March 29, 2022
President Biden releases FY23 Budget, increasing health spending by $26.9 billion
President Joe Biden released his fiscal year (FY) 2023 budget on March 28, requesting $127.3 billion in discretionary funding for the Department of Health and Human Services (HHS), a $26.8% increase from the 2021 enacted level. The National Institutes of Health (NIH) would get $49 billion, which includes a $5 billion investment in the Advanced Research Projects Agency for Health (ARPA-H) to conduct research on "cancer and other diseases such as diabetes and dementia." The Food and Drug Administration (FDA) would receive a $2.1 billion increase over FY 2022 appropriations to total $8.4 billion, including for monitoring of global supply chains and artificial intelligence investments. The Centers for Disease Control and Prevention (CDC) budget would increase by $2.3 billion over FY 2022 appropriations to total $10.675 billion. In addition, the budget includes a $41.9 million increase compared with FY 2022 appropriations to total of $453.8 million for HHS’ Office of Inspector General to keep pace with "HHS' growing expenditures, programs, and risks" and a 10.6% increase for the Department of Veterans Affairs for a total of $301.4 billion, including a "historic" $122.7 billion investment in veteran medical care, $13.9 billion for veteran mental health care, and $497 million for suicide prevention.
Biden's budget request includes investments across multiple agencies to support several priority initiatives, including preparing for future pandemics and other biological threats ($81.7 billion), improving public health infrastructure and domestic and global threat surveillance ($28 billion), increasing public health capacity at CDC and state and local levels ($9.9 billion), addressing the nation’s mental health ($51.7 billion) and opioid ($10.4 billion) epidemics, reducing new cases of HIV/AIDS ($850 million), and reducing maternal mortality and race-based disparities ($470 million). In addition, the budget includes $92 million to support the president’s goal of reducing the cancer death rate by 50% over the next 25 years.
While the president’s budget does not include specific health care policies included in the House-passed Build Back Better Act, it does call on Congress to pass legislation to cut "costs for prescription drugs, health care premiums, child care, long-term care," and more. In addition, the budget requires all health plans to cover mental health benefits, ensure plans have adequate behavioral health provider networks, and includes $275 million to ensure the Department of Labor can enforce mental health parity laws.
"Budgets are about more than dollars. They’re about values. And the President’s budget is a reflection of our values as a nation," said Health and Human Services Secretary Xavier Becerra. "From addressing health disparities to strengthening behavioral health to investing in our children, this budget will help turn hardship into hope for millions of families. And it will ensure we can fulfill our department’s crucial mission of improving the health and well-being of the American people."
Like most presidential budgets, the documents are largely aspirational, and lawmakers of both parties have made clear they’re unlikely to adopt Biden’s proposals in full.
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 detail.
Health initiative or topic
Public health capacity
Investments in CDC and State and local governments to bolster public health infrastructures, strengthen the public health workforce, modernize data collection, improve vaccination programs, advance health equity in CDC programs for viral hepatitis, youth mental health, and sickle cell disease.
Future pandemic preparedness
Investments in HHS, the CDC, Office of the Assistant Secretary for Preparedness and Response, NIH, and FDA to prepare for future biological threats and strengthen U.S. and global health security.
Advanced Research Projects Agency for Health (ARPA-H)
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.
Biden's Cancer Moonshot
Investments in CDC, FDA, and NIH to support the president’s goal of reducing the cancer death rate by 50% over the next 25 years.
To help end the opioid crisis, including funding for States and Tribes, medication-assisted treatment, research, and expanding the behavioral health provider workforce. The budget also includes $663 million specific to the Department of Veteran’s Affair’s (VA’s) Opioid Prevention and Treatment programs. The budget also would remove the word “abuse” from agency names within HHS to better recognize addiction as a disease.
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)
For the first time, requests mandatory funding for IHS to ensure a more predictable funding stream for IHS and to address health inequities experienced by American Indians and Alaska Natives.
Investments in the Agency for Healthcare Research and Quality (AHRQ), CDC, HRSA, NIH, and IHS to improve data on health disparities; support the maternal mental health hotline; create new pregnancy medical home demonstration projects, and bolster and train the maternal health workforce. Funding increases will support CDC’s Maternal Mortality Review Committees, HRSA’s State Maternal Health Innovation Grants program, and other maternal programs.
Funding includes $7.5 billion to establish a Mental Health Transformation Fund, $4.1 billion to permanently extend Community Health Center Funding, $35.4 billion to improve mental health access in Medicaid, and $3.5 billion to improve Medicare mental health coverage. In addition, the budget requires all health plans to cover mental health benefits, ensure plans have adequate behavioral health provider networks, and includes $275 million to ensure the Department of Labor can enforce mental health parity laws.
Investments include a “historic” $122.7 billion investment in veteran medical care, $13.9 billion for veteran mental health care, $497 million for suicide prevention, as well as funding bumps for women veterans’ health care, and infrastructure improvements.
For additional information concerning this Alert, please contact:
|Washington Council Ernst & Young|
| • Any member of the group, at (202) 293-7474.|