Public Policy News – June 2021
President’s Budget Proposes Significant Education Spending
President’s Budget Proposes Significant Health Spending
HHS Secretary Testifies on FY 2022 Budget Request
Department of Education Continues Regulatory Push
NIH Holds Advisory Committee to the Director Meeting
On May 28 President Biden released the full details of his first budget proposal to Congress. President Biden’s top fiscal year (FY) 2022 budget priorities are public health, climate and clean energy, innovation, and education. His proposal would provide $769 billion in nondefense spending—a $123 billion increase or 16% over the FY 2021 enacted level. Under the president’s budget request, funding for Department of Education (ED) discretionary programs would be $102.8 billion, a 41% increase compared to the FY 2021 enacted level. The Pell Grant program maximum award would increase by $1,875 for the 2022–2023 school year, and eligibility for Pell and campus-based aid would be extended to recipients of the Deferred Action for Childhood Arrivals program.
The budget request for ED includes the president’s FY 2022 budget priorities and proposals previously outlined in the American Jobs Plan and the American Families Plan (AFP). The request also
- proposes to invest $14.3 billion for free community college tuition and incorporates the AFP’s proposal to subsidize tuition at historically Black colleges and universities (HBCUs), tribal colleges and universities (TCUs), and minority-serving institutions (MSIs) for families earning less than $125,000 a year;
- calls for a competitive Health Professionals of the Future grant program for HBCUs, TCUs, and MSIs “to create or expand graduate programs that prepare students for high-skilled jobs in the health care sector and help diversify the healthcare sector pipeline”; and
- includes $1 billion for a new School-Based Health Professionals grant program to support increasing the number of counselors, nurses, and mental health professionals in schools.
The Biden Administration’s budget request would provide $131.8 billion in discretionary funding and $1.5 trillion in mandatory funding for activities at the Department of Health and Human Services. The budget request would seeks to bolster pandemic preparedness and response efforts, address mental health and substance use disorders, mitigate health inequities, and tackle community violence. New priorities include efforts to strengthen the nation’s public health infrastructure and workforce, expand activities across the agency to help eliminate health disparities and promote cultural competency, and enhance support for research and interventions to reduce violence across the nation’s communities.
The budget request includes an additional $150 million to expand the Centers for Disease Control and Prevention’s (CDC’s) social determinants of health program by funneling additional funds to states and territories. Additionally, the CDC’s climate and health program, which focuses on public health implications of climate extremes on health risks and the use of evidence-based interventions targeting at-risk and vulnerable populations, would receive an additional $100 million in fiscal year (FY) 2022 to be disseminated to all states and territories. The budget request includes
- $11.2 billion across HHS to continue initiatives that address opioid and substance use disorder;
- $165 million for the Health Resources and Services Administration’s (HRSA’s) Rural Communities Opioid Response Program (a $55 million increase above the FY 2021 enacted level);
- $220 million for the Behavioral Health Workforce Education and Training program (up $75 million); and
- $51 million in the Substance Use and Mental Health Services Administration’s (SAMHSA’s) criminal and juvenile justice programs (an increase of $45 million over the FY 2021 budget request), $375 million in the Certified Community Behavioral Health Clinics grant program, and $17 million for SAMHSA’s Minority Fellowship Programs.
Lewis-Burke’s full analysis of the budget request can be found here.
Department of Health and Human Services (HHS) Secretary Xavier Becerra testified before the Senate Labor, Health and Human Services, Education and Related Agencies Appropriations Subcommittee to discuss priorities under the president’s fiscal year (FY) 2022 budget request for HHS. Chair Patty Murray (D-WA) described the budget request as representing a “world of change” in comparison to the last few years and praised proposed funding increases for the Centers for Disease Control and Prevention; investments in eradicating the opioid and HIV/AIDS epidemics; and support for addressing maternal and infant mortality, particularly among underserved populations. Ranking Member Roy Blunt (R-MO) noted some areas of agreement, including increases to the National Institutes of Health and the proposal for a new Advanced Research Projects Agency–Health (ARPA-H) within the agency, but joined other Republican members on the committee to criticize the amount of funding dedicated to the Unaccompanied Children Program. He also highlighted the need for parity between defense and nondefense discretionary spending.
Secretary Becerra noted the Biden Administration’s commitment to plan for the next public health crisis through enhanced preparedness and response capabilities, tackle substance use disorders, provide support for firearm prevention research, and expand access to affordable health care. Secretary Becerra also touched on the proposal for ARPA-H, stating, “this major investment in federal research and development will leverage ambitious ideas to build transformational innovation through health research and the application and implementation of health breakthroughs.”
Other topics of discussion included increasing transparency and accountability for the Provider Relief Fund; providing better authority to expand the use of telehealth, especially when the public health emergency declaration ends; considering more support for programs to curb the opioid epidemic, including research on chronic pain management and treatment alternatives; and expanding the commitment to address health disparities and social determinants of health across HHS.
The Office for Civil Rights (OCR) in the Department of Education (ED) continues efforts to implement President Biden’s March 8 executive order regarding sexual discrimination. OCR released a letter to students, educators, and stakeholders on April 6 to announce the ongoing review of Title IX of the Education Amendments of 1972 and that ED plans to solicit public comment on the current Title IX regulations. In June ED held a series of Title IX public hearings. More details on those hearings can be found here.
The Office of Postsecondary Education has also announced public hearings to receive feedback on potential issues for future rulemaking sessions, including borrower defense for students defrauded by institutions of higher education, gainful employment rules, and loan repayment and cancellation policies for select student populations. The public hearings will be held virtually on June 21, 23, and 24. Other issues that may be considered include Pell Grant eligibility for prison education programs and public service loan forgiveness.
The National Institutes of Health (NIH) Advisory Committee to the Director (ACD) held its meeting remotely on June 10–11. NIH leadership spent much of the meeting discussing the agency’s COVID-19 research efforts. With more than 50% of the nation now fully vaccinated, NIH leadership will address vaccine hesitancy and focus on replicating the success of its COVID-19 research efforts for other health challenges such as cancer, Alzheimer’s disease, and diabetes. NIH Director Dr. Francis Collins expects the newly proposed Advanced Research Projects Agency for Health to accelerate these medical breakthroughs.
NIH remains focused on COVID-19 research through its trans-NIH initiatives such as Rapid Acceleration of Diagnostics (RADx), which expands diagnostics for testing populations that have yet to be vaccinated. NIH recently released the RADx–Underserved Populations Return to School Diagnostic Testing Approaches funding opportunity to help develop COVID-19 diagnostic testing for children too young for vaccine eligibility. Also, the Community Engagement Alliance (CEAL) Against COVID-19 Disparities program is working to address the disparate impact of COVID-19 on communities of color through community partnerships to eliminate misinformation and reduce vaccine hesitancy. NIH hopes the CEAL approach will also address long-standing health disparities in the nation.
NIH leadership also provided updates on the agency’s efforts to promote a safe and inclusive biomedical research environment. Dr. Michael Lauer, deputy director for extramural research, reported on the progress to implement the ACD Working Group Recommendations on Changing the Culture to End Sexual Harassment. Dr. Lauer highlighted new NIH guidelines to “enhance diversity and create safe environments at conferences supported by NIH grants” (NOT-OD-21-053) and a notice of special interest calling for the addition of “harassment as an area of interest to research to understand and inform interventions that promote research careers of individuals in the biomedical sciences” (NOT-OD-21-068). Dr. Marie Bernard, NIH chief officer for scientific workforce diversity, discussed the UNITE Initiative, the agency’s suite of programs aimed at enhancing diversity, equity, and inclusion. The presentation included progress reports from UNITE’s five working committees. NIH anticipates releasing several reports over the coming months, with a full analysis of the request for information issued for comments to advance the UNITE Initiative; an analysis of intramural and extramural listening sessions; and a survey of diversity, equity, and inclusion activities at each NIH institute.