April 9, 2021
President Biden releases $1.5T 2022 budget request
$25 billion increase to HHS includes focus on public health capacity, research and equity
On Friday (April 9), President Joe Biden released his first budget request, calling on Congress to provide $769 billion for non-defense programs and $753 billion in national defense funding for Fiscal Year (FY) 2022. The president's request amounts to a 16% increase over current funding levels for domestic programs and a roughly 1.5% increase for the Pentagon. The budget requests $131.7 billion for the Department of Health and Human Services (HHS), a $25 billion or 23.5% increase from the 2021 enacted level. According to a summary document, the HHS request "builds upon investments already made to respond to the COVID-19 pandemic by prioritizing investments to prepare for future public health emergencies and advance global health security; addresses the opioid crisis; expands biomedical capabilities; promotes health and social service equity; expands access to child care and early learning programs; strengthens social services; supports survivors of domestic violence; and invests in civil rights enforcement."
The request calls for $8.7 billion for the Centers for Disease Control and Prevention (CDC), a $1.6 billion increase over FY 2021 and the largest increase in nearly 20 years "to restore capacity to the world's preeminent public health agency." This includes funding to support core public health capacity improvements in States and Territories, modernize public health data collection nationwide, train new epidemiologists and other public health experts, and build international capacity to detect, prepare for, and respond to emerging global threats. The budget also calls for a $150 million increase for CDC's Social Determinants of Health program, in part to enhance data collection on racial and ethnic communities. It also includes $95 million for the National Strategic Stockpile to replenish medical supplies and continue restructuring that began during the health crisis.
The National Institutes of Health (NIH) would also get a bump of $9 billion to a level of $51 billion, including $6.5 billion to launch the Advanced Research Projects Agency for Health (ARPA-H) to "drive transformational innovation in health research and speed application and implementation of health breakthroughs," with an initial focus on cancer and other diseases such as diabetes and Alzheimer's. The budget also invests $10.7 billion to support research, prevention, treatment and recovery support services to help end the opioid crisis, including targeted investments to support populations with unique needs, and doubles spending on the Community Mental Health Services Block Grant Program for states, among other items.
See below a chart of key health care initiatives outlined by the Biden administration in their budget request and visit the budget landing page for more details.
Health initiative or topic
Advanced Research Projects Agency for Health
$6.5b (new funding)
Launch of the ARPA-H within the NIH to drive innovation in health research and speed application and implementation of health breakthroughs, with a focus on cancer and other diseases such as diabetes and Alzheimer's.
Strategic National Stockpile
ASPR's Strategic National Stockpile (SNS) to maintain replenishment of critical medical supplies and restructuring efforts initiated during the COVID-19 pandemic.
$10.7b ($3.9b increase)
To help end the opioid crisis, including funding for States and Tribes, medication-assisted treatment, research, and expanding the behavioral health provider workforce.
Community Mental Health Services Block Grant
$1.7b (more than double)
Doubling of funding for the Community Mental Health Services Block Grant and additional funding to support the needs of those who are involved in the criminal justice system, partnerships between mental health providers and law enforcement, and suicide prevention activities.
$670m ($267m increase)
Investments in CDC, the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), and NIH aim to reduce new HIV cases while increasing access to treatment, expanding use of pre-exposure prophylaxis, and ensuring equitable access to services and supports.
Indian Health Services (IHS)
$8.5b (>$2.2b increase)
To ensure a more predictable funding stream for IHS, includes an advance appropriation for IHS in 2023 to support Administration and tribal priorities and commits to a robust consultative process.
Social Determinants of Health (SDOH)
$153m (150m increase)
Funding for CDC's SDOH program to support all States and Territories in improving health equity and data collection for racial and ethnic populations. Other investments across the budget are aimed at increasing the diversity of health care workforce and expanding access to culturally competent care.
To bolster Maternal Mortality Review Committees, expand the Rural Maternity and Obstetrics Management Strategies program, help cities place early childhood development experts in pediatrician offices with a high Medicaid/CHIP rates, implement implicit bias training for health care providers, and create State pregnancy medical home programs.
For the CDC to start a new Community Based Violence Intervention initiative to implement evidence-based community violence interventions locally. Also doubles funding for firearm violence prevention research at CDC and NIH.
Health impacts of climate change
$220m ($200m increase)
$110 million for NIH's Climate Change and Human Health program to support research aimed at understanding the health impacts of climate change and $110 million for CDC's Climate and Health program to identify potential health effects associated with climate change and implement health adaptation plans.
$340m (18.7% increase)
The increase in Title X funding is aimed at improving access to reproductive and preventative health services and advance gender and health equity.
Health care civil rights
$47.9m (24% increase)
Funding for the HHS Office for Civil Rights to ensure protection of civil rights in health care.
Rural access and workforce
Investments in programs that help rural communities by providing access to quality health care and health professionals. Increases funding within HRSA to help rural health care providers stay open and funding for rural residency programs. The request also funds efforts to increase the number of individuals from rural areas going to medical school or other training programs, and returning or staying in rural communities to provide care, with a focus on primary care and other in-demand providers.
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