President’s FY2025 Budget Request
Yesterday, President Biden released Budget of the United States, the Administration’s budget request to Congress for fiscal year 2025 (FY2025). The Administration also released the HHS Budget in Brief, which outlines $130.7 billion in discretionary funding for the Department of Health and Human Services (HHS). Notably, the FY2025 budget request once again includes legislative requests for a new 5-year national hepatitis C virus (HCV) elimination program, as well as a PrEP Delivery Program. In addition, for the first time, the budget request includes $10 million at the Department of Justice for efforts to modernize outdated criminal statues with a discriminatory impact on people living with HIV.
As all FY2024 appropriations are not final, the FY2025 Presidential Budget Requests in the attached chart and memo are compared to the final FY2023 appropriation. It is important to note that this is a budget request and does not have the power of the law. Only Congress has the power to appropriate funds. NASTAD will continue to monitor the FY2025 appropriations process and advocate for the highest possible funding levels on behalf of HIV, hepatitis and drug user health programs.
Department of Health and Human Services
The HHS Budget in Brief includes a legislative language proposal on access to PrEP through Medicaid and Children’s Health Insurance Program (CHIP). The budget proposal “requires states to cover Pre-Exposure Prophylaxis and associated laboratory services with no cost sharing for Medicaid and CHIP beneficiaries, and places guardrails on utilization management practices, like prior authorization and step therapy.” In addition, the budget requests that $9.8 billion over 10 years is repurposed for a mandatory funding program, entitled ‘Pre-Exposure Prophylaxis (PrEP) Delivery Program to End the HIV Epidemic in the United States’ (PrEP Delivery Program). The program will provide PrEP and services to people who are un- or underinsured, as well as expanding the number of PrEP providers. This request is similar to requests in FY2023 and FY2024, referred to as the National PrEP Program.
Additionally, the HHS Budget in Brief calls for a HHS-wide hepatitis C elimination initiative. The program will accelerate the availability of point-of-care HCV diagnostic tests, provide broad access to curative HCV treatment and scale up existing hepatitis prevention, community outreach, and provider education efforts. The Office of Management and Budget (OMB) assessed that the net cost to the federal government across all accounts is $4.0 billion over ten years. The proposal includes the federal government paying all cost sharing associated with hepatitis C curative drugs for Medicare Part D beneficiaries.
Minority HIV/AIDS Fund
The budget proposal includes flat funding from FY2023 for the Minority HIV/AIDS Fund, for a program total of $60 million.
Centers for Disease Control and Prevention (CDC)
The CDC released their Justification of Estimates for Appropriation Committees that presents a detailed explanation of the President’s Budget Request for CDC. The President’s budget funds CDC at $9.7 billion. The budget provides $1.391 billion for the CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention (NCHHSTP).
|
Budget Activity |
Final FY2023 |
FY2025 President’s Request |
|
Domestic HIV Prevention and Research |
$1.013 b (+$22 m) |
$1.013 b (+$0) |
|
HIV Prevention |
$755.6 m ($0) |
$755.6 m ($0) |
|
EHE Initiative |
$220 m (+$20 m) |
$220 m (+$0 m) |
|
School Health |
$38.1 m (+$2 m) |
$38.1 m (+$0 m) |
|
Viral Hepatitis |
$43 m (+$2 m) |
$43 m (+$0 m) |
|
Infectious Diseases and the Opioid Epidemic |
$23 m (+$5 m) |
$23 m (+$0 m) |
Division of HIV Prevention
The budget proposed level-funding the Division of HIV Prevention (DHP) at the last Congressionally enacted allocation during FY2023, totaling $1.013 billion.
Division of Viral Hepatitis
The budget proposed level-funding the Division of Viral Hepatitis (DVH) at the last Congressionally enacted allocation during FY2023, totaling $43 million.
Infectious Diseases and the Opioid Epidemic
The budget proposed level-funding the infectious diseases and the opioid epidemic (IDO) program at the last Congressionally enacted allocation during FY2023, totaling $23 million.
STD Prevention
The budget proposed $174.3 million for the Division of STD Prevention, flat funding over FY2023.
TB Prevention
TB Prevention is funded at $137 million, which is level with FY2023.
Health Resources and Services Administration (HRSA)
HRSA detailed their FY2025 President’s Budget Request in the Justification of Estimates for Appropriation Committees. The budget would provide $16.3 billion in mandatory and discretionary funding for HRSA, which is about $2 billion higher than FY2023.
Ryan White Program
The budget requests a $10 million increase for the Ryan White Program Ending the HIV Epidemic program, with all other parts of the Ryan White Program flat funded from FY2023 levels.
|
Budget Activity |
Final FY2023 |
FY2025 POTUS Request |
|
Ryan White HIV/AIDS Program |
$2.571 b (+$76.2 m) |
$2.581 b (+$10 m) |
|
Part A |
$680.8 m (+$10.3 m) |
$680.8 m ($0) |
|
Part B |
$464.6 m (+$20.6 m) |
$464.6 m ($0) |
|
Part B ADAP |
$900.3 m ($0) |
$900.3 m ($0) |
|
Part C |
$209 m (+$3.5 m) |
$209 m ($0) |
|
Part D |
$77.9 m (+$1.1 m) |
$77.9 m ($0) |
|
Part F: AETCs |
$34.9 m (+$0.5 m) |
$34.9 m ($0) |
|
Dental |
$13.6 m (+$0.2) |
$13.6 m ($0) |
|
SPNS |
$25 m ($0) |
$25 m ($0) |
|
Ryan White EHE |
$165m (+$40 m) |
$175m (+$10 m) |
Bureau of Primary Care
The President’s Budget Request includes $157 million at the Bureau of Primary Care for Ending the HIV Epidemic Initiative activities. This funding will focus on expanding HIV prevention services, specifically PrEP. This requested funding level is the same as the final FY2023 appropriation.
Title X Family Planning Program
The Title X Family Planning Program received a increased request of $103.5 million, for a total funding level of $390 million
340B Drug Pricing Program
For FY2025, the President requests $12.2 million for the 340B Drug Pricing Program, which is flat funding from FY2023. In addition, the request proposes to require “covered entities to annually report to HRSA how the savings achieved through the Program benefits the communities they serve and provide HRSA regulatory authority to implement this requirement.” HRSA also requests explicitly regulatory authority for contract pharmacy compliance and transparency.
National Institutes of Health (NIH)
The Budget includes $26 million for Ending the HIV Epidemic activities at NIH. This is flat funding from FY2023 and includes plans to expand implementation research.
Department of Interior
Indian Health Services
The budget includes $15 million for the Ending HIV and Hepatitis C program at the Indian Health Services. This $10 million increase from FY2023 will be used to diagnose and treat all patients living with HIV and increase PrEP access.
Department of Housing and Urban Development
HOPWA
The Budget requests $505 million for HOPWA. This is a $6 million increase over FY2023. HOPWA’s FY2024 funding level was finalized in H.R.4366 - Consolidated Appropriations Act, 2024, which was signed into law on March 9, 2024. The finalized FY2024 level is $505 million, making this request flat funding from FY2024.
Department of Justice
For the first time, the budget request includes funding at the Department of Justice to “promote equity and protect civil rights by including $10 million for a new initiative to modernize outdated criminal statutes with a discriminatory impact on HIV-positive individuals.”
Please contact the PLA team with questions. NASTAD will continue to provide updates on the FY2025 appropriations process.
Download a PDF version of the letter notifying our members