Key investments focus on public health preparedness, behavioral health, health disparities, child health and wellness, and advancing research
The Biden-Harris Administration today submitted to Congress the President’s Budget for fiscal year 2023. The President’s Budget details his vision to expand on the historic progress our country has made over the last year and deliver the agenda he laid out in his State of the Union address—to build a healthier America, reduce the deficit, reduce costs for families, and grow the economy from the bottom up and middle out.
“Budgets are about more than dollars. They’re about values. And the President’s budget is a reflection of our values as a nation,” said Health and Human Services Secretary Xavier Becerra. “From addressing health disparities to strengthening behavioral health to investing in our children, this budget will help turn hardship into hope for millions of families. And it will ensure we can fulfill our department’s crucial mission of improving the health and well-being of the American people.”
The President’s FY 2023 budget request for HHS proposes $127.3 billion in discretionary budget authority and $1.7 trillion in mandatory funding for FY 2023. Highlights include:
- Responding to Emergent Challenges. The budget includes $81.7 billion in mandatory funding over five years across the Office of the Assistant Secretary for Preparedness and Response (ASPR), Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and Food and Drug Administration (FDA) to support President Biden’s plan to transform U.S. capabilities to prepare for and respond rapidly and effectively to future pandemics and other high consequence biological threats.
- Addressing Health Disparities. The maternal mortality rate in the United States is significantly higher than most other developed countries and is especially high among Black and Native American/Alaska Native women, regardless of their income or education levels. The Biden-Harris Administration is committed to promoting maternal health and ensuring equitable access to affordable, quality healthcare for our nation’s pregnant women and mothers. HHS invests over $470 million in funding across the Agency for Healthcare Research and Quality (AHRQ), CDC, the Health Resources and Services Administration (HRSA), NIH, and Indian Health Service (IHS) to reduce maternal mortality and morbidity. This includes increased funding to CDC’s Maternal Mortality Review Committees and other Safe Motherhood programs; HRSA’s State Maternal Health Innovation Grants program and a new Healthy Start program initiative; and other maternal health programs across HHS.
The budget also takes a historic first step toward addressing stark health disparities faced by American Indian and Alaska Native communities by proposing all IHS funding as mandatory beginning in FY 2023. Mandatory funding allows for growth beyond what can be accomplished through discretionary spending and provides the much-needed predictability and stability that will improve the operations of IHS, Tribal Health Programs, and Urban Indian Organizations. The budget includes $9.3 billion in FY 2023 – this is a $2.5 billion or 37 percent increase above the FY 2022 level. Funding would grow to $36.7 billion by FY 2032, an increase of 296 percent across the budget window, to begin closing documented funding gaps for direct health care services and infrastructure. The budget is informed by the long-standing recommendations of tribal leaders as well as numerous tribal consultations and will have a lasting impact on the health status of IHS patients across Indian Country.
- Strengthening Behavioral Health. The budget supports the President’s call for full parity between physical health and behavioral health care, comprising mental health and substance use disorder care. The budget addresses the significant connection between mental health and substance use by investing in a broad spectrum of behavioral health services. The budget provides a historic investment of $697 million in 988 and Behavioral Health Services, which will expand access to crisis care services for people with suicidal ideations or experiencing a behavioral health crisis. The National Suicide Prevention Lifeline will transition from a 10-digit number to 9-8-8 in July 2022.
The budget also includes new historic mandatory investments totaling $51.7 billion over ten years to improve behavioral health. Specifically:
- $7.5 billion for a new Mental Health Transformation Fund, to be allocated over 10 years to expand access to mental health services through mental health workforce development and service expansion, including the development of non-traditional health delivery sites, the integration of quality mental health and substance use care into primary care settings, and the dissemination of evidence-based practices.
- $4.1 billion to permanently extend funding for Community Mental Health Centers.
- $1.2 billion in additional outlays to strengthen consumer protections and improve access to behavioral health services in the private insurance market, including a proposal to require coverage of three behavioral health visits with no enrollee cost-sharing.
- $3.5 billion to improve Medicare mental health coverage and make access more affordable by modernizing Medicare fee-for-service mental health benefits, covering three behavioral health visits per year without cost-sharing, revising the criteria for psychiatric hospital terminations from Medicare, eliminating the 190-day lifetime limit on psychiatric hospital services, and applying the Mental Health Parity and Addiction Equity Act to Medicare.
- $35.4 billion to improve mental health access in Medicaid through increasing access to providers, expanding and converting the Demonstration Programs to Improve Community Mental Health Services into a permanent program to improve access to behavioral health services, establishing a performance fund to improve behavioral health, and encouraging utilization of clinically appropriate criteria for Medicaid covered behavioral health services.
The overdose epidemic has been one of the most significant public health challenges of our time, and the COVID-19 pandemic has had devastating impact on this ongoing crisis. According to CDC data, drug overdose deaths increased nearly 30 percent in 2020. This budget addresses the overdose epidemic by investing $11.0 billion, including $10.4 billion in discretionary funding, in programs addressing opioids and overdose-related activities across HHS. These are foundational programs supporting the Department’s Overdose Prevention Strategy.
The budget also proposes to remove the word “abuse” from the agency names within HHS—including the Substance Use and Mental Health Services Administration, the National Institute on Alcohol Effects and Alcohol-Associated Disorders, and the National Institute on Drugs and Addiction. Individuals do not choose to “abuse” drugs and alcohol; they suffer from a disease known as addiction. It is a high priority for this Administration to move past outdated and stigmatizing language that is harmful to the individuals and families that suffer from addiction.
- Investing in the Health and Well-Being of Children. How we care for our children impacts their success later in life, and HHS has a responsibility to ensure our programs serve children equitably. The budget provides $20.2 billion in discretionary funding for the Administration for Children and Families’ (ACF) early care and education programs, including $12.2 billion for Head Start, which provides services to more than a million children, pregnant women, and families every year throughout the country, and $7.6 billion for the Child Care and Development Block Grant. It also includes $450 million for Preschool Development Grants to increase the capacity of states to expand preschool programs. The budget invests $4.9 billion over 10 years in increased mandatory funding for services to stabilize families and prevent the need for foster care by allowing states to serve more children and families; seeks to improve outcomes for children in foster care by investing $1.3 billion over 10 years to support states in making kinship placements; and increases funding for services for youth who experienced foster care in transitioning to adulthood by $1 billion over 10 years.
- Advancing Research to Improve Health. HHS is at the forefront of key efforts to expand scientific knowledge and its application to healthcare, public health, human services, and biomedical research, as well as ensuring the availability of safe food and drugs. The budget continues to support innovative science and research to advance the health and well-being of all Americans. The budget includes an additional $92 million for CDC and FDA in response to President Biden’s Cancer Moonshot to reduce the death rate from cancer by at least 50 percent over the next 25 years. This effort will aim to diagnose cancer sooner by increasing access to screening, advancing new testing technologies, and supporting research to target specific treatments and therapies to patients speeding progress against the deadliest and rarest cancers, including childhood cancers. The Budget also includes $5 billion for the Advanced Research Projects Agency for Health, a bold new entity that will conduct innovative research including our ability to prevent, detect, and treat cancer.
For more information on the President’s FY 2023 Budget for HHS, please visit: www.hhs.gov/budget.
Additional Statements by HHS Officials
Jennifer Cannistra, Acting Assistant Secretary for Children and Families, Administration for Children and Families
“ACF’s fiscal year 2023 budget advances our mission to support child and family well-being through critical investments in areas such as child-welfare, early childhood development, family violence prevention services, supports for increased refugee arrivals, and increased capacity of the unaccompanied children program. The budget demonstrates ACF’s commitment to advancing equity and using whole-family approaches to improve service delivery, increase cross program effectiveness, and support economic mobility. ACF’s fiscal year 2023 budget is not only a statement of priorities, but also a driver of action to meet the unique needs of children, families, and communities and build a strong foundation for the next generation.”
Alison Barkoff, Acting Assistant Secretary for Aging, and Administrator, Administration for Community Living
“Our communities are stronger when everyone is included, everyone is valued, and everyone can contribute. This requires equitable access to health care, education, transportation, recreation, and other systems, resources and opportunities. ACL and HHS are committed to making community living an option for every American, regardless of age or disability, race or ethnicity, gender identity or sexual orientation, income or any other factor, and this budget aligns with that commitment.”
Robert Valdez, Ph.D., M.H.S.A, Director, Agency for Healthcare Research and Quality
“Science and research to improve healthcare delivery are key components of a high-quality, safe, equitable, and sustainable healthcare system. The COVID-19 pandemic put our system to the test and highlighted areas in need of improvement. We are pleased that the President’s Budget Request proposes a number of increases that will help us more closely respond to those aspects of healthcare. With almost $20 million requested for new Long COVID investments and $8 million in funding to improve diagnostic safety, we will be able to invest in research and tools to improve the quality of care for patients. This year’s funding will also support ongoing data collection and research that informs policy development on opioid and polysubstance abuse, primary care, maternal health and health equity.”
Rochelle P. Walensky, M.D., M.P.H., Director, Centers for Disease Control and Prevention
“Long term investments in our public health system are needed and necessary to address the profound public health challenges our nation is facing today. The FY 2023 President’s Budget request for CDC is designed to revitalize our nation’s fragile public health system as we continue our collective goal to protect the health of all Americans.”
Chiquita Brooks-LaSure, Administrator, Centers for Medicare & Medicaid Services
“The COVID-19 pandemic has had devastating effects on the health and wellbeing of people across the country – effects that will be felt for years to come. That’s why the President’s budget proposal would invest in the nation’s physical and mental health needs, as well as pandemic preparedness and resiliency. At CMS, we will work to advance equitable health care systems so that all people, especially the underserved, are able to access high quality care when and where they need it.”
Robert M. Califf, M.D., Commissioner, Food and Drug Administration
“The funding outlined in this year’s FDA budget request is critical to fulfilling the agency’s mission as we continue our work on a wide range of COVID-19 and non-COVID priorities. The FDA has focused our budget request on some of today’s most urgent needs such as human and animal food safety, medical device security and e-cigarette oversight. We also continue to look ahead at our role in public health, including at ways to modernize our efforts to keep pace with evolving science, technology and potential public health emergencies. Additional funding brings new ways to leverage opportunities to protect and advance the health of every American with reliable and science-based information. We look forward to continuing our work with Congress to help meet the critical public health challenges ahead.”
Carole Johnson, Administrator, Health Resources and Services Administration
“Health Resources and Services Administration programs have played a critical role in combatting the COVID-19 pandemic in the hardest hit communities across the country. Our budget request demonstrates our commitment to underserved and rural communities by expanding our vital work to improve access to quality health care services; transform mental health care; reduce maternal and infant mortality; and grow, diversify and promote the well-being of the health care workforce.”
Liz Fowler, Acting Director, Indian Health Service
“The President’s Fiscal Year 2023 Budget includes significant new investments for IHS, tribal and urban Indian health programs. The budget addresses many of the recommendations made by tribal leaders for several years. The bold action taken in the president’s budget demonstrates the Administration’s continued commitment to honor the United States’ treaty responsibility to Tribal Nations and strengthens the nation-to-nation relationship. Today’s announcement also acknowledges the need to identify long-term solutions to address IHS funding challenges, which directly impact the health of American Indian and Alaska Native people.”
Lawrence A. Tabak, D.D.S., Ph.D., Acting Director, National Institutes of Health
“The NIH request for a $62.5 billion total program level, including mandatory funding to advance the Administration’s vision for pandemic preparedness, is critical to addressing the new opportunities and historic challenges in biomedical research expected during the coming year. It will continue to lay the groundwork for a robust biomedical research enterprise for years to come as the nation adapts to meet the demands and possibilities in our changing world.”
Miriam Delphin-Rittmon, Ph.D., Assistant Secretary for Mental Health and Substance Use
Administrator and the leader of the Substance Abuse and Mental Health Services Administration
“Millions of people in America today are experiencing mental illness, coping with substance use disorder, or both – they deserve a healthcare system where everyone who needs help can access care when and where they seek it. This funding brings us closer to providing necessary wraparound services in all communities across the country.”