President Biden released his Fiscal Year (FY) 2023 budget, formally beginning the appropriations process for the 2023 federal budget. Typically, the President’s budget is viewed as a starting point for the heading into negotiations on Capitol Hill, highlighting the administrations priorities. Overall, the National Rural Health Association (NRHA) is pleased to see the President’s commitment to rural health-related line items in the FY 23 budget. Below are details on what is included, what isn’t included, and what NRHA plans to fight for in FY 23.
The Department of Health and Human Services (HHS)
The President’s budget request includes $127.3 billion in discretionary funding for HHS, an increase of $19 billion from the $108.3 billion included in the FY 22 budget.
The Federal Office of Rural Health Policy (FORHP): The President’s discretionary includes $374 million to carry out rural health activities at the Federal Office of Rural Health Policy for FY 23, which is $43 million above the FY 22 enacted budget.
- Included in the President’s budget is $57.5 million for the Medicare Rural Hospital Flexibility Grants Program, a decrease of nearly $5 million from FY 22 enacted levels. NRHA will continue working with lawmakers to see the Medicare Rural Hospital Flexibility Grants Program see increased funding in FY 23 as we know these programs are critical to rural provider sustainability.
- The request includes $21 million for the Small Hospital Improvement Grant Program, equal to the funding allocated in FY 22.
- The request does not include the $5 million to establish a Rural Emergency Hospital (REH) Technical Assistance Program, as we saw in FY 22.
- The President’s budget includes $12.5 million for the State Offices of Rural Health, equal to what was allocated in FY 22.
- The President’s budget includes $12.7 million for the Rural Residency Development Program, an increase of $2.2 million over FY 22 enacted levels.
- The President’s budget includes $165 million for the Rural Communities Opioid Response Program, an increase of $30 million over FY 22 enacted levels.
- The President’s budget includes $10 million for the new Rural Health Clinic Behavioral Health Initiative. This newly proposed initiative allows clinics in rural areas where there are no existing behavioral health providers to fund the salary of a behavioral health provider, address provider burnout, and expand the availability of services such as mental health screenings, counseling, and therapy.
The Health Resources and Services Administration (HRSA): The President’s discretionary request includes $13.3 billion for HRSA, an increase of $41 million above the FY 22 enacted budget.
- The President’s budget includes $210 million for the National Health Service Corps, an increase of $92 million over the FY enacted levels.
- The President’s budget includes $44 million for telehealth programs within HHS, an increase of $10 million from the FY 22 enacted level.
- The President’s budget includes $17 million for the $340B Drug Pricing Program/Office of Pharmacy Affairs. This is an estimated $7 million increase over the FY 22 enacted level.
The Centers for Disease Control and Prevention (CDC): The President’s discretionary request includes $9.9 billion for the CDC, an increase of $1.4 billion from the record $8.5 billion included in the FY 22 budget.
- Unfortunately, not included in the President’s budget is set aside funding for the creation of an Office of Rural Health within CDC. NRHA will continue working with Appropriators on Capitol Hill to see this office set up as outlined in S.3159/HR 5848 Rural Health Equity Act.
The Department of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies (USDA): The President’s budget request includes $28.5 billion in discretionary funding for USDA, an increase of $3.375 billion from the $25.125 billion included in the FY 22 budget.
- Included in the President’s budget is $3.3 billion for the Rural Community Facilities Program at USDA, a decrease of $150 million from the $3.45 billion included in the FY 22 enacted budget.
- Unfortunately, the President’s budget once again zeroed out the USDA Rural Hospital Technical Assistance Program. In FY 22, Congress allocated $2 million for this critical program. NRHA will again work to see funding restored for this vital program.
As the House and Senate Appropriations Committee’s begin working on the FY 23 budget, NRHA will work to see funding levels increased for these rural health line items. For more information see the Fiscal Year 2023 Budget in Brief.