On March 28, the Department of Health and Human Services (HHS) Secretary Xavier Becerra presented the President's HHS budget for FY 2023 at a press conference. Becerra began the conference by saying that “Challenges and opportunities are faced at HHS every day. And we're about taking those on, from taking control of COVID-19, reducing the cost of healthcare for Americans to making better care more available for more Americans. Maybe no American behind closing gaps in care, or as we'd like to say, find the fingerprints of fairness and inclusion on everything we do at HHS, and strengthening behavioral health. Those are just some of the critical priorities we have at HHS.”
“Before we get into the budget, I think it's important to say that we've made tremendous progress in fighting COVID,” Becerra continued. “But we know our work isn't finished. More importantly, I think it's important to make it very clear. Our resources are depleted. We need support from Congress to finish this fight. The Provider Relief Fund, which I know you're all very aware of, which Congress enacted and created resources to reimburse doctors and other medical providers for COVID care. Well, that fund is no longer accepting new claims for COVID-related testing and treatment services. On, or about, April 5, that fund will not accept any new claims for vaccination services as well. Doctors, nurses, pharmacists, labs, other providers, all of them will no longer be able to submit a claim for payment from that fund. Additionally, our current supply of monoclonal antibody treatments is projected to run out as soon as late May of this year. Last Monday, we had a cut the supply of monoclonal antibody treatments to every state by about 35 percent. We're now in the process of having to scale back plans to purchase more doses of preventative therapies for those Americans who are immunocompromised. There are serious consequences from a lack of funding at HHS. We will do what we can with what we have, and we will continue to work with Congress to secure more of those funds that we need.”
A press release, that was published at the time of the press conference on HHS’s website, says that “HHS proposes $127.3 billion in discretionary and $1.7 trillion in mandatory budget authority for FY 2023. This budget demonstrates the Administration's commitment to reinvesting in public health, research, and development to drive growth and shared prosperity for all Americans by making major investments in priority areas, including overdose prevention, mental health, maternal health, cancer, and HIV. It also advances equity through the work of the federal government and helps ensure our programs serve people of color and other marginalized populations with the opportunities promised to all Americans. The mandatory budget proposals in this budget improve care, drive quality, promote the well-being of the whole family, and focus on prevention.”
In the conference, Becerra commented, “Now to the budget. $128.8 billion in discretionary authority, $1.7 trillion and mandatory funding. Those dollars are focused on investments such as battling cancer through the President's Cancer Moonshot, mental health, maternal health, overdose prevention, and HIV. Some quick snapshots, and the team here is able to go into details if you'd like, at $1.7 billion in mandatory funding over five years to support long term pandemic preparedness, future pandemic preparedness against anything like COVID, again, any other kind of biological threat. We want to be prepared. It's going to take some money.”
“$20.8 billion in discretionary funding for behavioral health programs in FY 2023,” he continued. “That's $5.3 billion above the FY 2022 enacted budget. $470 million in funding to reduce maternal mortality and morbidity in FY 2023. All funding for the Indian Health Services under this budget would go towards mandatory accounts, rather than discretionary, that would help ensure and assure growth and more representative support for Indian Health Services—something that is a constitutional and trust obligation for the U.S. government. $20.2 billion in discretionary funding for the Ministry for Children and Families’ early care and education programs that's 2.7 billion over the FY 2022 enacted budget. $119 million to protect vulnerable older adults, an increase of $44 million over FY 2022 enacted.”
Becerra continued, “The name on this building [is] Hubert Humphrey. Senator Humphrey’s famous saying was, ‘The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in shadows of life, the sick, the needy, and the handicapped.’ That moral test takes life in HHS, his [the President] budget. It turns hardship into hope and opportunity into inclusion by building a healthier America. We hope Congress will enact it.”
When the floor was opened for questions, a member of the press asked, “What are the plans the administration has in the short term to help people, the uninsured especially, have access to COVID testing to help bridge those gaps?”
Becerra responded by saying that “We're going to continue to use all the resources we have. We're going to continue to provide support, we're going to continue to use those community health centers that have been so instrumental in getting shots in arms for so many people who [have] usually been left behind. We're going to continue to try to expand and make use of whatever authorities we have with telehealth; we're going to stretch where we can. But there's no question, if we don't get the resources that we need, we're just going to fall behind. And I don't think at a time when we're turning the page on this fight on COVID that we want to fall behind.”
Becerra then called on Carole Johnson, Administrator of the Health Resources and Services Administration (HRSA). Johnson said that “As you all know, at HRSA we work all day, every day to try to reach people in underserved, under resourced, and geographically isolated communities. And there's no doubt that the uninsured program has created a safety net during COVID for uninsured individuals across America. And as you all have told these stories over the last several days [about] how many people have come to depend on these critical services for testing, treatment, and vaccination. As the Secretary said, we'll do everything we can within the resources that we currently have to try to meet that need. We're directing people to COVID test.gov. We're directing people to find a health center. If they can access community health centers in your community, we're directing people to make sure that they check again, whether they're eligible for Medicaid, we're doing everything we can to try to get people access to these resources. But there is no doubt that the uninsured program is what is providing a critical bridge for people and why the consequence of not having funding matters.”
Charlotte, N.C.-based Premier, Inc. released a statement from Blair Childs, senior vice president of public affairs after the budget was announced. Childs says that “The health information collection system established during the pandemic provided inadequate information and burdens on providers. The Administration’s budget proposal to layer provider reporting mandates and penalties on top of this antiquated, highly manual and ineffectual system is misguided. What the nation needs is an automated, 21st century supply chain data infrastructure, as recommended by the GAO and Business Executives for National Security, that provides real-time, actionable data during times of emergencies. Premier strongly urges Congress to create this system by passing the Medical and Health Stockpile Accountability Act of 2022 (H.R. 6520)”
The full report, which can be found here, states that “While CMS was able to collect valuable information from certain providers during the public health emergency, CMS is limited and often faces significant delays around the collection and reporting of quality data. This proposal permits CMS to require all Medicare providers, suppliers, and contractors to collect and report relevant data under a declared public health emergency as specified by the Secretary, and to enforce these requirements with intermediate penalties such as civil monetary penalties. By permitting CMS to require relevant data submissions from all Medicare providers, suppliers, and contractors during public health emergencies, and setting clear and consistent expectations for data reporting and allowing more flexible enforcement, CMS could improve compliance and better inform government response to public health emergencies. [Budget Neutral]”
Interestingly, a Health Affairs study entitled, “National Health Expenditure Projections, 2021–30: Growth To Moderate As COVID-19 Impacts Wane,” was released March 28 with new estimates from the Office of the Actuary (OACT) at the Centers for Medicare and Medicaid Services (CMS). “New estimates released today from the OACT at CMS and published online in Health Affairs project a rate of national health spending growth of 4.2 percent for 2021, reaching nearly $4.3 trillion, after the 9.7 percent growth seen in 2020 that was driven by large inflows of federal supplemental funding to mitigate the impacts of the COVID-19 pandemic on the health sector,” the study says. “Average rates of health spending growth of 4.9 percent and 5.3 percent are projected for 2022–24 and 2025–30, respectively.”
