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This post has been updated. It was originally published on June 4, 2025.

Public Health Implications of House-Passed Reconciliation Bill Public Health Implications of One Big Beautiful Bill Learn how the House-passed reconciliation bill impacts critical public health programs in this legislative alert. On May 22, the House of Representatives passed the One Big Beautiful Bill Act (H.R. 1) by a 215-214 vote. This reconciliation bill proposes changes to Medicaid, the Affordable Care Act, food nutrition programs, and the nation’s debt limit, among other things. If this bill were signed into law, several potential impacts to states include: Increased coverage loss for noncompliance with work requirements. Future challenges for states to fund their share of Medicaid and SNAP. Limitations on how states incentivize high-quality care or improve access to care as a result of caps on future state-directed payments. Potential increase in food insecurity for vulnerable populations. For more information, view the full bill text of the legislation. Outlook The bill now moves to the Senate, and the ASTHO Government Affairs team is closely monitoring consideration of this legislation. It is unclear which provisions will be included in the Senate’s bill, considering specific rules that require their bill to address budgetary matters primarily. Furthermore, several Republican senators have expressed concerns about the cost and scope of changes proposed in the House bill. The Senate Majority Leader has expressed interest in passing a bill before July 4. Medicaid Work Requirements Requires states to implement work requirements by December 31, 2026, and the Secretary of HHS to develop guidance for states to implement these requirements by December 31, 2025. The work requirements would require able-bodied adults aged 19-64, without dependents, to work (or perform other qualifying activities) for at least 80 hours a month. There would be exemptions for certain individuals (e.g., pregnant women, those with serious medical conditions, and tribal members). States may issue hardship waivers for specific individuals facing short-term hardship (e.g., inpatient care, related outpatient care, natural disasters, high unemployment rate in county). States would be required to verify an individual's compliance with work/community engagement requirements within one month of enrollment and one month before redetermination. States would be responsible for verifying compliance, establishing outreach plans to make individuals aware of new requirements, and developing an appeals process before disenrollment. Medicaid Expansion Lowers the federal match for the expansion population (from 90% to 80% FMAP) if a state “provides any form of financial assistance, through Medicaid or under another program established by the state” that allows undocumented immigrants, except for children and pregnant women. It is important to note that 14 states and D.C. provide fully state-funded coverage for children and seven states provide for adults regardless of their immigration status. Sunsets a temporary 5% enhanced FMAP for new states that expand Medicaid after the bill's enactment. Requires states to impose cost-sharing for individuals in Medicaid expansion with incomes up to 100% of the federal poverty level. Cost-sharing may not exceed $35 per service or a total of 5% of an individual’s income and would not apply to primary and other preventive care. Requires states to conduct eligibility determinations for their expansion population every six months by December 31, 2026. Provider Taxes Prohibits states from establishing new provider taxes and freezes existing provider taxes at current rates. Overlaps with a CMS proposed rule released May 12, 2025. Modifies the criteria HHS must use to determine whether taxes are redistributive when considering a waiver of uniform tax requirement. May create future challenges for states to fund the state share of Medicaid. States would need to increase state general funds or cut benefits/coverage. All states except Alaska have provider taxes. Provider taxes account for at least 17% of the state share. However, some states rely on the provider tax for a higher amount — Michigan, New Hampshire, and Ohio use provider taxes to fund more than 30% of the state share. State-Directed Payments Caps future state-directed payments at 100% and non-Medicaid expansion states at 110% of the Medicare rate. Most states require managed care plans to provide add-on payments to health providers (known as directed payments) to incentivize high-quality care, train new providers, or support safety net providers. Would limit a state’s future options to incentivize high-quality care or improve access to care. CMS Eligibility/Long-Term Care Staffing Rule Delays Delay the implementation of eligibility rules for Medicaid, CHIP, Basic Health Program, the Medicare Savings Program, and long-term care staffing standards until 2035. Delaying the eligibility rules may result in additional individuals losing coverage and associated federal cost savings. Reproductive Health and Gender Transitions Prohibits the use of federal Medicaid funds for gender transitions for minors and adults. Also prohibits federal funding for Planned Parenthood and other abortion providers described as “nonprofit organizations, that are essential community providers that are primarily engaged in family planning services or reproductive services, provide for abortions other than the Hyde Amendment exceptions, and which received $1,000,000 or more.” Other Provisions Clarifies language related to required Medicaid coverage for the 90-day period while an individual verifies citizenship or immigration status. Also allows for federal match only if the individual is certified after 90 days. Requires states to check the Social Security Administration’s Death Master File quarterly to disenroll deceased individuals and providers by January 1, 2028. Requires states to conduct monthly checks of Medicaid providers and disenroll providers/suppliers terminated in other states by January 1, 2028. Requires HHS to revise treatment of federal cost savings and requires the Secretary to certify Section 1115 waivers as well as develop a new methodology for applying budget neutrality “savings” in a waiver extension period. Requires HHS to create a system to prevent Medicaid enrollment in multiple states and establishes a process to regularly collect enrollee addresses by October 1, 2029. Requires Medicaid agencies to regularly obtain addresses for enrolled individuals and verify using certain data sources. Requires HHS to administer a survey to pharmacies that receive Medicaid payment of drug prices to determine the national average drug acquisition costs of covered outpatient drugs. Bans spread pricing in Medicaid or when a Pharmacy Benefit Manager (PBM) charges a health plan more for a medication than it pays the pharmacy that dispenses it, keeping the difference as profit. Affordable Care Act Requires the federal government to reimburse health plans for cost-sharing reductions (CSR), which would reduce silver plan premiums and the size of the premium tax credits. This would also block CSRs for plans that provide abortions, except to save the life of a mother, rape, or incest. Requires a new income and eligibility verification process for the following by January 1, 2026: Removes special enrollment periods for individuals with income changes. Modifies definition of “lawfully present” immigrants for eligibility in ACA marketplace. Prohibits gender transition procedures. Improving Americans' Access to Care Requires PBMs in the Medicare Part D prescription drug program to share information with plan sponsors on their business practices, including formularies. Permits drug product sponsors to have one or more orphan drug indications, therefore permitting them to be exempt from the Drug Price Negotiation program. Updates the timeline by which a manufacturer is eligible for negotiation until an orphan drug receives a non-orphan indication. Requires states to establish a process for enrolling out-of-state pediatric providers as participating providers without additional screening procedures. Delays the Medicaid disproportionate share hospital (DSH) payment reductions set for $8 billion reductions per year — originally planned to take effect for FY 2026-2028 — to take effect for FY 2029-2031. Also, delays reduction to Tennessee’s DSH payments, set to expire in FY 2026. Revises the Medicare physician fee schedule to replace the split fee schedule conversion factor with a new single conversion factor based on a percentage of medical inflation — the Medicare Economic Index — to take effect as of January 2026. Food Nutrition Programs Redefines the Thrifty Food Plan (TFP) by tying it to a specific 20-50 year old adult male and female and two children (ages 6-8 and 9-11) reference family. It also requires cost neutrality for future reevaluations of the TFP’s market baskets starting no sooner than October 1, 2028, and at five-year intervals after that. Revises the Supplemental Nutrition Assistance Program (SNAP) by implementing work requirements for able-bodied adults without dependents (ABAWD). It also raises the age of a dependent child, for whom a parent/caretaker is exempt, from under six to under seven, and codifies exemptions for individuals under 18 or over 65. Codifies exemptions for individuals under 18 or over 65, those who are medically certified as unfit for employment, pregnant women, homeless individuals, veterans, and former foster youth up to the age of 24. Exemptions for homeless individuals, veterans, and former foster youth are set to expire on October 1, 2030. Limits state waivers for ABAWD to 12 months and only for counties with an unemployment rate exceeding 10%. ABAWD who do not meet the work requirements, do not qualify for other specific exemptions, or live in an area with exemptions would be subject to losing their SNAP benefits after three months. Creates

Learn about federal health agencies' plans to operate during the upcoming government shutdown in this legislative alert.

President Trump Releases FY26 Budget Proposal On the morning of May 2, the White House released President Trump’s FY26 discretionary budget proposal, which outlines the Administration’s funding priorities for the upcoming fiscal year beginning on October 1, 2025. It does not include mandatory proposals for programs like Medicaid. It is important to note that this proposal presents top-level requests for each federal agency and does not include details such as funding tables that are usually shared as part of congressional justification documents transmitted from agencies to Congress. We are reviewing this document closely and what follows is a preliminary review. As a reminder, Congress has the authority to approve, reject, or modify the Administration’s budget recommendations. Therefore, it is critical that public health leaders continue to educate and inform members of Congress about the impact of public health funding and the need for sustainable and predictable resources for governmental public health activities at federal, state, territorial, and local agencies. A complete budget request with additional details such as congressional justifications and mandatory funding proposals is expected to be released by the White House in the coming weeks. Following the more detailed budget release, the ASTHO government affairs team will analyze the budget when additional information becomes available. For more information view the FY26 budget proposal. Revitalizing Federalism Doc - Leg Alert - 20250502 Trump FY26 Budget Proposal <!-- We strongly encourage state and territorial health leaders to review the budget document on federalism carefully, because it calls for resetting the balance between federal and state government. --> Public Health Funding Proposals Note this information is pulled directly from the budget documents released this morning by the Administration. Overall, the budget proposes a $163 billion, or 23%, reduction in non-defense discretionary spending. Prioritizes $500 million in funding for Make America Healthy Again by, “providing resources to HHS that would allow the Secretary to tackle issues related to nutrition, physical activity, healthy lifestyles, over-reliance on medication and treatments, the effects of new technological habits, environmental impacts and food and drug quality and safety.” Specifically: Supports the creation of food boxes that would be filled with commodities sourced from domestic farmers and given directly to American households. Prioritizes food safety nationwide including support for increased production and demand for services. CDC The budget “maintains more than $4 billion for CDC” and decreases funding by $3.6 billion. “Refocuses CDC’s mission on core activities such as emerging and infectious disease surveillance, outbreak investigations, and maintaining the Nation’s public health infrastructure, while streamlining programs and eliminating waste.” Merges multiple programs into one grant program and proposes to give states flexibility to address local needs. Specifically, the budget proposes consolidating funding for infectious disease and opioids, viral hepatitis, sexually transmitted infections, and tuberculosis programs into one grant program funded at $300 million. Eliminates the following: National Center for Chronic Diseases Prevention and Health Promotion National Center for Environmental Health National Center for Injury Prevention and Control Global Health Center Public Health Preparedness and Response Preventive Health and Human Services Block Grant The budget refocuses CDC on emerging and infectious disease surveillance, outbreak investigations, preparedness and response, and maintaining the nation’s public health infrastructure. HRSA The budget “maintains $6 billion for activities that were formerly part of HRSA” and decreases funding by $1.7 billion. The budget consolidates a variety of programs that were “formerly part of HRSA,” and proposes reductions or eliminations, including the following: $74 million decrease in funding for Ryan White HIV/AIDS program activities that do not focus on core health care and support services directly to patients, such as education and training. $274 million decrease in funding for Maternal and Child Health programs, which are duplicative of other federal programs or could be addressed through block grant funding. $1 billion decrease in funding for health workforce programs that provide scholarships and support for individuals to enter “high-paying medical careers.” $286 million decrease in funding for Title X Family Planning programs. SAMHSA The budget “maintains $5.7 billion for activities that were formerly part of SAMHSA” and decreases funding by $1 billion. The budget proposes to refocus activities that were formerly part of SAMHSA by eliminating funding for the following: Mental health programs of regional and national significance. Substance use prevention programs of regional and national significance, and substance use treatment programs of regional and national significance. These programs either duplicate other federal spending or are too small to have a national impact. According to the budget document text, “These eliminations are also supported by mental health and substance use disorder block grant funding.” ASPR Decreases funding by $240 million for ASPR. Eliminates funding for ASPR’s Hospital Preparedness Program. This proposal, “allows States and Territories to properly scope and fund hospital preparedness.” Other HHS Programs Eliminates the Sexual Risk Avoidance Program. Eliminates the Teen Pregnancy Prevention program, which is “similar to the mandatory Personal Responsibility Education program administered by Administration for Children and Families.” Reduces funding levels for the HHS Office of Minority Health and Office on Women’s Health to promote efficiency and invest in areas that align with Administration priorities. These programs were previously under the Office of Assistant Secretary of Health. Consistent with the recently announced HHS reorganization, the budget relocates these programs within the newly formed Administration for a Healthy America. FEMA The budget cuts FEMA grant programs, refocusing the agency on emergency management. The budget would end activities such as webinars promoting the distribution of disaster aid based on “intersectional” factors like sexual orientation and prioritizing “investment in diversity and inclusion efforts...and multicultural training” over disaster prevention and response. FEMA will no longer “instill equity as a foundation of emergency management.” Other eliminated programs, such as National Domestic Preparedness Consortium, lack authorization from Congress and duplicate the efforts of existing federal and state programs. EPA Provides $124 million, a $9 million increase in funding, for the EPA's drinking water program, which protects Americans, and especially children, from unsafe or contaminated water. The $9 million increase from the 2025 enacted level is to “properly equip EPA with funds to respond to drinking water disasters, directly helping people on the ground recover from such emergencies.” Decreases funding by $2.4 billion for the state revolving fund (SRF). When it comes to water infrastructure, the “States should be responsible for funding their own water infrastructure projects.” Contrary to that design, in practice, the program has been heavily earmarked by Congress for projects that are ultimately not repaid into the program and bypass states’ interest and planning. In addition, the SRFs are largely duplicative of the EPA’s Water Infrastructure Finance and Innovation Act (WIFIA) program and the Department of Agriculture’s (USDA) Water and Wastewater Loan and Grant program, and they received a massive investment in the Infrastructure Investment and Jobs Act (IIJA). The budget proposes to return the SRFs to their intended structure of funds revolving at the state level, and therefore provides the decreased funding level of $305 million total to allow states to adjust to alternative funding sources for their water infrastructure. Environmental Protection Agency Environmental Justice Program: The budget eliminates this funding that sought to support reduce environmental harms, including health outcomes, to minority and low-income communities that face disproportionate harm from pollution. website yes

Important Federal Funding Update! FY25 Federal Government Funding Update This legislative alert provides an update to the proposed FY25 funding continuing resolution. ASTHO issued a legislative alert yesterday detailing what seemed to be a likely bipartisan continuing resolution, but it appears we unfortunately spoke too soon. In a surprise development late yesterday, the bipartisan budget deal to keep the federal government funded and authorize critical public health programs imploded. If Congress does not approve a bipartisan continuing resolution (CR), a government shutdown will occur beginning this Saturday, Dec. 21. The situation in Washington, D.C. is highly volatile and the ASTHO Government Affairs team cannot predict what will happen next. HHS released its FY25 contingency plan to prepare for a potential shutdown. We encourage all state and territorial health officials to review the document and subsequent operating division details for CDC, HRSA, ASPR, and other federal agencies. ASTHO will be monitoring Congressional developments closely and will share relevant information as it becomes available. Please contact Carolyn Mullen, senior vice president of Government Affairs and Public Relations, with any questions. article yes

Congress released FY24 Labor, Health and Human Services, Education, and Related Agencies appropriations bill.

The White House released President Biden's FY25 budget proposal, outlining the administration's funding priorities for the upcoming fiscal year.

Congress is expected to vote and approve an extension of the current two-tiered continuing resolution to keep the federal government open, avoiding a partial government shutdown on Jan. 19, 2024.

On June 26, 2024, the House Labor Health and Human Services and Education (LHHS) appropriations subcommittee released its version of the FY25 LHHS appropriations bill.

2023 Legislative Alerts website

On November 14, 2023, the U.S. House of Representatives approved a two-tiered short-term continuing resolution to keep the government open and avoid a shutdown later in the month.

On Oct. 26, 2023, House Speaker Johnson shared a letter to his colleagues laying out a tentative schedule for federal funding.

Public Health Implications of Debt Limit Increase astho, association of state and territorial health officials, debt ceiling, legislative alert, debt limit increase, debt limit, public health, covid funding, federal spending, president joe biden and house speaker kevin mccarthy, national debt, democratic presidents, raise the debt ceiling, food stamp, united states, government spending, house republicans, credit rating, work requirements, kevin mccarthy, suspending the debt ceiling, borrowing costs, social security, white house, 31.4 trillion, federal government, congressional budget office, speaker kevin mccarthy, spending cuts ASTHO | How the likely debt ceiling increase affects public health funding. Over the Memorial Day holiday weekend, President Joe Biden and Speaker Kevin McCarthy (R-CA) announced a bipartisan deal to raise the debt ceiling, rescind some unobligated COVID-19 funding, and implement limits on federal spending. This week, Congress will debate whether the legislation, titled the Fiscal Responsibility Act of 2023 (H.R. 3746), will be signed into law before the X date (i.e., when the federal government is expected run out of funding to meet its financial obligations) of June 5. A House vote is expected today and the Senate is expected to vote as early as Friday or Saturday of this week. View the full bill text and a section-by-section summary of the legislation. Outlook The ASTHO government affairs team believes this legislation has a high likelihood of being approved by Congress because it represents a bipartisan compromise of leadership in both political parties. Below is a summary of the legislation’s key provisions. Debt Ceiling Raises the debt ceiling through Jan. 1, 2025. Caps on Spending Establishes caps on discretionary spending for FY24 and FY25. The cap for non-defense discretionary spending (i.e., the pot of money used to pay for CDC, NIH, HRSA, FDA, Education, and other agencies) is relatively level for FY24 after making several adjustments that serve as separate specific spending allowances. The cap for FY25 is limited to 1% growth. Analysis Caps on spending for the next two years mean it will be very difficult for Congress to provide increases in federal funding for programs, projects, or activities without significantly decreasing funding for other areas of the budget. Incentivize Regular Order If Congress does not approve all annual appropriations bills by January of the calendar year, an automatic continuing resolution is established for the remaining bills not enacted, providing funding for the federal government at 99% of current levels beginning on April 30. This is essentially a sequestration that applies across the government on April 30, even if some appropriations bills are already enacted for those agencies, such as Defense. There are 12 annual appropriations bills, and more controversial bills like Labor, HHS, and Education (containing CDC, ASPR, HRSA, and SAMHSA) tend to be the ones that run the longest on continuing resolutions due to difficult negotiations on funding and policy riders. These new provisions do not change what happens on Sept. 30, and Congress still needs to pass a normal continuing resolution. In the absence of that action, a Shut Down threat remains on Oct. 1. Rescinds Unobligated Federal COVID-19 Funding The legislation specifically rescinds certain unobligated federal accounts and amounts of money appropriated through various emergency supplemental funding bills. Given the way Congress appropriated COVID-19 funding, and the way funding was later transferred between federal accounts and agencies, it is extremely difficult to discern which federal public health programs are affected by the rescissions. However, it appears that the funding provided to the Infectious Disease Rapid Response Reserve Fund has not been fully rescinded and remains intact. ASTHO will be seeking additional guidance from our federal partners for additional information. Supplemental Nutrition Assistance Program (SNAP) Work Requirement Adjustments According to the section-by-section summary, “SNAP’s able-bodied adults without dependents time limit and subsequent work requirement applies to individuals aged 18-49. This section would gradually adjust through the age of 54 while exempting the homeless, veterans, and individuals aging out of foster care. These provisions sunset on Oct. 1, 2030.” Modification of General Exemptions According to the section-by-section summary, “states are allowed to annually exempt up to 12% of ABAWDs not otherwise exempt from the work requirement. USDA has interpreted the law as allowing states to carry over unused exemptions from year to year, building up large balances and allowing them to exempt more individuals from work requirements. Beginning in 2024, this provision would end the ability of states to carry forward these exemptions. Additionally, beginning in 2024, the percentage of available exemptions is permanently reduced from 12% to 8%. website yes

Analysis: President Biden’s FY24 Budget Proposal On March 9, the White House released President Biden’s FY24 budget proposal, which outlines the Administration’s funding priorities for the upcoming fiscal year. As a reminder, Congress has the authority to approve, reject, or modify the Administration’s budget recommendations. ASTHO issued a statement in response to the FY24 President’s budget proposal and a legislative alert outlining a snapshot of the new initiatives and policies proposed by President Biden. State and territorial health officials should view the HHS budget in brief for details and additional information about these programs included in the Congressional justifications hyperlinked below. Centers for Disease Control and Prevention (CDC) Health Resources and Services Administration (HRSA) Substance Abuse and Mental Health Services Administration (SAMHSA) Assistant Secretary for Preparedness and Response (ASPR) Food and Drug Administration (FDA) Department of Interior (DOI) HRSA The request proposes $15.9 billion for HRSA, an increase of $1.5 billion above FY23. Highlights include: $290 million, an increase of $125 million, to end the HIV epidemic. $512 million, an increase of $225.5 million, for the Title X Family Planning program to improve access to reproductive and preventive health services. $937.3 million, an increase of $121.6 million, for the Title V Maternal and Child Health Block Grant. This includes $333.7 million for Special Projects of Regional and National Significance funding and $145 million to support investments to improve maternal health and address disparities in maternal mortality and morbidity. $415.9 million, an increase of $63.4 million, to expand access and improve health care in rural communities. This includes $165 million, an increase of $20 million, for the rural communities opioid response program. $2.7 billion, an increase of $892.5 million, for HRSA workforce programs. This includes: $965.6 million, an increase of $547.7 million, for the National Health Service Corps. $387.4 million to train mental health and substance use disorder providers. $27.5 million to support new approaches to recruiting, supporting, and training new health care providers. $25 million to support the mental health and well-being of health care providers. $110.2 million to expand the diversity of the health profession workforce. $7.1 billion, an increase of $1.3 billion, for health centers. This includes $1.9 billion in discretionary funding and $5.2 billion in new proposed mandatory funding, considering the expiration of the current authorization at the end of FY23. $415.9 million, an increase of $63.4 million, for rural health related activities. $130 million for a new program to support patients diagnosed with Long COVID. $276 million, an increase of $119.4 million, to improve maternal health. CDC The request proposes $11.58 billion for CDC, an increase of $2.4 billion above FY23. Highlights include: $600 million, an increase of $250 million, to support public health infrastructure and capacity. $340 million, an increase of $165 million, for public health data modernization. $100 million, an increase of $92 million, for social determinants of health. $160 million, level funding, for the preventive health and health services block grant. $100 million, an increase of $50 million, for the Center for Forecasting and Outbreak Analytics. $1.26 billion, an increase of $336.6 million, for Immunization and Respiratory Diseases. This includes $999 million, an increase of $317 million, for the Section 317 immunization program and $251 million for the influenza program. $764.8 million, an increase of $72 million, for global health programs. $106 million, an increase of $35 million, for Public Health Workforce and Career Development. $35 million for the Infectious Disease Rapid Response Reserve Fund. $1.54 billion, an increase of $153 million, for HIV/AIDS, Vital Hepatitis, STI, and Tuberculosis prevention. This includes $310 million for the Ending HIV Epidemic Initiative, an increase of $90 million. $1.4 billion, an increase of $590.3 million, for injury prevention and control. This includes: $713.7 million, an increase of $207.8 million, for opioid abuse and overdose prevention and surveillance. $15 million, an increase of $6 million, for addressing adverse childhood experiences. $35 million, an increase of $22.5 million, for firearm injury and mortality prevention research. $268.1 million, an increase of $250 million, for youth and community violence prevention. $420.8 million, an increase of $174 million, for environmental health programs. $362.8 million for occupational safety and health. $1.8 billion, an increase of $388.2 million, for chronic disease prevention and health promotion. $943.2 million, an increase of $38.1 million, for public health preparedness and response. $845.8 million, an increase of $95 million, for emerging and zoonotic infectious diseases. $86 million, an increase of $1 million, for the Agency for Toxic Substances and Disease Registry. The proposal also includes the following realignments that will help CDC increase accountability, reduce administrative burden, and provide programmatic flexibility: Realign $26 million for Lyme Disease to be included as a non-add under the Vector-Borne Diseases program, project, or activity (PPA). Consolidate the Public Health Emergency Preparedness Cooperative Agreement, Academic Center for Public Health Preparedness, and all other CDC Preparedness programs into a single PPA labeled “Domestic Preparedness” to provide CDC with greater flexibility to respond to public health emergencies. Consolidate all other Environmental Health, Climate and Health, and Safe Water PPAs into a single PPA labeled “Environmental Health Capacity” under the Environmental Health Activities budget activity. SAMHSA The request includes $10.8 billion for SAMHSA, an increase of $3.3 billion above FY23. Highlights include: $4.9 billion, an increase of $2.1 billion, for SAMHSA’s mental health activities. This includes $1.65 billion for the Community Mental Health Block Grant. $836 million, an increase of $334.4 million, to the 9-8-8 and Behavioral Health Crisis Services program. $5.5 billion, an increase of $1.3 billion, for substance use services that include harm reduction, treatment, and recovery services. This includes: $2 billion, an increase of $425 million, for state opioid response grants. $2.7 billion, an increase of $425 million, for the Substance Use Prevention, Treatment, and Recovery Services Block Grant. $183.8 million, a decrease of $151.1 million, for Health Surveillance and Program Support. $245.7 million, an increase of $8.9 million, for substance use prevention. ASPR The request proposes $4.3 billion for ASPR, an increase of $642.2 million above FY23. Highlights include: $995 million, an increase of $30 million, for the strategic national stockpile. $312.1 million, an increase of $7 million, for the Health Care Readiness and Recovery (formerly the Hospital Preparedness) program. Within this total, $240 million is provided for formula-based cooperative agreements to states, territories, and freely associated states, Washington, D.C., and three high-risk political subdivisions. FDA $780.0 million for the tobacco program. With these resources, FDA will continue to invest in product review and evaluation, research, compliance and enforcement, public education campaigns, and policy development. The budget also requests an additional $100 million in user fees and requests authority to include manufacturers and importers of all deemed products among the tobacco product classes for which FDA assesses tobacco user fees. To ensure that resources keep up with new tobacco products, the proposal would also index future collections to inflation. This proposal would ensure FDA has the resources to address all regulated tobacco products, including e-cigarettes, which currently have high rates of youth use, as well as future novel products. $1.7 billion for food safety, nutrition, and cosmetics, an increase of $210.6 million above FY23, to support efforts and commitment to strengthen FDA’s food safety and nutrition capacity. DOI The Administration supports funding the renewal of our Compacts of Free Association relationships with the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. The Administration intends on seeking $6.5 billion in economic assistance over 20 years to be provided through a mandatory appropriation at the Department of State, and language calling for continued implementation of the Compacts at the Department of the Interior. Overall, the United States remains committed to its long-standing partnerships with the governments and people of the freely associated states. website yes

ASTHO legislative alert, Dec. 20, 2022: End-of-Year Funding and Policy Package Summary

ASTHO legislative alert, analysis of reauthorization of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program.

On June 30, 2022, the House Committee on Appropriations held its markup of the FY23 Labor, Health and Human Services, Education and Related Agencies appropriations bill.

On April 4, 2022, the U.S. Senate indicated that they have reached an agreement on a $10 billion bipartisan emergency supplemental funding bill for the federal COVID-19 response.

On March 28, 2022, the White House released President Biden’s FY23 proposed budget. The budget outlines the Administration’s funding priorities for the upcoming fiscal year. Congress has the authority to approve, reject, or modify the budget’s recommendations.

A collection of written and oral Congressional testimonies from ASTHO members and public health leaders on leading public health issues.