Policy Corner: March 10, 2023
Categories: Policy Corner Archives
President Releases FY 2024 Budget Recommendations
Yesterday, President Biden released his fiscal year (FY) 2024 budget recommendations and sent his requests to Congress. Next week, many of the federal agencies will host webinars to review the budget proposals more in depth. The next step in the appropriations process is for Congress to pass appropriation bills based on the President’s requests and the priorities of Congress. There will be many opportunities over the next few months to advocate for increases for programs of interest. Meanwhile, here is a cursory review of the budget.
U.S. Department of Health and Human Services (HHS)
The President’s budget proposes $144.3 billion in discretionary and $1.7 trillion in mandatory proposed budget authority for FY 2024 for HHS. The overall funding priorities for the are geared to:
- Extending Medicare solvency and lowering drug prices
- Expanding access to health care (e.g., increased funding for health centers)
- Increased funding for public health preparedness
- Transforming behavioral health care
- Improve well-being of children and seniors
- Advancing scientific knowledge to improve lives
- Expand the health care workforce
These priorities are reflected in many of the agencies’ budget proposals. Below are highlights of recommendations for HHS programs of interest to brain injury.
Administration for Community Living (ACL)
The President’s budget provides $3.1 billion for ACL, an increase of $493 million above the FY 2023 enacted level, in order to expand access to direct services; strengthen caregiving infrastructure; protect rights and prevent abuse; and support community living options for people with disabilities. Specifically, funding proposals of interest to brain injury:
- No increase for the TBI Program, $13M total, which is level funding.
- No increase for National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), $119M total, which is level funding.
- +4M for Lifespan Respite Care, a total of $14M.
- +2.5M for falls prevention among older adults, a total of $10M.
- +90M for Home and Community-based Services for older adults, a total of $500M.
- +33M for Independent Living Programs, a total of $161M.
- +4M for Assistive Technology, a total of $44M.
Centers for Disease Control and Prevention (CDC), National Injury Center
The FY 2024 budget includes $1.4 billion, an increase of $590 million above FY 2023 enacted to expand activities related to opioid overdose ($713 million), rape prevention ($102 million), firearm injury and mortality research ($35 million), the National Violent Death Reporting System ($35 million), and adverse childhood experiences ($15 million).
National Institutes of Health (NIH)
The FY 2024 budget includes an additional $462 million in base funding to continue All of Us and the Brain Research Through Advancing Innovative Neurotechnologies (BRAIN), both initiatives are supported by the 21st Century Cures Act. The additional funding holds these initiatives at their FY 2023 level, for a total of $1.2 billion that includes authorized and base funding. The All of Us program seeks to create one of the largest and diverse longitudinal biomedical datasets, leading to breakthroughs in medical research and treatment. The BRAIN initiative is transforming brain and nervous system research to cure and treat brain conditions.
U.S. Department of Veterans Affairs (VA)
The President’s budget for VA includes the largest increases for Veterans, their families, caregivers, and survivors. The budget includes increases for suicide prevention, to address homelessness, and to support women Veteran’s health care. The total FY 2024 request for VA is $325.1 billion, a $16.6 billion (+5.4%) increase above the FY 2023 budget enacted level.
U.S. Department of Education – Special Education
The President’s budget provides an additional $2.7 billion over FY 2023 enacted levels for Individuals with Disabilities Education Act (IDEA) programs, including a $2.1 billion increase for Part B grants to states and preschool programs, a $392 million increase for Part C grants to support proposed reforms to expand early intervention services for underserved children, a $150 million increase in grants to recruit and retain special education personnel, and a $20 million increase to improve outcomes for military-connected children with disabilities.
Senators Introduce Legislation to Build the Healthcare Workforce
This week, Senators Amy Klobuchar (D-Minn.), Susan Collins (R-Maine), Jacky Rosen (D-Nev.), and Thom Tillis (R-N.C.) reintroduced bipartisan legislation to build the healthcare workforce in rural and medically underserved areas. The Conrad State 30 and Physician Access Reauthorization Act would allow international doctors to remain in the U.S. upon completing their residency under the condition that they practice in areas experiencing doctor shortages. The Conrad State 30 and Physician Access Reauthorization Act extends the Conrad 30 program for three years, improves the process for obtaining a visa, and allows for the program to be expanded beyond 30 slots if certain thresholds are met. The bill also provides worker protections to prevent the doctors from being mistreated. A version of the bill was included as an amendment in the comprehensive immigration bill that passed the Senate in 2013.
Currently, doctors from other countries working in America on J-1 visas are required to return to their home country after their residency has ended for two years before they can apply for another visa or green card. The Conrad 30 program allows those doctors to stay in the United States without having to return home if they agree to practice in an underserved area for three years. The “30” refers to the number of doctors per state that can participate in the program.
The legislation is cosponsored by Senators Angus King (I-Maine), John Thune (R-S.D.), Jeff Merkley (D-Ore.), Shelley Moore Capito (R-W.Va.), Chris Coons (D-Del.), Rand Paul (R-Ky.), Dick Durbin (D-Ill.), Jerry Moran (R-Kans.), Jeanne Shaheen (D-N.H.), Roger Wicker (R-Miss.), Tina Smith (D-Minn.), Roger Marshall (R-Kans.), Richard Blumenthal (D-Conn.), Kevin Cramer (R-N.D.), Elizabeth Warren (D-Mass.), and John Boozman (R-Ariz).