On August 1, the Senate Appropriations Committee passed the Fiscal Year 2025 (FY25) Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations bill out of committee with bipartisan support by a vote of 25-3.

Overall, the Senate Labor-HHS bill would provide more funding for public health programs than the House Labor-HHS bill, approved last month by the House Appropriations Committee on a party-line vote, which proposed cuts to many public health programs and eliminated others. (NACCHO Government Affairs published a detailed analysis of the House Labor-HHS bill when it was released, which you can read here.) The Senate bill includes $122.8 billion for the Department of Health and Human Services (HHS), which is an increase of $5.8 billion, or 5% above FY24 levels. Additional details from the Senate’s Committee report were released late last week, and a summary of the bill’s contents for local public health is below.

In response to passage of the bill, Senator Tammy Baldwin (D-WI), Chair of the Senate Labor-HHS Appropriations Subcommittee said, “our bill addresses the kitchen table issues I hear about every day from Wisconsinites–lowering childcare costs for families, connecting more Americans with good-paying jobs, expanding access to mental health care, and taking on the opioid and fentanyl crisis.” Senator Baldwin explained that the bill was created in a bipartisan way in stark contrast to the House’s version of the funding bill. She also acknowledged compromises in the bill that had the support of Labor-HHS Subcommittee Ranking Member Shelley Moore Capito (R-WV).

While this is another important step towards getting an FY25 spending bill into law, there are still many steps to go in the process, and the funding levels included below are expected to change as Congress negotiates a final agreement. Time is also a factor: both chambers of Congress are in recess during August with plans to return to Washington in September. We anticipate that Congress will need to pass a Continuing Resolution ahead of the September 30 fiscal year deadline and continue FY25 negotiations after the November election.

More details on the Senate’s FY25 proposal below:

Centers for Disease Control and Prevention (CDC)

The Senate proposal would fund the Centers for Disease Control and Prevention (CDC) at $9.4 billion, which is an increase of $200 million above FY24, compared to the House proposal that would significantly reduce CDC funding by $1.8 billion (22%).

Under the Senate proposal, some key programs for local health departments would receive slight increases in funding from FY24:

• Public Health Infrastructure and Capacity, $365 million ($15 million above FY24)
  
• Public Health Data Modernization, $195 million ($20 million above FY24)
  
• Public Health Emergency Preparedness Cooperative Agreements, $735 million (no change)
  
• 317 Vaccine Program, $696.9 million ($15 million above FY24)
  

Unlike the House proposal, the Senate proposal does not eliminate any public health programs, and many receive slight increases:

• National Center for Injury Prevention and Control, $776.379 million ($10 million above FY24)
  
• Center for Forecasting and Outbreak Analytics (CFA), $70 million ($15 million above FY24)
  
• Ending HIV Epidemic Initiative (EHE), $613 million (no change)
  
• Preventive Health and Health Services Block Grant, $160 million (no change)
  

Administration for Strategic Preparedness and Response (ASPR)

The Senate bill includes $3.8 billion for the Administration for Strategic Preparedness and Response (ASPR), an increase of $200 million over FY24. This includes the Medical Reserve Corps program at $6.24 million (no change); and the Hospital Preparedness Program at $309 million (+$4 million from FY24).

Health Resources and Services Administration (HRSA)

The Senate bill includes $8.94 billion in discretionary funding for the Health Resources and Services Administration (HRSA), an increase of around $34 million from FY24 levels and $1.5 billion more than proposed in the House bill. Within HRSA, the bill would provide level-funding for the Ryan White HIV/AIDS program at $2.57 billion and maintains level-funding for Ending the HIV Epidemic Initiative at FY24 levels, which would be eliminated under the House proposal. Unfortunately, no funds were included for the Public Health Workforce Loan Repayment Program, a key NACCHO priority.

Substance Abuse and Mental Health Services Administration (SAMHSA)

The Senate bill includes $7.5 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA), an increase of about $26 million from FY24 and about $70 million less than proposed in the House version. Notably, the House version would transfer approximately $500 million of the Opioid Overdose Prevention and Surveillance program at CDC to SAMHSA and administer these funds as part of an existing block grant.

Committee Report Language

Along with the specific funding allocations, committee report language gives context to the funding appropriations and shows Congress’ intent and expectations for the use of federal funds. The accompanying report included language championed by NACCHO to strengthen local public health:

• Local Public Health Departments.—The Committee notes that Federal funding intended for both State and local health departments does not consistently reach local health departments beyond those directly-funded. The Committee encourages CDC to require States to fund local health departments when programmatically appropriate.

Other notable language that would strengthen local public health in the report included:

• Public Health Data Modernization Initiative [DMI].—The Committee commends CDC’s work to advance public health data modernization and acknowledges that efforts to enhance public health data system capabilities will result in fast and more reliable data sharing. The Committee provides $195,000,000 for CDC to continue bringing together State, Tribal, local and territorial public health jurisdictions and public and private sector partners with the goal of establishing modern, interoperable, and real-time public health data and surveillance systems to protect the American public. The Committee recommends CDC ensure that funding from DMI is allocated to jurisdictions through the National Center for Health Statistics to support necessary upgrades to their vital statistics systems to enable more, better, and faster vital records data. The Committee requests a briefing within 90 days of enactment of this act on the progress and plans for programs and activities supported by DMI funding. The Committee directs HHS to prioritize CDC data modernization and IT projects, focusing on improving enterprise capabilities and infrastructure. The Committee further directs HHS to continue to provide quarterly reports for all ongoing projects.

• Public Health Infrastructure and Capacity.—The Committee includes $365,000,000 in public health funding that is not segmented by disease, condition, activity. Rather, it is provided for cross-cutting, core public health infrastructure needs, including but not limited to workforce, health information and data systems, public health policy and communications, equity, financial management, community partnership development, and organizational capacity. By providing maximum flexibility, this funding will allow public health agencies to determine and address their greatest needs and build core capabilities that will strengthen and support new and existing programmatic functions. The Committee again directs that no less than 70 percent of this funding be awarded to health departments. The Committee encourages CDC to strengthen infrastructure in local health departments by continuing to directly award funds to local health departments, and by urging State health department recipients to allocate resources to local health departments. The Committee urges CDC to publicly track and report to the Committee how funds provided to State health departments are passed through to local health departments.

More Details

For additional details on what is included in the Senate FY25 Labor-HHS bill, please refer to chart and linked materials below.

FY25 Senate Labor-H Report

FY25 Senate Labor-H Bill Text

FY25 Senate Labor-H Bill Summary

FY25 House Labor-H Report

FY25 House Labor-H Bill Text

FY25 House Labor-H Bill Summary (Majority)

FY25 House Labor-H Bill Summary (Minority)