This analysis was prepared by Crossroads Strategies, LLC on behalf of AACOM.

House Bill - H.R 8774

On June 13, the House Appropriations Committee passed the Fiscal Year 2025 (FY25) funding bill for the Department of Defense and related programs by a vote of 34 – 25. 

The legislation provides a total discretionary appropriation of $833.053 billion, which is $8.57 billion (1%) above the Fiscal Year 2024 level and consistent with the limit put forth by the Fiscal Responsibility Act. Of this, the bill allocates $41.2 billion for DOD medical and health care programs, which includes: $592.5 million above the President’s Budget Request for cancer research; $40 million above the President’s Budget Request for the ALS research program; $10 million above the President’s Budget Request for the arthritis research program; $25 million above the President’s Budget Request for the neurofibromatosis research program; and $175 million above the President’s Budget Request for the traumatic brain injury and psychological health research program.

On June 28, the full House passed H.R. 8774 by a vote of 217 – 198, with 17 Members not voting. House Republicans ultimately chose to include restrictions to abortion access, gender-affirming care, climate change efforts and diversity and inclusion programs – only 5 House Democrats voted for passage. 

H.R. 8774 includes the following healthcare-relevant provisions:

• Military Medical Manpower –The Committee remains concerned that the Department’s handling of military medical billet reductions, in response to the reforms mandated by the National Defense Authorization Act for Fiscal Year 2017, has negatively impacted access to quality healthcare services for servicemembers and their beneficiaries, particularly in areas deemed high risk and health shortage areas by the Department of Health and Human Services. Therefore, in addition to the report directed in House Report 118–121, the Committee directs the Director of the Defense Health Agency (DHA) to provide a briefing to the congressional defense committees, not later than 60 days after the enactment of this Act, on the progress of implementing the report recommendations, including an identification of any barriers to implementation. In addition, the Committee continues to direct the Services’ Surgeons General to submit vacancy rates by occupational code to the congressional defense committees on a quarterly basis and further directs the Director of the DHA to submit vacancy rates among military and civilian medical personnel by location and specialty to the congressional defense committees on a quarterly basis.
• Metastatic Cancer Research – The Committee encourages the Director of the Congressionally Directed Medical Research Programs to continue to partner with outside experts and other federal agencies to implement the recommendation from the April 2018 Task Force Report to Congress on Metastatic Cancer concerning diverse enrollment in clinical trials. The Committee also encourages the Assistant Secretary of Defense for Health Affairs to implement the recommendations to inform patients about risk factors for metastasis, increase cancer patient awareness of healthcare resources and create standardized survivorship care plans for patients with metastatic cancer while validating whether their use improves outcomes for these patients. The Committee remains interested in areas where assistance from other federal agencies is required to fully implement the recommendations of the Task Force’s report.
• Joint Warfighter Medical Research – The Committee recommendation includes $20,000,000 for the continuation of the joint warfighter medical research program. The funding shall be used to augment and accelerate high priority Department of Defense and Service medical requirements and to continue prior year initiatives that are close to achieving their objectives and yielding a benefit to military medicine. The funding shall not be used for new projects nor for basic research, and it shall be awarded at the discretion of the Secretary of Defense following a review of medical research and development gaps as well as unfinanced medical requirements of the Services. Further, the Committee directs the Assistant Secretary of Defense for Health Affairs to submit a report, not later than 180 days after the enactment of this Act, to the congressional defense committees that lists the projects that receive funding. The report should include the funding amount awarded to each project, a thorough description of each project’s research and the benefit the research will provide to the Department of Defense.
• Medical Research – The Committee continues to monitor the transition of medical research conducted by the United States Army Medical Research and Materiel Command to the Defense Health Agency Research and Development organization to ensure that core medical research funding is responsive to the needs of servicemembers. Additionally, the Committee recommendation for fiscal year 2025 includes $1,164,000,000 for the Congressionally Directed Medical Research Programs (CDMRP) to fund high-risk, high-reward medical research. The Committee directs the Assistant Secretary of Defense for Health Affairs to submit to the House and Senate Appropriations Committees a request for prior approval for any changes in management structure; functional alignment; or the two-tiered, peer-reviewed process proposed for the CDMRP program, not less than 30 days prior to any proposed changes taking place. Additionally, the Committee continues to support the use of agile contracting methods, such as other transaction agreements, that may help mitigate the impacts on medical readiness through public-private partnerships and encourages the Department to continue to leverage these mechanisms to ensure expeditious delivery of medical solutions.
• Peer-Reviewed Cancer Research Program – The funds provided in the peer-reviewed cancer research program are directed to be used to conduct research in the following areas: bladder cancer; blood cancers; brain cancer (excluding glioblastoma); colorectal cancer; endometrial cancer; esophageal cancer; germ cell cancers; liver cancer; lymphoma; metastatic cancers; myeloma; neuroblastoma; pediatric brain tumors; pediatric, adolescent, and young adult cancers; sarcoma; stomach cancer; and thyroid cancer. The inclusion of the individual rare cancers research program shall not prohibit the peer-reviewed cancer research program from funding the previously mentioned cancers or cancer subtypes that may be rare by definition. The funds provided under the peer-reviewed cancer research program shall be used only for the purposes listed above. The Committee directs the Assistant Secretary of Defense for Health Affairs to submit a report, not later than 180 days after the enactment of this Act, to the congressional defense committees on the status of the peer-reviewed cancer research program. For each research area, the report shall include the funding amount awarded, the progress of the research and the relevance of the research to servicemembers and their families.
• Mental Health Professionals and Training – The Committee remains concerned about the shortage of current and prospective mental health care professionals, including social workers, clinical psychologists and psychiatrists, for servicemembers and beneficiaries. To address the shortage across the Military Health System, the Committee urges the Assistant Secretary of Defense for Health Affairs, the Director of the Defense Health Agency and the Services’ Surgeons General, to review the tools available to the Department of Defense to increase the number of mental health professionals it educates, trains and hires. This review should consider how the Health Professions Scholarship Program and programming through Uniformed Services University of the Health Sciences could be expanded to increase the number of mental health-related scholarships granted with the goal of increasing the pipeline of mental health providers. Further, the Committee encourages the Assistant Secretary of Defense for Health Affairs to exercise all available authorities to improve recruitment and retention of mental health providers.