Biden budget calls for future investments in health care as COVID aid runs out

The Biden administration’s 2023 budget asks Congress to devote greater funding to improve health care access for the next fiscal year. But the money aimed at absorbing the individual costs of pandemic essentials for 31.1 million uninsured people in the U.S. is already running out, and advocates are concerned about how lawmakers may reduce or forgo such funding as it considers the new White House proposal.

The White House’s budget released Monday called for $127.3 billion in discretionary health spending and $1.7 trillion in mandatory budget authority and would boost funding on things like improving access to mental health services for all Americans and efforts to “end cancer as we know it,” a priority Biden signaled in his State of the Union address earlier this month.

The proposed spending increases on those needs and others, such as maternal health, overdose prevention and HIV-AIDS treatment and support, were intended to “leave no American behind,” Health Secretary Xavier Becerra said. The budget also includes funding to defray the costs of child care and health care, pocketbook issues for millions of U.S. households.

Becerra said the nation will continue to rely on community health centers, telehealth and other modes of service delivery that make health care more accessible for millions of Americans, especially those seeking vaccines, tests and treatment for COVID. In its proposed budget, the Biden administration asked Congress to mandate $81.7 billion over the next five years to prepare the nation for the next pandemic. However, because Congress did not extend COVID funding in the $1.5 trillion omnibus spending bill passed in March, there is virtually no more government funding for COVID tests and vaccines, and some Americans are already feeling the effects of what happens when Congress and the White House don’t agree.

“Our resources are depleted. We need support from Congress,” Becerra said.

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The new budget reflects the Biden administration’s current spending wish list rather than a set-in-stone spending plan. Because the budget is a starting point for negotiations, Congress will make its own proposals and adjustments to how to spend the money, which means these priorities will likely face the same congressional gridlock that has defined much of President Joe Biden’s tenure so far.

Facing a government shutdown deadline and the crisis in Ukraine, the House stripped out COVID aid from the $1.5 trillion omnibus spending bill – contentious due to disagreements between Democrats and Republicans about how it would be funded – in order to strike a deal.

On March 9, House Speaker Nancy Pelosi, D-Calif., said in a released statement that it was “heartbreaking to remove the COVID funding” from the omnibus, but she urged her colleagues in Congress to “continue to fight for urgently needed COVID assistance.”

Senate Republicans have raised their own concerns about additional COVID relief funding without more transparency around how money already authorized has been spent, and what funding remains, along with better safeguards against fraud.

In a statement, Biden said his 2023 budget of $5.79 trillion would slash the federal deficit by $1.3 trillion, “delivering the largest one-year reduction in the deficit in U.S. history.”

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Since 2020, the U.S. is estimated to have spent over $4.5 trillion on “COVID-related activities,” Becerra said during a news conference Monday.

Becerra said the last day health care providers can file claims to cover the cost of vaccinating uninsured individuals against COVID-19 is “on or about April 5,” but according to Dr. Kavita Patel, a physician at a community health center who serves patients in and around Washington, D.C., she has already been told she cannot submit such claims for reimbursement. By March 22, the White House warned health care providers that the Uninsured Program would no longer be able to accept claims for tests and treatment “due to insufficient funds.”

Where Patel works, staff “budget down to the penny,” and she is already worried about what this loss in funding could mean for vaccine outreach efforts as new variants emerge and more booster doses may be needed to prevent further suffering. On Tuesday, the Food and Drug Administration authorized a second booster dose for people ages 50 or older to enhance their protection against hospitalization and death due to COVID-19 infection. But when providers have to “swallow the cost” of vaccinating people, after assuming that the government would cover vaccines, tests and medications to reduce the pandemic’s burden on the health care system and society, that “chips away at the other services we do,” Patel said.

“It’s a zero-sum game,” she said.

Pricing for diagnostic tests can range from $20 to $1,419, according to data from the Kaiser Family Foundation and the Peterson Center on Healthcare, becoming prohibitively expensive, especially for households with limited financial means.

Congressional action cannot come soon enough, said Edwin Park, research professor for Georgetown University’s Center for Children and Families, who is concerned about what happens if lawmakers fail to do so.

“We know that communities of color are more likely to be uninsured and thus would be disproportionately harmed if further COVID-19 funding is not provided,” Park said.

“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” in fighting the pandemic, Becerra said Monday.

On Thursday, Becerra is expected to argue for these budget priorities before members of Congress during the House Subcommittee on Labor, Health, Human Services, Education and Related Agencies.