White House

White House Releases President’s Fiscal Year 2025 Budget Proposal

Mar 15, 2024 | Adriane Casalotti, Victoria Van de Vate, Lauren Mastroberardino, Molly Curington

Here’s what local health departments need to know

On March 11, the Fiscal Year 2025 budget proposal was released, outlining the Administration’s funding priorities for the upcoming fiscal year. While the President’s Budget is an important marker to see requested funding levels and new policy proposals, it is not binding. Ultimately, Congress is responsible for setting the budget and appropriating funds. This year is particularly complicated, as Congress is still working to finalize full-year funding for some key agencies, including the Department of Health and Human Services, through the rest of Fiscal Year 2024 (ending September 30, 2024), while simultaneously beginning its work on funding the full government for Fiscal Year 2025.

Notably, this year’s Presidential Budget Request is lower than last year’s requests, as the proposal adhered to the agreed upon budget caps from the debt-ceiling deal in the spring (Fiscal Responsibility Act for FY25). This limits overall spending for FY25 and results in a budget for public health programs that is largely flat-funded or allows for only small increases.

Overall, the President’s Budget requests $130.1 billion for HHS, a 9.4% decrease from the FY24 Presidential request, but a 3% increase from the FY23 enacted level. For CDC, the request proposes $9.68 billion, which is a $499.2 million increase from FY23 enacted levels. For HRSA, the budget proposes $8 billion in discretionary, a 17% decrease from FY23. The budget also includes $8.1 billion for SAMHSA, an 8% increase from FY23. For ASPR, the budget proposes $3.8 billion, an increase of $138 million above FY23. For FDA, the budget proposes $7.2 billion a 7.4% increase from FY23.

Key programs for local health departments received flat or nominal increases from FY23:

  • Public Health Infrastructure and Capacity, $350 million (no change)
  • Public Health Data Modernization Initiative, $224.6 million (+ $49.6 million)
  • Public Health Emergency Preparedness Cooperative Agreements, $735 million (no change)
  • 317 Vaccine Program, $732 million (+$50 million)
  • Medical Reserve Corps, $6.24 million (no change)

Notable increases in other CDC programs include $1.6 billion, a $129 million increase, for chronic disease prevention and health promotion and $943,379,000, an increase of $182 million for CDC’s Injury Center to address community violence and suicide prevention, among other topics.

Additionally, the budget includes specific policy proposals the Administration would like to see enacted by Congress. These include:

  • Creation of a mandatory Vaccines for Adults program to provide uninsured adults with access to routine and outbreak vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). NACCHO supports this effort, which was also proposed in the President’s FY24 Budget.
  • Expansion of the Vaccines for Children (VFC) Program to include all children under the age of 19 enrolled in a separate Children’s Health Insurance Program and other specific changes, including setting a floor for provider reimbursements for vaccine administration, covering the vaccine administration fee for uninsured children without state share, and eliminating cost sharing for all VFC-eligible children.
  • Provision of new data authority, which CDC says, “will be able to allow for more complete and timely data sharing to support decisions at the federal, state, and local levels, while reducing burden on providers.”
  • Authority to use a subset of CDC funds to train and support a group of staff to deploy out to the field in a current or possible emergency.
  • Creation of $20 billion in mandatory funding across HHS to prepare for pandemics and other biological threats, with $6.1 billion going to CDC to “modernize and build laboratory capacity and strengthen public health data systems; enhance domestic and global disease surveillance, biosafety, and biosecurity efforts; and support capabilities for monitoring and evaluating vaccine and medical countermeasure safety and effectiveness.”
  • Ability to deem Medical Reserve Corps members as time-limited federal employees for the purposes of liability coverage and medical license credentials.
  • Developing a new mandatory Pre-Exposure Prophylaxis (PrEP) Delivery Program to End the HIV Epidemic in the United States (“PrEP Delivery Program”), aimed at “provid[ing] PrEP and associated services at no cost to uninsured and underinsured individuals and expand the number of providers serving underserved communities.”

As FY24 appropriations have not yet been completed, the chart below compares enacted FY23 levels and FY25 President’s budget proposals.

FY25 Proposed FY23 Enacted + / - FY23
Centers for Disease Control and Prevention $9.68 billion $9.18 billion +$499.2 million
Vaccines for Children $8.040 billion $5.217 billion +$2.823
Vaccines for Adults $12 billion 0 0
Immunization and Respiratory Diseases $969.3 million $919.3 million +$50 million
Influenza Planning and Response $231.358 million $231.358 million 0
HIV, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis $1.4 billion $1.4 billion 0
Domestic HIV Prevention and Research $1.013 billion $1.013 billion 0
Viral Hepatitis Prevention $43 million $43 million 0
Sexually Transmitted Infections Prevention $174.310 million $174.310 million 0
Tuberculosis Prevention $137.034 million $137.034 million 0
Infectious Diseases and the Opioid Epidemic $23 million $23 million 0
Emerging and Zoonotic Infectious Diseases $780.772 million $750.772 million +30 million
Emerging Infectious Diseases $233.997 million $213.997 million +$20 million
Food Safety $71 million $71 million 0
Epidemiology and Laboratory Capacity Grants (Prevention and Public Health Fund) $40 million $40 million 0
National Healthcare Safety Network $24 million $24 million 0
Advanced Molecular Detection (AMD) $40 million $40 million 0
Chronic Disease Prevention and Health Promotion $1.56 billion $1.43 billion +$129 million
Racial and Ethnic Approaches to Community Health $68.95 million $68.95 million 0
Tobacco $130.650 million $120.650 million +10 million
Tobacco (PPHF) $125.850 million $125.850 million 0
Million Hearts (PPHF) $5 million $5 million 0
Cancer Prevention and Control $499.549 million $409.549 million +90 million
Safe Motherhood/Infant Health $118 million $108 million +10 million
Diabetes Prevention Program $37.3 million $37.3 million 0
Diabetes Prevention Program (PPHF) $52.275 million $52.275 million 0
School Health $38.081 million $19.081 million +19 million
Birth Defects, Developmental Disabilities, Disabilities and Health $205.560 million $205.56 million 0
Surveillance for Emerging Threats to Mothers and Babies (SET-NET) $23 million $23 million 0
Environmental Health $266.850 million $246.850 million +$20 million
Climate and Health $20 million +$10 million
Environmental Health Activities $62.6 million $52.6 million +10 million
Childhood Lead Poisoning Prevention $61 million $51 million +$10 million
Asthma $33.5 million $33.5 million 0
Environmental and Health Outcome Tracking Network $34 million $34 million 0
Injury Prevention and Control $943.379 million $761.379 million +$182 million
Intentional Injury $323.550 million $164.550 million +$159 million
Unintentional Injury $13.3 million $13.3 million 0
National Violent Death Reporting System (NVDRS) $24.5 million $24.5 million 0
Injury Prevention Activities $29.950 million $29.950 million 0
Opioid Abuse and Overdose Prevention and Surveillance $506.079 million $505.079 million +$0.5 million
Public Health Preparedness and Response $943.3 million $905.1 million +$38.2 million
Public Health Scientific Services $804.097 million $754.497 million +$49.6 million
Public Health Workforce Development $71 million $71 million 0
Surveillance, Epidemiology, and Public Health Informatics $298.1 million $298.1 million 0
Health Statistics $187.397 million $187.397 million 0
CDC-Wide Activities and Program Support $723.570 million $723.570 million 0
Public Health Leadership and Support $128.570 million $128.570 million 0
Preventative Health and Health Services Block Grant (PPHF) $160 million $160 million 0
Infectious Disease Rapid Response Reserve Fund $35 million $35 million 0
Public Health Infrastructure and Capacity $350 million $350 million 0
FY25 Proposed FY23 Enacted + / - FY23
Assistant Secretary for Preparedness and Response (ASPR) $3.8 billion $3.66 billion +$138 million
Medical Reserve Corps $6.24 million $6.24 0
Health Care Readiness and Recovery (formerly Hospital Preparedness Program) $317.055 million $305.055 million +$12 million
Biomedical Advanced Research and Development Authority $970 million $950 million +$20 million
Strategic National Stockpile $965 million $965 million 0
Project BioShield $820 million $820 million 0
FY25 Proposed FY23 Enacted + / - FY23
Health Resources and Administration (HRSA) $16.3 billion $14.3 billion +$2 billion
Primary Healthcare Access: Community Health Center Fund $6.34 billion $4 billion +$2.34 billion
Public Health and Preventative Medicine $18 million $18 million 0
Maternal and Child Health Block Grant $831.7 million $816.2 million +$16 million
Healthy Start $172 million $144.5 million +$27.5 million
Ryan White Part A $680.752 million $680.752 million 0
Ryan White Part B $1.365 billion $1.365 billion 0
Ending the HIV Epidemic Initiative $175 million $165 million +$10 million
United States Department of Agriculture (USDA)
FY25 Proposed FY23 Enacted +/- FY23
Special Supplemental Nutrition Program for Women, Infacts, and Children (WIC) $7.7 billion $6 billion +$1.7 billion
FY25 Proposed FY23 Enacted + / - FY23
Department of Health and Human Services (HHS) $130.7 billion $128.6 billion +$2.2 billion
Title X Family Planning Program $390 million $286 million +$104 million

For additional detail on any of the above information, see:

About Adriane Casalotti

Adriane Casalotti is Chief of Government and Public Affairs at NACCHO.

More posts by Adriane Casalotti

About Victoria Van de Vate

Victoria Van de Vate is the Director of Government Affairs at NACCHO.

More posts by Victoria Van de Vate

About Lauren Mastroberardino

Lauren is a Government Affairs Senior Specialist at NACCHO.

More posts by Lauren Mastroberardino

About Molly Curington

Molly Curington is a Government Affairs Associate at NACCHO.

More posts by Molly Curington

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