April 6, 2022

Biden Administration Releases President’s Budget

The Biden Administration released its annual budget proposal, once again prioritizing health care funding, including HIV prevention, treatment and care. The VOICE will focus attention on the Health and Human Services (HHS) budget, which contains most of the healthcare delivery provisions that impact Academy members and your patients. With a $127.3 billion investment in discretionary programs and $1.7 trillion in mandatory programs for HHS, the budget showcases a deep commitment to reinvesting in public health, research, and making major investments in HIV, overdose prevention, mental health, maternal health and cancer.

With regard to HIV, the budget includes an increase of over $377 million for the Ending the HIV Epidemic initiative to bring an end to HIV by 2030. One of the most groundbreaking components of the budget proposal is $9.8 billion in mandatory funding over ten years to “guarantee pre-exposure prophylaxis (PrEP) at no cost for all uninsured and underinsured individuals; provide essential wraparound services through States, IHS and tribal entities, and localities; and establish a network of community providers to reach underserved areas and populations. The budget also expands access to PrEP under Medicaid by covering the drug and associated services without cost sharing, while removing utilization management practices that may limit access.” If this were fully funded, it would equate to the creation of a new national PrEP program, which the Academy has been involved in advocating for.

Also particularly impactful if implemented, is the shift of Indian Health Service funding from discretionary to mandatory. This technical change will insulate service delivery to the approximately 2.2 million of the nation’s estimated 3.7 million American Indians and Alaska Natives reliant on IHS from Congressional budget delays and government shutdowns. The full budget justification can be found here.

Additional investments include:

  • A nearly $2.7 billion investment for people with HIV in the United States through Ryan White HIV/AIDS Program funding (an increase of $71 million over FY’22 funding)
  • Part A: $666 million (a $4.6 million decrease)
  • Part B Care: $445 million (a nearly $1 million increase)
  • Part B ADAP: $900 million
  • Part C: $207 million (a $1.6 million increase)
  • Part D: $75 million (a $1.7 million decrease)
  • Part F AETCs: $34 million (a nearly $1 million decrease)
  • Part F Dental: $13 million
  • Part F SPNS: $25 million
  • An increase for the CDC’s Division of HIV/AIDS Prevention
  • An increase in CDC’s viral hepatitis programming
  • A modest increase in CDC’s opioid-related infectious diseases programming
  • A modest increase for the HOPWA (Housing Opportunities for Persons with AIDS) program
  • A $6 million increase to improve operations and oversight of the 340B Drug Pricing Program
  • A $4 million increase to the Title X Family Planning Program
  • A modest increase in the Teen Pregnancy Prevention Program

It is important to note that these numbers simply indicate the Biden Administration’s priorities in spending and do not necessarily reflect the level of investment that Congressional appropriators will approve. The Academy will continue to advocate that Congress preserve and build upon the President’s budget proposal to ensure the greatest funding for HIV prevention, treatment, and care.

View the latest Policy Update here.