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President Obama Signs the American Recovery and Reinvestment Act

February 20, 2009—President Obama has signed and approved The American Recovery and Reinvestment Act of 2009 with new language reflecting the negotiations between the House and Senate versions.   Many of the changes that will affect public health policy come from Senate and House negotiations over short term supplemental funding for NIH.

The bill contains $10.4 billion for NIH, available through September 2010.  This raises the initial investment in NIH in the House version by $6.5B.  These funds, while still in the administrative and planning stage, will be loosely dispersed as follows, according to Dr. Raynard Kington, Acting Director of NIH:

  • $8.2B for NIH to expand jobs and provide groundbreaking biomedical research to study diseases such as Alheimer’s, Parkinson’s, cancer, and heart disease.
    • $7.4B of this will be directed to the Common Fund under the Office of the Director of NIH and will be dispersed proportionately at the same rates as appropriated by congress for general NIH research.
    • $800M will be directed to a range of scientific efforts determined only by the research’s merit, opportunity and immediate need.
  • $1B for NIH to renovate or repair non-Federal research facilities and help them compete for biomedical research grants.  These include universities, teaching and research hospitals and other research facilities.
  • $500M for renovation and restoration of NIH headquarter buildings in Bethesda, MD.
  • $300M for shared instrumentation between NIH facilities.

NIH will view this $10.4B as supplemental to its annual $26B budget and will be directed entirely to research that can be reviewed, funded and underway prior to the September 2010 deadline.  These funds will be dispersed and directed in one of three ways: using existing RO1 mechanisms and proposals, supplementing existing grants (following usual NIH procedures), or through a new program known as the NIH Challenge Grant Program (NCGP).  The NCGP will provide up to $500K/year for two years for groundbreaking research with a focus on new and young researchers.  Roughly $100-200M is expected to be dispersed using the NCGP.

The American Recovery and Reinvestment Act of 2009 has also designated $1.1B total for comparative effectiveness research.  Of that amount;

  • $300M is to be used by the Agency for Health Research and Quality (AHRQ) for comparative effectiveness research
  • $400M is to be transferred to NIH to help patients and doctors determine the effectiveness of different treatments
  • $400M will be allocated at the discretion of the Secretary of Health and Human Services

These funds, according to language in the bill, are intended to "support research that evaluates and compares the clinical effectiveness, risk and benefits of two or more medical treatments and services." 

In addition the bill has specific provision for the following:

  • Provides $19B to assist in the adoption of Health Information Technology (HIT), in order to modernize healthcare, improve quality, reduce errors and reduce cost.
  • Provides an additional $87B over the next two years in additional federal matching funds to help states maintain Medicaid programs without cutting eligibility.
  • Provides a substantial subsidy for COBRA premiums up to 9 months to help laid-off workers who were previously covered under an employer provided healthcare plan.
  • Provides $1B for a new Prevention and Wellness fund to lower healthcare costs through prevention, wellness initiatives and education.

Lung Cancer Alliance will continue to update you on the stimulus package and its effect on public health as more details emerge.