The Federal Budget and Appropriations
Funding levels for federal public health programs that support the work of local health departments are set annually through the congressional appropriations process. Each year, the president requests funding through his budget request to Congress, and Congress writes and passes legislation allocating funds for the upcoming fiscal year, which begins on October 1. NACCHO works with the presidential administration and Congress throughout the year to advocate for strong funding for programs that are crucial for local public health. Both past and current priorities are outlined below.
On March 9, President Joe Biden released his fiscal year (FY) 2024 budget request. The budget requests $144 billion for the Department of Health and Human Services (HHS), an 11.5 percent increase from enacted FY2023 levels, including $11.581 billion for the Centers for Disease Control and Prevention (CDC), an increase of $2.397 billion from FY2023. Within the CDC, the president proposes increased funding for the Public Health Infrastructure and Capacity Program and the Data Modernization Initiative (DMI). The President’s Budget also proposes realignment of all CDC Preparedness programs into a new Domestic Preparedness category, including the Public Health Emergency Preparedness Cooperative Agreements (PHEP), with proposed funding at $943 million. Read more about the President’s Budget here.
As Congress begins its appropriations work, NACCHO is engaging with key lawmakers and committees to highlight local public health priorities for FY2024:
- $100 million for the Public Health Workforce Loan Repayment Program at the Health Resources and Services Administration (HRSA);
- Report language to ensure funding from the CDC to states makes it to the local level as intended; and
- $1 billion for the CDC Public Health Infrastructure and Capacity Program.
In March, NACCHO President Margy Jahn provided written testimony to the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies (L-HHS) on these priorities. NACCHO will similarly submit testimony to the Senate L-HHS Subcommittee later this spring.
NACCHO is working in coalition with partners to emphasize the need to fund the Public Health Workforce Loan Repayment Program in FY2024. In 2022, Congress passed bipartisan legislation last year to create the program but did not provide any funding. To demonstrate broad support for the program, NACCHO led a letter, signed by 120 other organizations, to House appropriations leaders urging them to fully fund the Public Health Workforce Loan Repayment Program at $100 million in FY2024.
NACCHO also joined in coalition with other stakeholders to advocate for public health programs and priorities important to our members:
Congress passed the Consolidated Appropriations Act of 2023 on December 22, 2022 which allocated discretionary federal funding for the rest of fiscal year 2023. NACCHO advocated with Congress throughout the appropriations process for key local public health priorities, which are outlined in written testimony to both the House and Senate Appropriations Subcommittees on Labor, Health and Human Services, Education and Related Agencies. A summary of the final FY2023 appropriations bill, including funding levels for NACCHO priorities, is available here.
COVID-19 Funding Announcements
NACCHO government affairs has developed a spreadsheet for members to reference all grant funding opportunities available through COVID-19 relief packages. The sheet will be updated regularly.
COVID-19 Relief Laws
On March 10, 2021 the Congress passed the American Rescue Plan Act, a $1.9 trillion COVID-19 relief package. This package contains billions in funding for the public health response to the COVID-19 pandemic, as well as additional funds to stimulate the economy with direct payments to individuals and to strengthen the social safety net for additional child tax credits and other supports.
On December 28, 2020, President Trump signed another COVID-19 relief package as part of the FY21 omnibus legislation to fully fund the government through the end of the fiscal year. The $900 billion package did not include any new funding for state and local governments. Click here for a complete summary of key provisions in the law. The package includes strong funding for the governmental public health activities necessary to slow the spread of the virus, as advocated for by NACCHO, including over $22 billion for testing, contact tracing, and mitigation efforts, and nearly $9 billion for vaccine distribution and infrastructure.
On March 27, 2020, Congress passed and the President signed the Coronavirus Aid, Relief and Economic Security Act, a bill including $2 trillion for COVID-19 response and to fund economic relief measures. NACCHO sent out a press release applauding the bill.
On March 6, 2020, the President signed the Coronavirus Preparedness and Response Supplemental Appropriations Act (HR 6074), an emergency supplemental funding bill providing $8.3 billion to address COVID-19. NACCHO sent out a press release applauding the bill.
- Federal Funding Infographic: How money reaches local health departments from the federal government.
- NACCHO Video: Roadmap to the Federal Budget
Chief, Government & Public Affairs
Senior Specialist, Government Affairs
Government Affairs Associate