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Biden's budget sees HHS building on past success

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Mar 11, 2024
Photo illustration of Joe Biden over a blue background with elements of ballots.

Photo illustration: Brendan Lynch/Axios. Photo: Alex Wong/Getty Images)

President Biden's 2025 budget proposes relatively flat funding for the Department of Health and Human Services, along with a mandate to expand on some of the most noteworthy drug reforms in the Inflation Reduction Act.

Why it matters: It's starter dough for the Biden campaign's health care rhetoric — and a look at the proposals that could carry over into a second term.

What's inside: The blueprint seeks $130.7 billion in funding for HHS, a 1.7% increase from 2023 enacted levels.

  • For context, Biden proposed $144 billion in funding for HHS in FY24, which was an 11.5% increase over the prior year.
  • Congress still hasn't settled on the FY24 spending for the Labor-HHS section of the next minibus.

Zoom in: While a more detailed breakdown is due out this afternoon, here are some toplines from the budget document:

  • It would expand the IRA's $35 insulin price cap and $2,000 out-of-pocket drug cost cap beyond Medicare to the commercial market, along with expanding the number of drugs subject to drug price negotiation.
  • It would make permanent the enhanced Affordable Care Act subsidies in the IRA, which are due to expire in 2025.
  • To extend the solvency of Medicare's hospital insurance trust fund, it calls for taxing high-income individuals and using the savings from drug price negotiations. It's a repeat from last year's budget.
  • There's increased funding for mental health care efforts, such as the 988 suicide hotline. The document also seeks Medicare parity between behavioral health and physical conditions — also a priority of Senate Finance Chair Ron Wyden — plus more for state opioid grants.
  • It again proposes a national program to expand Hepatitis C treatment and a vaccines for adults program, as well as a new effort to guarantee access to PrEP.

By the numbers: The administration highlighted several funding increases.

  • Putting $150 billion over 10 years to expand Medicaid home and community-based services.
  • $390 million for the Title X family planning funding program, which is a 36% increase from the 2023 level. House Republicans notably proposed completely eliminating funding for the program in the FY24 Labor-HHS bill.
  • A $2 billion increase for the Cancer Moonshot, across programs at NIH, FDA, CDC and ARPA-H.
  • Doubling existing funding for the Office of Research on Women's Health at NIH.
  • An increase of $82 million for maternal health efforts, including reducing maternal mortality.
  • $499 million more for CDC's prevention and public health funding, bringing the total to $9.8 billion in discretionary and mandatory funding.

What they're saying: "The budget invests in America and the American people to grow the economy from the middle out and bottom up," said White House budget director Shalanda Young, on a press call this morning.

What we're watching: The flat funding for HHS could portend an austere year for the department, depending on how Congress responds.

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