April 14, 2021

President Biden Releases Budget Proposal

Late last week, President Biden released his much anticipated budget proposal. The $1.5 trillion proposal calls for investments in priority areas, including public health. Of special note, the plan calls for a $25 billion (23.5%) increase in the Department of Health and Human Services (HHS), including more than $8.7 billion for the Centers for Disease Control (CDC), which represents a $1.6 billion or 22 percent increase. The budget also accounts for the creation of the Advanced Research Projects Agency for Health under NIH, focused on research innovation in cancer, diabetes, and Alzheimer’s disease. NIH overall could see a $9 billion (21%) increase, a $54 million (19%) increase for Title X Family Planning, and a $150 million increase for CDC’s Social Determinant of Health Program.

Of particular importance to Academy members, the proposal commits to ending the HIV/AIDS epidemic, makes a major investment toward ending the opioid epidemic, and promotes health equity for American Indians and Alaska Natives.

Specifically, the President’s proposal requests $670 million for expanded access to antiretroviral treatment and PrEP to prevent HIV transmissions and improve access to routine and critical health services. This is a $267 million increase over current fiscal year funding. Further investments in the CDC, Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), and NIH aim to reduce new HIV cases while increasing access to treatment, expanding use of PrEP, and ensuring equity in access to services and supports, reflecting the Administration’s commitment to accelerating the work of ending HIV as an epidemic.

The budget request also calls for an historic investment of $10.7 billion into ending the opioid epidemic – an increase of $3.9 billion over current levels. This investment includes putting more resources into research, prevention, treatment, and recovery support services, with targeted investments to support populations with unique needs, including Native Americans, older Americans, and rural populations. The COVID-19 pandemic has exacerbated an already deadly opioid crisis, so this proposal represents a truly critical investment.

Finally, as providers continue to grapple with the consequences of major health disparities, the President’s proposal aims to rectify some of the long-standing health inequities experienced by American Indians and Alaska Natives. Specifically, the proposal calls for a $2.2 billion increase in funding for the IHS, including for the first time an advanced appropriation in 2023. The purpose of an “advanced appropriation” is to create a stable funding stream, protecting the appropriation from sequestration cuts or government shutdowns, for example, by ensuring the next year’s money is already in the budget.

This proposal represents a strong commitment to the core issues the Academy cares about. The staff will continue to work with the Administration and Congressional appropriators to help ensure proposed investments become reality. The White House is expected to release its full annual budget later in the spring, which will include proposed budgets for Social Security, Medicare, and Medicaid.

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