March was an active month with the March 1 State of the Union, March 15 signing into law the FY2022 Omnibus Appropriations bill, and March 28 release of President Biden's FY2023 budget proposal. The House and Senate Budget and Appropriations Committees have jumped right into organizing budget hearings and collecting appropriations submissions, including community project funding requests from constituents. Many more people have also returned to Capitol Hill, holding meetings in offices and hearings in person. Congress aims to draft the 12 appropriations measures by summer recess and there is still a hard push for several bills: COVID funding, ARPA-H authorization, Cures 2.0, FDA user fees legislation, National Defense Authorization Act, America COMPETES Act and much more.
FY2020 BUDGET HIGHLIGHTS
President Bident unveiled his FY2023 budget proposal that covers everything from pandemic preparedness to NSF research acceleration to Defense procurement. You can find the agencies and issues of most interest by accessing the White House fact sheets. Some highlights G2G found particularly interesting include:
- Total Funding: The FY23 budget request seeks $127.3 billion in discretionary budget authority for the Department of Health and Human Services (HHS), a $13.3 billion (11.6%) increase.
- Research: The FY23 budget request allocates $49 billion to the NIH for research, which is a $4 billion increase, and $470 million across AHRQ, CDC, HRSA, NIH and the Indian Health Service to reduce maternal mortality and morbidity with $86 million specifically focused on equity. The NIH budget includes $5 billion for ARPA-H, which has yet to be authorized by Congress although it included $1 billion in funding in the FY2022 Omnibus law.
- Pandemic Preparedness: The FY23 budget request proposes to establish an $82 billion mandatory fund to support both domestic and international pandemic preparedness efforts including $6.5 billion at USAID and the State Department as well as significant additional resources at CDC ($28 billion), NIH ($12 billion), Assistant Secretary for Preparedness and Response that oversees BARDA ($40 billion) and FDA ($1.6 billion).
- Maternal Health: The FY23 budget request allocates $276 million, a $202 million increase over FY22, across HRSA to reduce maternal mortality and morbidity.
- Mental Health: The FY23 budget request seeks $275 million for the Department of Labor over ten years to enhance enforcement of the 2008 Mental Health Parity and Addiction Equity Act, as well as $125 million in mandatory funding for the HHS over five years to enforce mental health and substance use disorder parity requirements.
- Patient Safety: The FY2023 budget request includes $79 million for AHRQ for patient safety research to reduce patient safety risks and harms, support patient safety organizations, and address healthcare-associated infections – will support the Comprehensive Unit-based Safety Program and Network of Patient Safety Databases and invest $10 million in 5 Diagnostic Safety Centers of Excellence with each focused on specific conditions, populations, or settings of diagnostic safety with at least one Center focusing on each of the “Big Three” conditions: cancer, heart disease and infectious disease which together account for more than 50% of diagnostic errors annually. In sum, 12 million Americans suffer a diagnostic error each year and more than 4 million experience severe consequences because of these errors or from diagnostic delays – all costing $100 billion annually.
- Digital Health: The FY23 budget request includes $45 million to HRSA to promote telehealth, a 25% increase over FY22, plus $18 million for AHRQ digital healthcare research portfolio, a $2 million increase over FY22. AHRQ’s Digital Healthcare Research Program provides foundational research to ensure that digital healthcare systems are designed to improve quality, safety and equity while not resulting in excessive burden on physicians. The FY23 budget will support the establishment of 2 Centers of Excellence in Telehealth Implementation
Defense and Veterans
- Total Funding: The FY23 budget request seeks $813.3 billion for national defense, $773 billion is for DoD, which is a $30.7 billion increase (4.1%) above FY2022.
- Personnel: The FY23 budget request includes 4.6% pay increase for military and civilian personnel and funds $15 per hour minimum wage for the federal workforce. It also supports talent management initiatives to improve racial and gender diversity throughout the military career life cycle and includes $479 million to implement the Independent Review Commission on Sexual Assault in the Military recommendations.
- Readiness: Focused on incorporating multi-dimensional and long-term readiness beyond operational readiness, the FY23 budget request funds the Joint Force Readiness with $134.7 billion, an increase of $6.3 billion (4.9%) over the FY22 enacted level. Among the services, Navy has the highest readiness funding at $47.4 billion, then Air Force $35.5 billion, Army $29.4 billion, Marine Corps $4.1 billion, and Space Force $3 billion.
- Cybersecurity: Cyber resiliency of the Joint Force is the top priority. Cyberspace activities overall are allocated $11.2 billion in the FY23 budget request.
- Air Force: The total funding for Air Force is $56.5 billion with $11 billion for the Joint Strike Fighter, which funds 61 F-35 planes.
- Navy: The total funding for Navy is $40.8 billion which funds 2 Virginia class submarines.
- Army: Focused on combat effective ground forces, the budget includes $12.6 billion total with $381 million for 72 armored multi-purpose vehicles and $1.1 billion for 3,721 Joint Light Tactical Vehicles.
- Research: The FY2023 budget request continues DoD’s focus on modernizing and innovating by providing the largest investment ever in RDT&E—more than 9.5% over the FY2022 enacted level. Science and Technology (S&T) investments include: RDT&E request $130.1 billion, S&T $16.5 billion, Microelectronics $3.3 billion, 5G $250 million, and Industrial Base Analysis and Sustainment program, including investments in Artificial Intelligence, chemical production, bio-manufacturing, and rare earth element supply chains.
- Climate Crisis: The FY23 budget request allocates $3.1 billion toward addressing the climate crisis – spanning from operational energy and power sourcing to S&T to contingency preparedness.
- Defense Health: The Defense Health Program for continued COVID-19 clinical testing and public health efforts is set to receive $188 million in the FY23 budget request. The expanded surveillance activities, including wastewater surveillance Whole Genomic Sequencing of COVID variants plays a key role in the president’s proposal.
- Veterans Health: Department of Veterans Affairs (VA) Medical and Prosthetic Research is allocated $916 million in discretionary spending for VA research in the FY2023 budget request as well as $30 million for the VA’s American Rescue Plan allocation, for a total investment of $946 million. This is a $64 million or 7.3% increase over FY2022 enacted funding levels.
See full fact sheets from the White House for each federal department and agencies here.