Biden Requests $133.7B for HHS Budget, Other Health Spending Plans

President Joe Biden has requested an increase in the HHS budget next year to strengthen public health infrastructure and crisis-related needs, among other top health spending proposals.

The president’s budget for fiscal year (FY) 2022—Biden’s first since taking office—requests a total of $6 trillion. Of that, the president requested $133.7 billion for the HHS budget, representing a 23 percent increase from this year’s budget of $108.4 billion.

The HHS budget in this proposal, released Friday, is a slight increase from a proposal President Biden released in April covering discretionary spending. In that proposal, the president requested $131.7 billion, a 23.5-percent increase from the 2021 enacted level.

The Centers for Disease Control and Prevention (CDC) will see a significant boost from the increase in HHS' budget, with a requested $8.7 billion in discretionary funding for the agency. This would be the latest budget authority increase in nearly two decades and is intended to bolster the country’s public health infrastructure, including public health data collection and global crisis preparation and response efforts.

The budget also requested funding to expand mental healthcare access, end gender-based violence, promote health equity, and reduce maternal mortality rates—all of which will also foster public health infrastructure and meet crisis-related needs, the budget indicated.

The COVID-19 pandemic shone a spotlight on racial and ethnic disparities in healthcare, with data showing higher rates of infection and death among Black, Hispanic, and Alaska Native/American Indian populations. But the inequity had carried over from a pre-pandemic life as evident by Black maternal health disparities—an issue Biden intends to address using more than $200 million.

The president also requested to increase funding for the Indian Health Service by $2.2 billion and give the CDC’s Social Determinants of Health program $152 million. The administration also plans to double federal investment in community health centers to increase health equity, the budget stated.

The budget would also establish an Advanced Research Projects Agency for Health tasked with creating “a new generation of medical breakthroughs.” The $6.5 billion agency would initially focus on cancer and other diseases such as diabetes and Alzheimer’s using federal research and development spending in health. The funding is part of the $51 billion requested for the National Institutes of Health (NIH), part of HHS.

President Biden also proposed $10.7 billion in discretionary funding for HHS—an increase of $3.9 billion compared to the previous fiscal year—to help end the opioid epidemic, as well as $670 million for ending the HIV/AIDs epidemic.

The budget also included $2.1 billion for the Department of Justice to address the “gun violence public health epidemic.”

Beyond the budget requests, President Biden also touched on the administration’s healthcare agenda to lower costs and expand and improve coverage. However, the president did not request funding for agenda items, which included the controversial public option.

The budget stated that the president supports a public option available through the ACA marketplaces and giving people over 60 years the option to enroll in Medicare early with the same premiums and benefits.

Lowering prescription drug costs was also on the administration’s healthcare agenda. The president plans to let Medicare negotiate payment for some high-cost drugs and requiring manufacturers to pay rebates when prices rise faster than inflation.

“These reforms would lower drug costs and save money for Medicare beneficiaries and people with job-based insurance. The reforms could also yield over half a trillion in Federal savings over 10 years, which could help pay for coverage expansions and improvements,” according to the budget report.

In a statement on Friday, HHS Secretary Xavier Becerra said, “HHS is at the center of many challenges facing our country today— the COVID-19 pandemic, mental and other behavioral health challenges, the opioid addiction crisis, racial inequality and more. The President's FY 2022 budget invests in building a healthier America by giving us the resources we need to protect and invest in the wellbeing of families nationwide today and the years to come.”

“With these new investments, we are on better footing to take on the next public health crisis, partner with states and support families right now who have struggled as a result of the pandemic,” added Becerra. “The increased investment supports families in areas such as behavioral health (mental health and substance use), maternal health, emerging health threats, science, data and research, tribal health, early child care and learning, and child welfare. To build back a prosperous America, we need a healthy America, and President Biden's budget builds on that vision while investing in the many programs housed at HHS to save lives."

The Association of American Medical Colleges (AAMC) also applauded President Biden on Friday for his “visionary commitment to improving the health of the nation by proposing meaningful, increased investments in medical research, public health, and patient care in his FY22 budget request.”

“We have learned over this past year just how integral the NIH, the CDC, and other federal health and research agencies are to the health and well-being of every individual in our nation,” AAMC president and CEO David J. Skorton, MD, and chief public policy officer Karen Fisher, JD, added in a statement.

Skorton and Fisher also supported the president’s proposal to increase access to affordable healthcare coverage “by permanently extending Affordable Care Act marketplace subsidies to more people” and for investments in health equity.

The American Hospital Association (AHA) said over the weekend that it does not endorse the introduction of a public option plan, arguing that it would “increase the strain COVID-19 has placed on our health care system.”

“This type of proposal would strip significant resources from providers by relying on inadequate reimbursement rates, increasing the risk of hospital closures and threatening access to care for patients and communities,” said Rick Pollack, president and CEO of AHA.