President Biden Issues FY 2023 Federal Budget

President Joseph R. Biden, Jr. on Monday issued his administration’s federal budget proposal for the 2023 federal fiscal year. The $5.7 trillion budget proposal seeks to continue the nation’s recovery from the COVID-19 pandemic, strengthen the country’s fiscal and economic conditions, promote economic and job opportunities, and address nationwide challenges related to climate change, health, and equity.

At a high-level, the Presidents FY 2023 Budget seeks $127.3 billion in discretionary funding, a $26.9 billion increase over the 2021 enacted level, for the U.S. Department of Health and Human Services. This amount excludes funding for the Indian Health Service (IHS), which the Biden Administration is proposing to shift from discretionary to mandatory funding. Major health- and public health-related investments set forth in the President’s Budget include:

  • Preparation for Future Pandemics and Advancing Health Security – The Biden-Harris Administration Budget proposes significant investments ($81.7 billion) in pandemic preparedness and biodefense to enable an agile, coordinated, and comprehensive public health response to future threats. The Budget also provides $40 billion to the Office of the Assistant Secretary for Preparedness and Response (ASPR) to invest in advanced development and manufacturing of vaccines, therapeutics, and other diagnostics for high-priority threats. The Biden-Harris Administration also proposes $28 billion for the U.S. Centers for Disease Control and Prevention to enhance the public health system infrastructure, domestic and global threat surveillance, public health workforce development, public health laboratory capacity, and global health security.
  • Building Advanced Public Health Systems and Capacity – The FY 2023 Budget proposes $9.9 billion in discretionary funding to build capacity at the CDC and state and local levels, representing an increase of $2.8 billion over the 2021 enacted level. These resources are anticipated to improve the core immunization program, expand public health infrastructure and workforce in states and territories, and support efforts to modernize public health data collection.
  • Expanding Access to Vaccines – The Biden-Harris Administration proposes establishing a new Vaccines for Adults (VFA) program to provide uninsured adults with access to all vaccines recommended by the CDC Advisory Committee on Immunization Practices (ACIP) at no cost. The VFA program, designed to complement the Vaccines for Children (VFC) program, would reduce disparities in vaccine coverage and promote infrastructure for broad access to routine and outbreak vaccines.
  • Ending the HIV/AIDS Epidemic – The Budget includes $850 million across HHS to reduce new HIV cases, increase access to pre-exposure prophylaxis (PrEP), and ensure equitable access to services and supports for those living with HIV. The Budget proposes a new mandatory program to guarantee PrEP at no cost for all uninsured and underinsured individuals, provide essential wrap-around services through states, IHS, tribal entities, and localities, and establish a network of community providers to reach underserved areas and populations. These activities are aligned with the Administration’s National HIV/AIDS Strategy for the United States, 2022-2025.
  • Advancing Maternal Health and Health Equity – The FY 2023 Budget proposes $470 million to reduce maternal mortality and morbidity rates, expand maternal health initiatives in rural communities, implement implicit bias training for health care providers, create pregnancy home demonstration projects, and address the highest rates of perinatal health disparities. The Budget seeks to extend and increase funding for the Maternal, Infant, and Early Childhood Home Visiting program, as well as strengthen collection and evaluation of health equity data.
  • Expanding Access to Health Services for Low-Income Women – The Biden-Harris Administration provides $400 million, an increase of nearly 40 percent from the 2021 enacted level, to the Title X Family Planning Program, which provides family planning and preventive health services to low-income communities.
  • Accelerating Innovation Projects for Health – The FY 2023 Budget proposes a major investment of $5 billion for the Advanced Research Projects Agency for Health (ARPA-H) to drive innovation in health research and speed application and implementation of health breakthroughs. ARPA-H is anticipated to have an initial focus on cancer and other diseases such as diabetes and dementia. Funding for ARPA-H, along with additional funding for the National Institutes of Health (NIH), total a $49 billion request to support research that enhances health, lengthens life, reduces illness and disability, and spurs new biotechnology productions.

The release of the proposed budget by the President comes just weeks after Congress passed funding for the 2022 fiscal year and sets off a lengthy process in which Congress considers funding proposals for the next fiscal year.

A statement from HHS Secretary Xavier Becerra on the FY 2023 Budget is available here. The Biden-Harris Administration has published a series of fact sheets on the FY 2023 Budget; these include a general overview fact sheet and a fact sheet on pandemic preparedness and biodefense. The full FY 2023 Budget Proposal is available here.