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On April 9, President Biden submitted his $1.2 trillion discretionary spending budget to Congress for federal fiscal year (FY) 2022. Of the amount, $769 billion is requested for non-defense spending, a 16% increase from the prior year. The budget request includes a 23% increase in spending for the Department of Health and Human Services ($132 billion requested) and the Centers for Disease Control and Prevention (CDC), the largest budget increase in nearly two decades ($8.7 billion requested).
The budget should be viewed as further confirmation of the President’s priorities and where he would like to see Congress appropriate discretionary funding. Ultimately, Congress will determine funding levels. Specific to health care, the budget request places particular emphasis on public health, mental health, rural health care delivery, addressing health care disparities, and addressing economic disparities that have a negative impact on health outcomes. Requested funding levels for key agencies and programs are outlined below.
Health and Human Services:
- Improve Public Health Preparedness – $8.7 billion: The CDC would use this additional funding to support core public health capacity improvements in states and territories, modernize public health data collection, train new epidemiologists and other public health experts, and build international capacity to detect, prepare for, and respond to emerging global threats.
- Rebuild Strategic National Stockpile – $905 million: This funding would go to the Assistant Secretary for Preparedness and Response’s Strategic National Stockpile to maintain replenishment of critical medical supplies.
- Address Mental Health Crisis – $1.6 billion: The request, if fulfilled, would double the FY 2021 funding level for the Substance Abuse and Mental Health Services Administration’s Community Mental Health Services Block Grant and would provide additional support across a range of mental health programs.
- Increase Opioid Crisis Funding – $10.7 billion: Requests a $3.9 billion increase over FY 2021 funding levels to address the opioid crisis. The request includes funding for states and tribal governments, medication-assisted treatment, research, and the behavioral health workforce.
- Promote Health Equity – $153 million: The request asks for $153 million for the CDC’s Social Determinants of Health program to support improving health equity and data collection for racial and ethnic populations. This is an increase of $150 million over the FY 2021 funding level. The request also asks for an additional funding to increase the diversity of the health care workforce.
- Reduce Maternal Mortality – $200 million: This would fund the 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 percentage of Medicaid and Children’s Health Insurance Program patients, implement implicit bias training for health care providers, and create state pregnancy medical home programs.
- Supports Rural Health Care Access: The request includes an unspecified amount for the Health Services Resource Administration to “help rural healthcare providers stay open” and increase funding for rural residency programs.
Housing and Urban Development:
- Increase Housing Choice Vouchers – $30.4 billion: The request would expand vital housing assistance to 200,000 more families. The funding request includes a focus on those who are homeless or fleeing domestic violence.
- Increase Homeless Assistance Grants: Asks for a $500 million increase over FY 2021 funding levels for Homeless Assistance Grants. If fulfilled, this would support an estimated 100,000 households. Similar to the choice vouchers, the program focuses survivors of domestic violence and homeless youth.
Department of Agriculture:
- Increase Supplemental Nutrition Program for Women, Infants, and Children – $6.7 billion: Requests a $1 billion increase over the FY 2021 funding level.
- Expand Rural Broadband Access: Asks for an increase of $65 million over FY 2021 funding for Reconnect, the Rural e-Connectivity Program which provides a down payment for grants and loans to deploy broadband to unserved areas.
It is anticipated that a comprehensive budget request for FY 2022 – including non-discretionary items – will be released in May.
