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On March 9, President Biden released his $6.9 trillion proposed budget request for fiscal year (FY) 2024 to Congress.
The proposed Health and Human Services (HHS) budget included in the request contains $144.3 billion in discretionary funding and $1.7 trillion in mandatory funding for FY 2024. The proposed HHS budget also extends the solvency of Medicare’s Hospital Insurance Trust Fund by at least 25 years without cutting benefits or provider payments.
The budget should be viewed as a roadmap 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, President Biden’s budget request places particular emphasis on extending the solvency of the Medicare Part A Trust Fund, preserving health insurance coverage, reducing the cost of prescription drugs, increasing access to mental health services, addressing health care disparities, and expanding the health care workforce. Specific initiatives are summarized below.
- Extends Part A Trust Fund: The budget proposes to extend the life of the trust fund until 2050 by increasing the Part A payroll tax on certain high-income individuals and expanding the number of Part D drugs subject to price negotiation.
- Preserves Health Insurance Coverage: The budget proposes $183 billion over 10 years to make the enhanced premium tax credits previously extended under the Inflation Reduction Act permanent. It also provides Medicaid-like coverage to individuals in states that have not adopted Medicaid expansion under the Affordable Care Act while incentivizing states with existing expansions to maintain coverage.
- Reduces Prescription Drug Costs: The budget would expand the Inflation Reduction Act’s inflationary rebates to the commercial market and cap the price of insulin at $35 per month for a prescription. In the Medicare program, the budget proposal limits cost-sharing for Part D generic drugs used to treat common, chronic conditions to $2.
- Increases Access to Behavioral Health Services: The budget proposal would expand coverage of mental health benefits and strengthen network adequacy requirements for behavioral health providers. For people with Medicare, the budget would cover three behavioral health visits without cost-sharing, requires parity in coverage between behavioral health and medical benefits, and expands coverage to additional behavioral health provider types. The budget also increases funding for the behavioral health workforce, youth mental health treatment, certified community-based behavioral health clinics, community mental health centers, and mental health research.
- Community Health Centers: It proposes to increase funding levels for community health centers to double their numbers over five years.
- Maternal Health: The proposed budget requires all states to provide continuous Medicaid coverage for 12 months postpartum. It also includes $471 million to support ongoing implementation of the White House Blueprint for Addressing the Maternal Health Crisis and reduce maternal mortality and morbidity rates. In addition, it proposes to expand maternal health initiatives in rural communities, implement implicit bias training for health care providers, create pregnancy medical home demonstration projects, and address the highest rates of perinatal health disparities by supporting the perinatal health workforce.
- Workforce: The budget proposes $2.7 billion for Health Resources and Services Administration workforce programs, including $947 million in mandatory resources to expand workforce capacity across the country. This includes $32 million to increase the nursing faculty to grow the nation’s nurse workforce. Additionally, these funds will be used to expand the National Health Service Corps and the Teaching Health Center Graduate Medical education Program.
