Biden Budget Proposes Major Increases for Federal Health Programs
BY ADAM CANCRYN and SARAH OWERMOHLE Politico May 28, 2021
President Joe Biden is proposing major new investments in federal health programs across the board, as part of an expansive $6 trillion budget request released Friday.
The fiscal 2022 blueprint envisions a more than 23 percent boost to HHS funding overall, while setting aside billions of dollars in new spending for agencies like the Centers for Disease Control and Prevention that have played a central role in the pandemic response.
The plan — which amounts to a wish list of White House priorities — emphasizes the need to pour money into the nation’s public health system and preparedness efforts, including setting aside $6.5 billion to establish a new medical research agency within the National Institutes of Health.
“The country has been weakened by a decade of disinvestment in these areas, which was squeezed under restrictive budget caps,” acting White House budget director Shalanda Young said on a call with reporters where she touted “the largest budget authority increase at the CDC in nearly two decades, to help rebuild its capacity to detect, prepare for and respond to emerging global threats.”
But the budget plan steers clear of major policy changes that Biden campaigned on, such as creating a public insurance option or lowering Medicare’s eligibility age. The president is instead calling on Congress to produce a public option, as well as pursue bills that would expand Medicare’s benefits and eligibility and would lower drug prices.
A prescription drug overhaul could save the government more than $500 billion over a decade, the White House’s budget overview claims. It also backs improving access to dental, hearing and vision coverage in Medicare, and covering low-income people through a public option in those states that haven’t expanded Medicaid.
Still, the plan offers no timeline or path toward accomplishing those goals — an omission that White House officials anticipate blowback over, according to planning documents obtained by POLITICO.
“There will be advocates, interest groups, activists and allies who will notice and be perturbed that their priority is not included in the Budget,” read internal talking points distributed ahead of the budget’s release.
The talking points encouraged officials to push back by stressing that the budget is “an honest and transparent accounting of the policies that the president is actively pursuing this year,” but don’t reflect Biden’s agenda for his entire presidency.
The proposal would increase HHS’ budget to $133.7 billion, from the $108.4 billion enacted in fiscal 2021. CDC would get $8.7 billion in discretionary funding to improve its preparedness for future health crises, with the White House proposing a doubling of funding for gun violence prevention research across both CDC and the NIH.
Overall, the CDC’s funding would rise to $15.4 billion under the blueprint, from roughly $14 billion in fiscal 2021. Biden is seeking a $9 billion increase for the NIH, which would bring its total funding to nearly $52 billion.
As part of that, NIH would receive $6.5 billion toward creating the Advanced Research Projects Agency for Health. The administration has pitched ARPA-H as an accelerator for research on treatments for cancer and other diseases.
At the Food and Drug Administration, funding would increase to $6.5 billion under Biden’s budget, up from about $6.1 billion in fiscal 2021.
The administration is using the budget to highlight a series of other public health priorities, including allocating $220 million to address maternal mortality and $11.2 billion across HHS focused on the opioid epidemic and substance abuse initiatives.
And in a effort to fulfill a campaign pledge, the budget drops some of the decades-old bans on federal funding for abortion that have been written into annual congressional spending bills. The change, however, is unlikely to survive in the Senate, where several moderate Democrats and nearly all Republicans want to keep the Hyde amendment and other anti-abortion measures in place
The proposed investments represent a sharp reversal from the Trump era, where the administration repeatedly sought to slash health spending and rein in massive programs like Medicare and Medicaid.
It also comes as Biden seeks trillions of dollars in new spending as part of legislative packages aimed at reinforcing the nation’s infrastructure and funding its economic recovery from the pandemic. In March, Congress passed a $1.9 trillion package designed to shore up Covid-19 response efforts.
Much of the White House’s proposed new spending in its budget blueprint would be driven by an infrastructure package now before Congress, and the administration’s proposed follow-up economic recovery plan. That proposal — the American Families Plan — includes an estimated $163 billion in spending over a decade to make permanent an expansion of Obamacare’s premium tax credits.
The administration is also asking to more than double the funding for refugee aid from $1.9 to $4.4 billion, of which $3.3 billion would go towards helping unaccompanied minors at the border. HHS’ refugee office is currently grappling with a record influx of migrant children into its custody, forcing it to siphon more than $2 billion from other activities within the department.
Alice Miranda Ollstein contributed to this report.