On May 28, President Biden released the remaining details of his Administration’s Fiscal Year (FY) 2022 proposed budget. The budget proposes $1.5 trillion in discretionary spending, including substantial increases for programs within Department of Health and Human Services, and non-defense discretionary spending overall.
The president’s budget is a first step in the annual appropriations process. Typically introduced in the first two weeks of February, President Biden’s budget was delayed, which is not atypical for a new, incoming Administration. The budget release was further deferred when the new Administration chose to prioritize passage of COVID relief measures in the months following President Biden’s inauguration.
Some highlights from the proposed budget that may be of interest to IHPC members include:
• National Institutes of Health (NIH)—The budget proposes funding the NIH at $52 billion in FY 2022, a $9 billion increase over the agency’s FY 2021 enacted level. The bulk of this increase, $6.5 billion, would be used to establish the Advanced Research Projects Agency-Health (ARPA-H) within the NIH. The Administration has touted the proposed ARPA-H as a public-private accelerator for research on treatments for cancer, Alzheimer’s, and other diseases.
• National Center for Complementary and Integrative Health (NCCIH)—Located within the NIH, the NCCIH would, under the president’s proposal, receive $184.3 million in FY 2022, an increase of $30.2 million or 19.6 percent above the agency’s FY 2021 enacted level. Of this amount, $26 million would be allocated to expand the Center’s research into pain and pain management.
• Health Services and Research Administration (HRSA)—The Biden Administration proposes $12.65 billion for HRSA, which represents a $496.5 million, or 4.1 percent, increase above the FY 2021 enacted level. The Community Health Centers program within HRSA would receive a $50 million increase in discretionary funding over the program’s FY 2021 level. This funding level would support awards for an additional 140 health centers, resulting in the total participation of approximately 440 health centers nationwide.
• Veteran’s Administration (VA)– The total FY 2022 request for the VA is $269.9 billion (with medical care collections), a 10% increase above the agency’s FY 2021 enacted level. The budget flat funds the Whole Health System, proposing $73.6 million (same as the program’s FY 2021 spending level) in FY 2022.
• Other notable trans-agency public health priorities featured in the president’s budget include $220 million to address maternal mortality and $11.2 billion for programs to address the opioid epidemic and substance abuse disorders.
The House and Senate Appropriations Committees are currently holding hearings and moving towards consideration or “mark up” of the 12 Fiscal Year 2022 appropriations bills. While President Biden’s budget proposal is referenced as part of these deliberations, Congress never accepts the President’s budget in its entirety. The House Appropriations Committees will consider all 12 spending bills before mid-July with the goal of bringing them to the full House before the second week of August. The Senate Appropriations Committee, although holding hearings, has not released a mark up schedule nor indicated when it plans to bring its FY 2022 appropriations bills to the Senate floor.
Fiscal Year 2022 begins on October 1, 2021, leaving little time for the House and Senate to pass and then reconcile differences in their respective appropriations bills. This scenario increases the likelihood that Congress and the Administration will have to enact a “continuing resolution (CR)” or a series of CRs, to fund federal agencies at last year’s level and keep the federal government operational when the new fiscal year begins. IHPC will continue to monitor and report on developments related to the FY 2022 appropriations process.