candidate countermeasures, focus on developing applicable drugs, and obtain regulatory approval for use within hospital and community-based settings.

Protect Patients from Healthcare-Associated Infections. CDC estimates that 1 in 20 hospitalized patients acquires a healthcare-associated infection (HAI), and over 1 million HAIs occur across the healthcare spectrum each year at a cost of over $30 billion.  HHS is committed to reducing the national rate of HAIs.  The Budget includes $44 million for HAI prevention activities at CDC, which include identifying emerging threats and protecting patients across healthcare through outbreak detection and control, gold-standard laboratory testing of the health care environment and contaminated products, and guideline development.

Complementing CDC’s efforts, the Agency for Healthcare Research and Quality (AHRQ) focuses on conducting research to develop new methods of preventing and reducing HAIs and disseminates these research findings to clinicians.  AHRQ’s Comprehensive Unit-based Safety Program accelerates the widespread adoption of evidence-based interventions to prevent HAIs.  For example, this effort reduced the rate of central line associated blood stream infections by 41 percent when implemented in over 1,000 intensive care units.  The request includes $34 million for AHRQ’s efforts to protect patients from HAIs.

Advancing Biomedical Research.The FY 2015 Budget includes $30.4 billion for the National Institutes of Health (NIH), an increase of $211 million over FY 2014, reflecting the Administration’s priority to invest in innovative biomedical and behavioral research that advances medical science while stimulating economic growth. In FY 2015, NIH will focus on generating the basic science for tomorrow’s health breakthroughs, translating these basic discoveries into tailored and more effective health interventions, and nurturing diverse scientific talent and creativity. Investment in NIH also helps drive the biotechnology sector and assure the nation’s place as a leader in science and technology.

BRAIN Initiative. In FY 2015, NIH plans to spend $100 million on research collaborations with academic institutions, the private sector, and other government agencies on the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. This project will develop new tools to comprehensively and precisely examine the activity of the millions of nerve cells, networks, and pathways in the brain in real time to gain revolutionary understanding of complex brain functions and their links to behavior and disease. The NIH contribution is part of a $200 million planned investment in FY 2015 by three government agencies (NIH, the National Science Foundation, and the Defense Advanced Research Project Agency) along with private sector partners.

Big Data. NIH will continue to ramp up efforts in FY 2015 to improve its ability to analyze many of the large and complex digital datasets of information, known as “Big Data,” that biomedical researchers are currently generating, such as high-resolution medical images, recorded physiological signals, and complete DNA sequences of large numbers of individuals. Improving the ability to use, protect, and responsibly share such data, including the development of a well trained workforce, represents a critical link in translating new research discoveries into clinical applications.

Improving Healthcare through Meaningful Use of Health IT. Health information technology (IT) is essential to improving our nation’s health care by moving from a transaction-based system to one that emphasizes quality and value.  The Budget includes $75 million for the Office of the National Coordinator for Health Information Technology (ONC) to coordinate and support investments in policies, standards, testing tools, and implementation guides that have dramatically accelerated the adoption and meaningful use of certified Electronic Health Record technologies. Within this total, ONC will begin to address health IT-related patient safety issues under the Health IT Safety Center (Center).  In FY 2015, the Center will begin a robust collection and analysis of health IT-related adverse events, which will facilitate benchmark data on the types and frequencies of events. The Center will monitor and analyze data on patient safety events, potentially unsafe conditions associated with health IT, and patient safety events that could be prevented by health IT. ONC will work closely with AHRQ, Patient Safety Organizations, the Joint Commission, and FDA on this effort.   

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Advancing the Health, Safety, and Well-Being of the American People

Supporting Families

Early Head Start—Child Care Partnerships.The Budget proposes $650 million in FY 2015 for Early Head Start – Child Care Partnerships, an increase of $150 million above FY 2014.  These funds will support and expand the availability of high quality early learning programs for tens of thousands of infants and toddlers through competitive grants to new and existing Early Head Start programs that partner with child care providers, especially those receiving federal child care subsidies. In addition, the Budget provides $120 million above FY 2014 to strengthen services for children served by the Head Start program.  Together, these investments total $8.9 billion, an increase of $270 million over FY 2014. 

Unaccompanied Alien Children (UAC).  By law, the Administration for Children and Families (ACF) must assume custody of all unaccompanied alien children apprehended by law enforcement who file claims to remain in the United States.  ACF provides support to state-licensed group homes to care for these children until ACF can place the children with sponsors.  Since FY 2011, the annual number of arriving UAC has increased from 6,560 to an estimated 60,000 for FY 2014.  ACF has implemented strategies to reduce the cost per child, but total costs have risen dramatically as the number of UAC has increased.  Due to the volatile nature of this program, the Administration is not able to reliably predict the number of UAC who will arrive in FY 2015 at this time.  The FY 2015 Budget for the UAC program is therefore $868 million, the same as FY 2014.

Child Support and Fatherhood Initiative.The Budget includes a set of proposals to encourage states to pay child support collections to families rather than retaining those payments. This effort includes a proposal to encourage states to provide all current monthly child support collections to Temporary Assistance for Needy Families (TANF) recipients. Recognizing that healthy families need more than just financial support alone, the proposal requires states to include provisions in initial child support orders addressing parenting time responsibilities, to increase resources to support and facilitate non-custodial parents’ access to and visitation with their children, and to implement domestic violence safeguards. The Budget also includes new enforcement mechanisms such as requiring states to implement electronic income withholding orders that will enhance child support collections. The Budget proposes an investment of $1.8 billion over 10 years for these initiatives.

Facilitating Transitions to Adulthood

Youth Transitions. The FY 2015 Budget proposes to better serve the most vulnerable youth.  The consequences of not doing so are serious for both individuals and society as a whole. When youth are disconnected from school, work, or family, they cost the nation billions of dollars every year in lost earnings, welfare and medical costs, and unmet personal potential.

The Budget includes $130 million within the Substance Abuse and Mental Health Services Administration (SAMHSA) for the President’s Now is the Time initiative. This investment provides $20 million to continue the Healthy Transitions program, which will assist 16 to 25 year-olds with mental illnesses and their families in accessing and navigating behavioral health treatment systems to ensure their vulnerability does not hinder their treatment. Youths with mental health conditions are less likely than similar adults to receive care. It is important to ensure these vulnerable youth do not fall through the cracks during this period because having an untreated mental health condition makes young adults more likely to experience homelessness, be arrested, drop out of school, or experience underemployment.

The Budget also provides $5 million within the Administration for Community Living to develop best practices and an evidence base to better support young people with intellectual and developmental disabilities as they transition from adolescence into young adulthood across all systems—health, education, employment, human services, and community living.  This initiative stems in part from the findings of a July 2012 GAO Report, Students with Disabilities: Better Federal Coordination Could Lessen Challenges in the Transition from High School.  GAO’s report builds on a growing body of evidence that the success of youth with disabilities exiting high school could be dramatically improved through better coordination across the systems that serve them.  The goals of this investment are to increase coordination between federal agencies serving these youth in order to reduce unnecessary institutionalization and to help transitioning youth with intellectual and developmental disabilities become active participants in their communities.

Demonstration to Address the Over Prescription of Psychotropic Medications for Children in Foster Care. The Budget includes $500 million for a new Medicaid demonstration in partnership with ACF to provide performance-based incentive payments to states through Medicaid, coupled with $250 million in mandatory child welfare funding to support state infrastructure and capacity building. This transformational approach will encourage the use of evidence-based screening, assessment, and treatment of trauma and mental health disorders among children and youth in foster care in order to reduce the over-prescription of psychotropic medications. This new investment and continued collaboration will improve the social and emotional outcomes for some of America’s most vulnerable children.

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Strengthening Public Health and Medical Preparedness and Response

Protecting the Public’s Health

Modernizing the Nation’s Food Safety System. Approximately 15 percent of food consumed in the United States is imported from another country.  The increasing globalization of the American food supply is even more prominent within specific products, for example, nearly 50 percent of fresh fruit, 20 percent of fresh vegetables, and 80 percent of seafood are imported.  The Administration continues its commitment to transforming the nation’s food safety system to one that is prevention based and ready to address today’s global challenges.  The FY 2015 Budget includes $1.5 billion, an increase of $273 million above FY 2014, to enhance efforts within FDA and CDC to advance implementation of the Food Safety and Modernization Act.  The Budget includes an increase of $263 million for FDA to implement regulatory action; enhance technical expertise, including training for federal, state, and tribal partners; improve the safety of imported products; and improve domestic and foreign inspection capacity.  The Budget also includes an increase of $10 million for CDC’s food safety activities to support and enhance three priorities, all of which are integral provisions of the legislation:  providing information to help guide food safety policy; detecting, investigating and stopping food-borne outbreaks; and advancing technology for faster, better food-borne disease control and prevention. 

Improving Oversight of Compounding Pharmacies. Ensuring the safety, quality, and availability of medical products available to Americans in the face of increasing complexity in the context of a global market is a critical priority and responsibility for FDA.  The recent enactment of the Drug Quality and Security Act expands FDA authorities related to compounding facilities.  In order to address this critical area of concern, the Budget invests $25 million for FDA to develop a more robust oversight program in three primary areas: inspections and enforcement activities, policy development, and improved coordination with partners.  

Project BioShield and Advanced Development. In FY 2015, HHS will continue to support the development and procurement of medical countermeasures against chemical, biological, radiological, and nuclear threats. The Budget includes $415 million to support advanced research and development through the BARDA and $415 million to develop and procure new measures through Project BioShield. Together, these efforts will improve the nation’s ability to prepare for and respond to the most pressing threats.

Pandemic Influenza. The 2013 outbreak of the novel avian influenza virus, H7N9, demonstrated the critical need for sustaining and enhancing the nation’s influenza preparedness and response capabilities.  Recent advances in science provide the momentum for investments in new strategies in vaccine development.  The Budget includes a total investment of $170 million in the Public Health and Social Services Emergency Fund to support pandemic flu activities. Of this amount, $73 million supports the advanced development of a universal influenza vaccine designed to be effective against all strains of flu to protect Americans from an influenza pandemic.  The Budget also supports the advanced development of a new class of antivirals to improve effectiveness against virus mutation and drug resistance and supports activities to improve vaccine manufacturing and production efficiency.  These efforts, together with the pandemic influenza activities in CDC, NIH, and FDA, will improve the nation’s protection against future novel influenza strain outbreaks.

Supporting Prevention

Reducing Tobacco Use. Having set a priority goal to reduce annual combustible tobacco use in the United States, HHS continues to make progress in reducing tobacco consumption and encouraging cessation among current users.  The FY 2015 Budget includes $1.1 billion to support tobacco efforts across HHS, an increase of $33 million above FY 2014.  FDA will implement the Family Smoking Prevention and Tobacco Control Act through expansions of inspection programs, compliance, advertising campaigns, and monitoring activities.  Of the total in FY 2015, $211 million is for CDC to implement comprehensive tobacco control and prevention activities, enhance educational efforts, expand the Tips from Former Smokers national mass-media campaign, and increase tobacco cessation quit line capacity.  HHS will continue work through the Tobacco Control Implementation Committee to align Departmental strategies with the Healthy People 2020 objective and the HHS Tobacco Control Strategic Plan in order to most effectively lead the nation toward a tobacco-free generation. The Budget also proposes to increase the tax on cigarettes to $97.65 per 1,000 cigarettes (or about $1.95 per pack) increase all other tobacco taxes by about the same proportion, and index the taxes for inflation after 2014.

Preventing Prescription Drug Overdose. The Budget includes $26 million for new interventions to fight prescription drug misuse, abuse, and overdose. This investment includes a $16 million increase for CDC to expand the existing State Core Violence and Injury Prevention Program to additional states with a high burden of prescription drug overdose. This investment will help state health departments enhance their infrastructure and implement a structured set of interventions to understand the nature of the epidemic unique in each state, leverage the best available evidence to save lives, and adopt foundational overdose prevention practices. Also within the total, the Budget includes a $10 million increase for SAMHSA to help state substance abuse authorities develop comprehensive prevention approaches through collaboration with state partners and integration of health information exchange systems with strategic plans. 

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Ensuring Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs

Continuing Program Integrity and Oversight

Combating Fraud, Waste, and Abuse in Health Care. The FY 2015 Budget makes cutting fraud, waste, and abuse a top Administration priority. In addition to the base discretionary Health Care Fraud and Abuse Control (HCFAC) funding in FY 2015, the Budget seeks new mandatory funding. Starting in FY 2016, the Budget proposes that all new HCFAC investments be mandatory, consistent with levels in the Budget Control Act. This investment supports fraud prevention initiatives like the Fraud Prevention System; reducing improper payments in Medicare, Medicaid, and CHIP; and

HHS–Department of Justice Health Care Fraud Prevention and Enforcement Action Team initiatives, including the Fraud Prevention Partnership between the federal government, private insurers, and other key stakeholders. The Budget’s 10year investment in HCFAC yields a conservative estimate of $7.4 billion in Medicare and Medicaid savings.

To help ensure the prudent use of federal funds, the Budget also includes $25 million in discretionary HCFAC funding for program integrity activities in private insurance, including the Marketplaces.

The Budget includes $400 million in discretionary and mandatory funding for the Office of Inspector General (OIG), an increase of $105 million above FY 2014. This increase will enable OIG to expand CMS program integrity efforts for the Health Care Fraud Prevention and Enforcement Action Team and improper payments and will enhance investigative efforts focused on civil fraud, oversight of grants, and the operation of Affordable Care Act programs.

The Budget also includes $100 million for the Office of Medicare Hearings and Appeals (OMHA), an increase of $18 million above FY 2014. OMHA received over 600,000 claims in FY 2013 compared to 313,000 received in FY 2012. The Budget will support adjudicatory capacity and central operations case processing in order to address a critical backlog in the number of appeals and maintain the quality and accuracy of its decisions.

Medicaid Program Integrity. States have the primary responsibility for combating fraud and abuse in the Medicaid program. CMS supports this effort through technical assistance and by contracting with eligible entities to carry out reviews, audits, identification of overpayments, education activities, and technical support. Other key CMS efforts include measuring Medicaid improper payments and efforts to transform the Medicaid data enterprise through the Medicaid and CHIP Business Information and Solutions program to provide states, auditors, and reviewers timely access to more complete encounter data and other claims information. The Budget includes an additional $25 million for the Medicaid Integrity Program.

340B Prescription Drug Discount Program.The 340B prescription drug program facilitates discounts on outpatient prescription drugs to safety-net clinics and hospitals. The Budget includes $17 million for the program, an increase of $7 million, to establish a cost recovery fee to improve program integrity and oversight.

Ensuring Responsible Stewardship of Taxpayer Dollars

Contributing to Deficit Reductions while Maintaining Promises to all Americans. The FY 2015 Medicare and Medicaid legislative proposals seek to strengthen these programs through payment innovations and other reforms that encourage high-quality and efficient care while continuing to reduce health care cost growth. Medicare savings would total $407 billion over 10 years by encouraging beneficiaries to seek value in their health care choices, strengthening provider payment incentives to promote high-value and efficient care, and lowering drug costs. The Budget includes $7.3 billion in savings over 10 years to make Medicaid more flexible, efficient, and accountable. Together, the FY 2015 legislative proposals allow HHS to support the Administration’s complementary goals of investing in the future and establishing a sustainable fiscal outlook.

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Opportunity, Growth, and Security Initiative

The Budget proposes a $56 billion, government-wide initiative to support both domestic and security expenditures that reflect the President’s priorities to grow the economy and create opportunities.  Resources for the initiative would be offset with a balanced package of spending reductions and the closing of tax loopholes. Multiple, specific HHS programs would benefit from the initiative. 

National Institutes of Health.  An additional $970 million would be provided by the initiative to increase the NIH budget to $31.3 billion.  Funds would be used to increase the number of new grants funded by 650, and provide additional resources for signature activities such as the BRAIN Initiative, improving the sharing and analysis of complex biomedical data sets, expanding research on Alzheimer’s disease and vaccine development, further accelerating partnership efforts to identify and develop new therapeutic drug targets, and other innovative projects. These investments would allow NIH to accelerate progress in areas that are priority public health concerns, deepen our understanding of disease, and establish a stronger foundation for entirely new approaches to the development of the next generation of treatments. 

Universal Influenza Vaccine Development.The initiative would provide an additional $50 million to support the advanced development of vaccine candidates for a universal influenza vaccine and to support activities to improve the basic effectiveness of existing vaccines. Successful development of a universal influenza vaccine would provide individuals with immunity across influenza strain types, providing the nation with more security against the threat of an annual influenza pandemic.  Within the Public Health and Social Services Emergency Fund, this investment would bring total funding for universal influenza vaccine development to $123 million in FY 2015.   

Investing in Health Care Facilities Construction within IHS.  The initiative would provide an additional $200 million for projects on the IHS health care facilities construction priority list.  This funding would build upon the FY 2015 request of $85 million to IHS to ensure that IHS could continue to provide appropriate, state-of-the-art care to American Indians and Alaska Natives in the future.  IHS would be able to build two to three additional health care facilities with this additional funding.

Head Start. The initiative would also provide an additional $800 million to further expand Early Head Start – Child Care Partnerships.  This investment would bring total funding for Early Head Start – Child Care Partnerships to $1.5 billion in FY 2015, and serve over 100,000 children in high-quality early learning programs. The initiative would also provide additional resources to support Head Start programs that expand program duration and invest in teacher quality.

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