Capture Intelligence:
FY2027 Federal Health Budget

What it funds

The vehicle through which VA pays for veteran care delivered in the private sector. The FY2027 Medical Community Care account sits at $56.2 billion — up $8.1 billion (17%) from FY2026 enacted. That single account now represents approximately 44% of all VA care delivery. The IDIQ ceiling of approximately $700 billion over ten years is the statutory maximum required to hold projected volume legally — not a spending projection. Verified — VA FY2027 Budget in Brief, April 3, 2026; GAO-26-108943

What changed

Two new mechanisms enter the contract that do not exist in the current CCN:

• Value-based payments. Episode-based payments begin with lower-extremity joint replacements (hips and knees). VA CFO Richard Topping testified before the House VA Committee (January 2026) that at least three additional VBP models will be added over the performance period. Critically: future alternative payment model designs will be proposed by TOPR awardees. The organization that proposes the next cardiac or oncology episode model shapes the contract's economics for its full run. Verified — House VA Committee testimony, January 2026
• Utilization management. New oversight requirements cover ED visits, inpatient admissions, concurrent hospital reviews, and high-cost drug administration. Requires clinical decision support at the point of authorization. The current contract has no such requirement. Any organization operating in care navigation or utilization review under the existing CCN is operating under different rules on day one of the new contract.

Competitive landscape

Incumbents: Optum Health (East and South regions), TriWest Healthcare Alliance (West region). Neither position is automatic — this is a new contract with new capability requirements that the current structure does not require incumbents to hold.

The Corporate Experience gating factor. Up to three references are permitted. Across all three references, the proposal must collectively demonstrate all three of the following or it is rated Unacceptable:

• Implementation of a network across multiple states
• Program management of a service across multiple states
• IT Integration with a client system across multiple states

Missing any single factor across all three references = Unacceptable rating. Binary. This structure forces teaming between traditional healthcare payers (Implementation strength) and systems integrators (IT Integration strength). Solo proposals from either category are exposed.

MOSA structure with No-Bid provision. A No-Bid is a compliant response to a task order. A specialized firm in network analytics, utilization review, rural telehealth, or clinical AI can win a bench position and wait for the matching task order without being penalized for passing on full-region awards.

What it funds

A companion dental network management vehicle to the medical IDIQ. Separate procurement, same structural logic: multiple-award IDIQ for nationwide dental network coordination for veterans using community care. Approximately $47 million. This vehicle is new — there was no standalone dental companion in prior CCN generations. Verified — SAM.gov

Competitive landscape

Proposals closed March 16. Awards are pending. Given that this solicitation has received considerably less scrutiny than the medical vehicle, it is more likely to contain evaluation inconsistencies that could support a protest.

What it funds

Oracle Health's prime contract for EHRM. The $2.768 billion covers sustainment of 19 currently live VA sites; 26 new go-lives planned in FY2027; help desk, training, and data hosting; and preparation of 28 FY2028-targeted sites. Verified — VA FY2027 Budget in Brief

The Michigan go-live

Four sites go live simultaneously in April 2026: Ann Arbor, Battle Creek, Detroit, and Saginaw. Ann Arbor and Detroit are Level 1A complex facilities — the highest classification in the VA system. No Oracle EHR deployment has previously attempted this complexity level. This is the first multi-site simultaneous deployment in the program's history. Verified — VA press releases; Healthcare IT News December 2025; Congress.gov hearing record

On March 4, 2026 — three weeks before the Michigan window — the Oracle federal EHR went down from 8:37 AM to 2:05 PM Eastern (nearly six hours) across all six live VA sites, 26 community clinics, and installations serving DoD and the Coast Guard. Cause: database performance issue. Verified — Fierce Healthcare, March 2026

The June 1 withhold

Congress withheld 30% of EHRM's FY2026 appropriation — approximately $1.02 billion — pending three conditions by June 1, 2026:

• An updated lifecycle cost estimate
• A facility-by-facility deployment schedule through full deployment
• The Secretary's certification of four or more consecutive successful go-lives without delays or patient harm

Structural problem with the cost estimate condition. Three lifecycle estimates exist: VA 2019 ($16.1B — GAO called it severely incomplete), IDA October 2022 ($49.8B: $32.7B implementation + $17.1B sustainment), and VA September 2025 ($37.2B, delivered by Deputy Secretary Paul Lawrence to Congress December 15, 2025). GAO's position as of December 2025: all three are outdated. GAO had not received the VA's September 2025 revision at the time of the hearing. GAO Director Carol Harris stated: "We have not received that estimate, so I would ask the department to provide that to us so we can review it." Verified — GAO-26-108812; House VA Subcommittee, December 15, 2025

Definitional problem with the go-live condition. The withhold language requires certification of deployments "without delays or patient harm." No quantitative threshold defines delay. No threshold defines patient harm. Certification rests on the Secretary's judgment. Context: VA OIG found 149 instances of patient harm at Spokane, 826 major performance incidents across the first five live sites, and a veteran's death linked to scheduling failures at Columbus. All of those sites were certified as go-lives. Verified — VA OIG reports July 2022, September 2024, March 2024

The program picture

Total EHRM obligations through Q2 FY2025: $13.84 billion. After Michigan completes, fewer than one in six VA medical centers will be live (~23 of 170). GAO-26-108812 (December 2025): 16 of 18 prior recommendations unimplemented. Twelve carry priority status. GAO Director Harris told Congress completing all remaining sites on the contract timeline is "impossible." Contract expires May 2028. Full deployment runs to end of FY2031. Verified — GAO-26-108812

GAO-25-108091 user survey (September 2024): 75% of current EHRM users disagree the system enables efficient care. 13% believe it makes the VA efficient. 58% say it increased patient safety risks. These numbers come from sites already live. Verified — GAO-25-108091

What it funds

Devices, cloud infrastructure, network interfaces, and identity management supporting the active deployment wave. This account is separate from the Oracle EHR prime contract and flows through independent contracting vehicles. Covers current live sites and 26 new FY2027 go-lives, with positioning for 28 FY2028-targeted sites. Verified — VA FY2027 Budget in Brief

What changed

Scale. As the deployment accelerates from 19 live sites to approximately 45 by end of FY2027, infrastructure requirements scale with every wave. Each new go-live requires device provisioning, network configuration, identity management integration, and data migration support that the Oracle prime contract does not cover.

What it funds

The EHRM Integration Office (EHRM-IO) program management office — the entity responsible for overseeing 170 total VA medical centers, a $37–49 billion lifecycle cost range, and an active GAO high-risk designation. Verified — VA FY2027 Budget in Brief

The staffing gap

313 positions authorized. Approximately 250 filled. The program then lost 24 additional staff to probationary firings and deferred resignation offers in early 2026. The functional vacancy rate heading into the most intensive deployment phase in the program's history exceeds 20% — at the precise moment the PMO is simultaneously managing the June 1 Congressional deadline, a four-site simultaneous go-live at the highest complexity level ever attempted, and 16 open GAO recommendations. Verified — Congressional testimony, February 2025 and early 2026 (note: 250 filled and 24 losses are from separate testimony timepoints; current fill rate is lower than 250)

What this means operationally

Program management functions the PMO cannot staff internally become contractor work. Michigan goes live this month and the PMO is demonstrably understaffed for it. Functions most likely to be contracted: acquisition support, data governance, quality assurance, deployment coordination, and Congressional reporting support.

What it funds

VA's total FY2027 IT request is $12.2 billion — a 62% increase over FY2026 per Federal News Network analysis. Of that, $4.24 billion is EHRM. The remaining non-EHRM IT covers cybersecurity, financial management modernization, scheduling systems, community care billing, interoperable health records, and digital mental health platforms. The budget specifically allocates $1.3 billion targeting high-impact healthcare delivery capabilities: scheduling and referral processes, community care billing expansion, and interoperable health records. Verified — Federal News Network April 6, 2026; VA FY2027 Budget in Brief

Active programs within this account

Ambient Scribe IDIQ (36C10B26R0006). A five-year IDIQ for ambient AI documentation at VA. Proposals closed April 3, 2026. Awards pending. The prior contract (36C10B26C0025) went to Rise8 and Thoughtworks at $4.9 million. Foreign influence concerns related to Thoughtworks were flagged; VA OIG was actively soliciting outside input on this question at time of publication. Verified — SAM.gov; contract record 36C10B26C0025

Cybersecurity — MITRE Assessment Remediation. Under the Strengthening VA Cybersecurity Act of 2022, VA contracted MITRE to assess five key VA systems. GAO-26-107980 (December 2025) confirmed the assessment addressed requirements and VA's remediation plan generally met the standard. The plan includes a cost estimate and implementation timelines. Remediation work is active across identity management, zero trust architecture, and incident response. Verified — GAO-26-107980

Community care billing. With $8.1 billion routed outside the VA system in FY2027, billing infrastructure is under volume pressure the system was not built for. The budget explicitly calls out billing expansion. Organizations with network billing, payment integrity, or claims processing capability should be tracking this.

What it funds

The largest single account in the VA budget. Covers direct care delivery at VA medical facilities — the clinical environment where AI tools, diagnostics, and scheduling systems operate. The FY2027 request explicitly names ambient scribe, clinical AI, and diagnostics as priority investment areas. Verified — VA FY2027 Budget in Brief

What's happening inside this account

The 17% growth in community care creates a knock-on effect on Medical Services: VA facilities see increased clinical complexity among patients who remain in direct care (lower-acuity patients route to community care more readily), while the referral authorization and triage function — 39.6 million referrals since the June 2019 MISSION Act launch — requires clinical decision support infrastructure to manage at volume. Verified — VA BiB for referral count, attributed to MISSION Act community care program

The Ambient Scribe IDIQ (36C10B26R0006) funded through this account closed April 3. Awards pending. Mental health residential rehabilitation (MHRRTP) expansion — a figure flagged for verification — will be addressed in Part 2 of this budget series.

What it funds

Construction, renovation, and infrastructure at VA medical facilities. Covers major and minor construction, non-recurring maintenance, and leases. Up 6.7% over FY2026. Verified — VA FY2027 Budget in Brief

The strategic dynamic

The community care workforce-substitution model creates a counterintuitive facility investment pattern. Patients routed to community care are largely those where VA capacity was the constraint — meaning the remaining VA direct care volume skews toward higher complexity, specialty, and behavioral health cases that the community network cannot readily absorb. Facility investment will prioritize modernization, specialty capacity, and right-sizing over general expansion.

The FY2028 advance appropriations request ($138.2 billion in medical programs + $53.8 billion in Toxic Exposures Fund advances) is what long-cycle contractors are planning against — not FY2027. Verified — VA FY2027 Budget in Brief

What it is

In December 2023, then-Deputy Secretary of Defense Kathleen Hicks issued a memorandum directing DHA to reattract at least 7% of available care from the private sector back to MTFs by December 31, 2026. The FY2025 NDAA (P.L. 118-159) subsequently encoded the staffing requirements to support the mandate, requiring each MTF to establish medical personnel requirements capable of achieving that shift. Verified — CRS IN12595; CRS IF13108; P.L. 118-159

The operational context

The Military Health System currently purchases more than 65% of total care for its 9.4 million beneficiaries through private sector contracts — primarily TriWest Healthcare Alliance (West Region, effective January 1, 2025) and Humana Military (East Region). Applied against the FY2026 MHS budget of approximately $64 billion, a 7% shift in private sector volume represents a directional signal of roughly $2.9 billion redirecting from managed care support contractors to MTF direct delivery. Analytical — MMT calculation from CRS data

The mandate is a reversal of a decade-long policy that reduced MTF staffing. GAO found that DHA "didn't have the staff to meet its estimated needs" for its management construct and "still doesn't know how many staff it needs." MTFs are chronically understaffed heading into a mandate to absorb more volume. Verified — CRS IN12595

The T-5 TRICARE transition (HealthNet to TriWest, effective January 1, 2025) has been complicated by referral delays, call center backlogs, and portal failures affecting over 1.5 million beneficiaries who moved from East to West Region. DHA has issued multiple policy waivers to manage access. An Inspector General review of the transition was directed by the FY2026 NDAA House report. Corroborated — MOAA documentation; Military.com

What MTFs need to absorb volume

To achieve 7% reattraction, MTFs need capacity they currently lack: scheduling systems that can handle increased appointment volume, telehealth infrastructure to extend clinical reach beyond facility walls, ambient documentation to make provider time more efficient, and clinical staffing to see patients. These are contractor opportunities.

What happened

On April 10–11, 2025, Defense Secretary Pete Hegseth signed a memorandum terminating $5.1 billion in DoD contracts. Within that total, he specifically cited: "DHA contracts for consulting services from Accenture, Deloitte, Booz Allen, and other firms that can be performed by our civilian workforce" — saving the department $1.8 billion. Verified — Washington Technology April 12, 2025; Nextgov/FCW April 12, 2025; Hegseth memorandum

GovTribe three-year prior obligation data at DHA: Booz Allen Hamilton, $345 million; Deloitte, $264 million; Accenture, $66 million. These are prior obligation figures across a three-year window — not the terminated contract values. Corroborated — GovTribe data via Washington Technology and Nextgov/FCW

What "in-sourcing" actually means

The Hegseth memo directed DoD and DOGE to prepare within 30 days a plan to in-source IT consulting and management services to the civilian workforce. The practical constraint: the federal civilian workforce available to absorb this work was simultaneously subject to reduction-in-force actions across the department. Work that cannot be absorbed internally will be re-competed — most likely in smaller, more performance-specific statements of work than the broad advisory vehicles that were terminated.

The support gap

Programs covered by the terminated DHA consulting contracts include EHRM program management support, MHS GENESIS sustainment advisory, and DHA IT portfolio management. Those programs are still running. The gap creates demand for specialized task orders rather than broad management consulting capability. Organizations with specific DHA program knowledge and documented performance metrics are better positioned for the replacement work than generalist consulting shops.

What changed on April 1

Federal Register 2026-06284 (April 1, 2026) transferred ONC's AI, data, and CTO functions to HHS OCIO. ONC's standalone name was restored. ONC confirmed its programs and priorities are unchanged. The structural change: where governance authority sits is different. That change is already in effect. Verified — Federal Register 2026-06284

The scale of what TEFCA now manages

As of February 2026, TEFCA exchanged nearly 500 million health records across 14,214 organizations through 81,000 unique connections across eight QHINs. In January 2025, the exchange volume was 10 million records. That is a 50-fold increase in thirteen months. This infrastructure is not theoretical — it is running at scale. Verified — ONC/healthit.gov

Before April 1, the policy authority governing information blocking and the IT contract authority governing QHIN operations reported to different principals. They now report to the same principal — the HHS CIO. This matters for contracts: the authority writing QHIN technical requirements and the authority holding QHIN contracts are now unified.

The HTI-5 rule

The proposed HTI-5 rule, published December 29, 2025, proposes removing 34 of 60 health IT certification criteria and revising seven more. Comment period closed February 27, 2026. That rule is now moving under OCIO authority. Organizations holding QHIN certifications or operating as TEFCA Participants or Sub-Participants should assume their certification baseline may shift on the next contract cycle. Verified — Federal Register, December 29, 2025

HHS consolidated from more than 40 separate IT departments under this reorganization. The OCIO is now the single decision-making authority for health IT standards, QHIN contracts, and information blocking enforcement. Corroborated — Federal News Network

What it is

The Agentic AI-Enabled Cardiovascular Care Transformation (ADVOCATE) program aims to produce the first FDA-authorized clinical agentic AI providing 24/7 specialty care for cardiovascular disease — the leading cause of death in the U.S., responsible for more than 200,000 preventable deaths annually. Nearly half of U.S. counties have no practicing cardiologist. Full proposals were due April 1, 2026 — the window is closed. Awards expected June 2026. Verified — ARPA-H.gov; STAT News January 2026

Three Technical Areas

• TA1: Patient-facing CVD agent. Autonomous AI for clinical reasoning, care navigation, and autonomous medical actions (medication adjustments, appointment scheduling). Connects to EHR, integrates with wearables. Available 24/7. Designed for FDA authorization for a specific intended use (heart failure management). Will almost certainly be proprietary technology.
• TA2: Supervisory agent. Disease-agnostic. Real-time monitoring, auditability, and control of clinical AI agents. ARPA-H has explicitly noted it would prefer this to be open source. This is the oversight architecture — it can scale beyond cardiovascular AI to any clinical agentic deployment. The organization that wins TA2 owns the oversight layer for every subsequent clinical agentic AI in healthcare, including potential DoD and VA deployments.
• TA3: Health system integration. Recruiting and partnering with health systems that will co-develop and deploy the technology in real clinical settings. These are deployment partners, not technology developers.

Program structure

Phase 1A: 12 months (development and prototype validation). Phase 1B: 12 months (independent V&V). Down-select. Phase 2: 15 months (large-scale real-world scalability). Total: 39 months. ARPA-H funds through Other Transaction Agreements — not contracts, grants, or cooperative agreements. Teaming is expected to be necessary. Solo proposals from a single organization are unlikely to cover all three TAs. ARPA-H is piloting secure LLMs to assist with initial solution summary review — a signal about how the agency intends to scale evaluation capacity going forward. Verified — ARPA-H.gov; STAT News January 2026; Fierce Healthcare January 2026

No clinical agentic AI has received FDA authorization as of this writing. ADVOCATE is designed to create that authorization pathway. The organization that first navigates it — and the health systems that deploy it — establish the clinical, regulatory, and reimbursement precedent for every agentic AI deployment in healthcare that follows.

What is proposed

The FY2027 HHS discretionary request proposes collapsing 28 HHS divisions to 15 through a new Administration for a Healthy America (AHA). The AHA would absorb: OASH, HRSA, SAMHSA, ATSDR, and NIOSH. The proposal also calls for a $5 billion reduction to NIH and elimination of NIMHD, the Fogarty International Center, and NCCIH. ARPA-H is zeroed in the proposal. Verified as proposed — HHS FY2027 Budget in Brief

Congressional history

Senator Susan Collins (April 3, 2026): Congress had "decisively rejected these particular cuts last year." The record supports her. For FY2026, Congress enacted approximately FY2025 funding levels across most contested HHS lines. NIH remained whole. ARPA-H was funded. Defense received $10.6 billion above the Pentagon's own request. The same Congress is now voting on FY2027. Full consolidation as proposed is unlikely to pass. Verified — CRS R48891; Collins statement April 3, 2026

Why act now regardless

Partial restructuring, administrative consolidation without full legislative action, and de facto priority shifts within agencies are possible without a statutory vote. HRSA and SAMHSA program funding and contracting authority can shift even if the organizational chart does not change. Organizations holding vehicles scoped to individual agencies need to model what happens to those vehicles if the reporting structure changes — that is a contract language question, not a legislative one.

The executive order

President Trump signed Executive Order 14398, "Addressing DEI Discrimination by Federal Contractors," on March 26, 2026. This is categorically different from prior anti-DEI executive actions. Earlier orders (EO 14151 and EO 14173, January 2025) were policy directives. This one creates an enforceable contract clause with direct legal consequences for contractors and all subcontractor tiers. Verified — EO 14398; DLA Piper; Morgan Lewis; Holland & Knight

The mandatory clause — six binding elements

By April 25, 2026, all federal agencies must insert the following clause into all covered contracts, modifications, and subcontracts at every tier:

• The contractor will not engage in any racially discriminatory DEI activities.
• The contractor will furnish all information and reports, including access to books, records, and accounts, for compliance verification.
• In the event of noncompliance, the contract may be canceled, terminated, or suspended in whole or in part.
• The contractor or subcontractor may be declared ineligible for further government contracts.
• The contractor will report any subcontractor's "known or reasonably knowable" violations and take remedial action directed by the agency.
• The contractor recognizes that compliance is material to the Government's payment decisions for purposes of section 3729(b)(4) of title 31, United States Code (False Claims Act).

Verified — EO 14398 clause text

What "racially discriminatory DEI activities" means

The EO defines the term as: disparate treatment based on race or ethnicity in recruitment, employment (hiring, promotions), contracting (vendor agreements), program participation, or allocation of resources. "Program participation" includes membership in or access to training programs, mentoring, leadership development, educational opportunities, clubs, and associations sponsored by the contractor. The EO does not address sex-based discrimination. Verified — EO 14398

The False Claims Act exposure

The clause's explicit statement that compliance is "material to the Government's payment decisions" eliminates one of the most common FCA defenses — that the violated requirement was not material to the government's decision to pay. A contractor that submits a payment claim while knowingly maintaining a prohibited program faces treble damages (three times the contract value), civil penalties, and potential debarment. DOJ has stated its intent to aggressively pursue FCA enforcement. Qui tam whistleblowers — including employees — can initiate actions independently. Verified — Winston & Strawn; DLA Piper; EO 14398

Implementation deadlines

Note: There is a timing gap — agencies must insert the clause before the FAR Council issues interim guidance. Consult legal counsel on how your specific contracting agency is interpreting the April 25 requirement.

What to do before April 25

• Audit internal programs under legal privilege. Review mentorship programs, ERGs, leadership development tracks, supplier diversity initiatives, and hiring processes for any eligibility criteria based on race or ethnicity.
• Update subcontractor agreements. The clause flows to every tier. Begin incorporating the clause into subcontractor agreements now and establish a monitoring system for "known or reasonably knowable" violations.
• Check for jurisdictional conflicts. Some state equal opportunity laws may conflict with the federal clause. Assess the compliance conflict before April 25.
• Document any program changes. If you modify or terminate any program in response to this EO, document the basis and process. FCA qui tam actions frequently originate from employees who observed the change.

Signal

The prime systems integrator model is gone. The DHMSM Program Office retains direct decision authority, supported by three separately contracted functions: Technical Integration, Product Management, and Human-Centered Design. None carries the authority over program direction and vendor management a prime SI would have held.

Solution vendors now hold direct FAR-based contracts. Oracle Health Millennium, Health Data Intelligence, and Patient Portal are Best of Suite. Philips eCare and Amwell are Best of Breed. Converge, Solventum Health Information Systems, and Henry Schein Dentrix complete the current vendor portfolio. OCI hosting constraint lifted — solution vendors can now host in their own cloud environments provided they meet DHA performance, security, and cost standards. Verified

Immediate action

Deployment Solutions RFP (HT003826RE001) posted April 6, 2026. Proposals due April 15, 2026, 12:00 PM EDT. Multiple-award IDIQ, $300 million shared ceiling. Price is not an evaluation factor. Government awards to every technically acceptable offeror.

OCI lockout clause locks awardees out of all DHMS work for the duration of the contract plus 12 months. Read the OCI clause before you bid. Firms that want task order access without foreclosing HCDS must make that decision now. Verified

What it funds

Enterprise application and desktop virtualization lifecycle support across the MHS footprint. CPFF, 1 base + 4 option years. $250 million. Verified

Competitive landscape

SPINVI is the confirmed incumbent — an 8(a) firm acquired by Core4ce in January 2023. Recompete is expected April 2026 with award November 2026. SeaPort-NxG vehicle required. Small business set-aside — teaming decisions and 8(a) positioning should be finalized now. Verified

What it is

Enterprise technology planning and risk management. OT prototype mechanism — 10 U.S.C. § 4022, not a traditional FAR acquisition. Each award valued $1.5-2.2 million. Verified

What it funds

Inventory of up to 80 DHA data systems. VAULTIS framework. Automated ML metadata harvesting. Part of DHA Data and Innovation Strategy launched March 2026. $34 million, WOSB set-aside. Posted December 22, 2025. Verified

What it is

MHS Information Platform currently runs on a 1+ petabyte AWS GovCloud environment. EIDS PMO managing 10 active contracts; manpower assessment underway to consolidate. SpinSys-Dinè bridge contract expiring. This is the highest-growth functional area in DHA IT. No RFP posted as of publication date. Corroborated

What it funds

$370 million across 52 condition areas. Pre-announcement March 5, 2026. Access through eBRAP, then Grants.gov CFDA 12.420. Platform Clinical Translation Award funds up to $15 million per award (with $8 million guaranteed from FY2026 funds). Requires preproposal followed by invitation-only full application. Verified

The timing trap

The pre-application window closes before the full FOA publishes. For some mechanisms, the submission calendar has already begun. Do not wait for the FOA — the eBRAP pre-application is the mandatory gating step and some mechanisms close that window first.

FY2027 funding context

The FY2027 CDMRP total will be set by House appropriators in mid-April markup, not by this budget. The FY2026 award cycle is running now. Verified

What it funds

$165 million across 20 cancer types. Pre-announcement February 20, 2026. All 14 additional programs have live pre-announcements at cdmrp.health.mil. Each program has its own timeline and mechanism structure. Full FOAs have not yet posted to eBRAP. There is no single deadline to plan against. Verified

Additional programs

• TBI/PH — Traumatic Brain Injury / Psychological Health
• Combat Readiness — Military medical readiness research
• Joint Warfighter — Joint operational medicine
• Military Burn — Burn treatment and recovery
• Toxic Exposures — Environmental and occupational exposures
• Breast Cancer, Ovarian Cancer, MS, Parkinson's, ALS, Lupus — Disease-specific research
• Spinal Cord Injury, Hearing Restoration, Vision — Injury rehabilitation

The funding context you need

P.L. 119-4 cut CDMRP by 57% in FY2025 — from $1.51 billion to $650 million. FY2026 restored it to $1.27 billion. That level is still 16% below FY2024. Research timelines interrupted by a one-year cut cannot be recovered by a funding restoration alone. Congressional advocacy during the FY2027 markup (mid-April) is the only mechanism to restore the FY2024 funding level. Verified

What it covers

Primary acquisition pathway for all OPMED PMO programs. Covers blood products (cryopreserved platelets, cold-stored plasma), deployed diagnostics (man-portable molecular systems), CPG implementation requirements, and force health protection programs. Continuous submissions accepted through September 30, 2027. Verified

Active programs in pipeline

• CLPH-511 (Cellphire Therapeutics): $29.25M contract W81XWH20C0030. FDA Fast Track granted March 2025. CRYPTICS Phase 2/3 trial stopped early for efficacy April 2025. Five-year shelf life at ≤-65°C. Procurement requirements follow.
• Man-Portable Diagnostic System: Cepheid GeneXpert Omni validated at Balikatan 25 in Philippines. Tropical fever panel tested in field conditions.
• En-route blood delivery: Updated operational guidance published December 2025 covering aerial delivery of fresh and stored blood products. Requirement generation underway.

What it is

Infrastructure engineering support task order through NIWC Atlantic. $129.6 million. Six original bidders on current vehicle. Expiring FY2026. Recompete expected to draw significant interest given scope. No solicitation posted as of publication date. Corroborated

Portfolio breakdown

What the portfolio reveals

Kunsan AB is the first INDOPACOM DHA MILCON entry — there was no INDOPACOM DHA medical construction in FY2026. Geographic pivot confirmed. Lakenheath and Rhine ORB are continuing increments on multi-year authorized builds — no reduction in commitment, natural increment progression. Fort Wainwright follows ARCTIC EDGE 26 exercise validation. Jacksonville SARP signals behavioral health and addiction treatment are inside the lethality framework. Verified — C-1 FY2027 confirmed