President Joe Biden’s 2023 budget proposal requested increased federal funding for health care programs, including support for the nation’s response to the pandemic and several other priorities. The president’s budget recommendation to Congress asked for $1.6 trillion for appropriated spending in fiscal year 2023, which begins September 1, including $873 billion for domestic programs. In addition, the budget requests $127 billion in discretionary funding for the Department of Health and Human Services (HHS), a $27 billion increase from current levels.

The CAP has engaged with the administration on its budget proposal through the years. For example, the budget document includes a legislative proposal that would allow the HHS secretary to temporarily waive or modify specific CLIA requirements during public health emergencies. The administration states that during the COVID-19 pandemic, it used enforcement discretion to allow pathologists to interpret slides remotely. The CAP lobbied heavily to achieve this action in 2020. Amending CLIA statute would give the government the ability to apply consistent criteria when granting a waiver to specific CLIA requirements.

Even though the president proposes the federal government's budget, Congress controls spending and must pass appropriations funding legislation.

The budget includes $81.7 billion in mandatory funding over five years across the Office of the Assistant Secretary for Preparedness and Response (ASPR), the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Food and Drug Administration (FDA) to support the President’s plan to prepare for and respond rapidly and effectively to future pandemics and other high consequence biological threats. As part of the plan, the ASPR would invest $40 billion to conduct advanced research and development of vaccines, therapeutics, and diagnostics for high priority viruses; scale-up domestic manufacturing capacity for medical countermeasures; and expand the public health workforce. Other investments in pandemic preparedness include:

• $975 million for the ASPR Strategic National Stockpile to sustain and expand current inventory (an increase of $130 million above 2022 enacted)
• $828 million for the ASPR’s Biomedical Advanced Research and Development Authority to support life-saving medical countermeasures and antimicrobial development (an increase of $83 million above 2022 enacted)
• $292 million to the ASPR Hospital Preparedness Program (an increase of $11 million above 2022 enacted).
• $842 million for the CDC’s domestic preparedness (level with 2022 enacted).
• $1.6 billion in new spending for the FDA to expand and modernize regulatory capacity, information technology and laboratory infrastructure to respond to any future pandemic or high consequence biological threat.