Behind the Bill: July 17, 2024

Planning for fiscal year (FY) 2025 is underway, and it looks like the US Department of Health and Human Services (HHS) and other federal agencies might be in for some budget tightness. Last week, the House Appropriations Committee began preliminary discussions. While this is their current proposal, a lot could change depending on the Senate’s input and final negotiations.¹

The current proposal makes substantial cuts to health programs, setting aside a total of $107 billion for HHS. That’s 7% lower than what was enacted for FY 2024, translating to a shortfall of $8.5 billion, and a massive $14 billion less than what the President asked for—the Figure provides insight into how this budget has changed since last year. This should come as no surprise considering the House Budget Committee’s FY 2025 budget resolution emphasized a substantial deficit reduction of $2.5 trillion in discretionary spending.²

The US Food and Drug Administration (FDA) spending bill provides $3.5 billion in direct appropriations—just half of what the President proposed. That said, an additional $3.5 billion is expected to come from user fees. In their budget request, the FDA highlighted the need to address supply chain disruptions and respond to recent shortages. In fact, 86% of surveyed cancer centers said they’re facing shortages of at least one type of cancer drug, and this is expected to continue. One top of those goals, the FDA has plans to upgrade its operations and facilities.^3,4

Though preliminary, the budget proposal reflects the House’s priorities and policy direction, especially in the wake of the recent Chevron and Corner Post Supreme Court rulings. With decreased funding, agencies like HHS and the FDA may struggle to enforce regulations as effectively, which could impact how they respond to and implement judicial rulings. Plus, with less deference in the courts and a prolonged statute of limitations, federal agencies face significant regulatory risk.

For now, the Further Consolidated Appropriations Act of 2024 funds federal agencies through September 30, 2024.

Join me every Wednesday as I highlight key court decisions, review notable health policies, and analyze what’s behind the bill in health care.

References

1. Labor, Health and Human Services, Education, and Related Agencies Appropriations Act, 2025. Subcommittee markup. Updated June 25, 2024 . Accessed July 15, 2024. https://appropriations.house.gov/sites/evo-subsites/republicans-appropriations.house.gov/files/evo-media-document/fy25-labor-health-and-human-services-education-and-related-agencies-subcommittee-bill-summary.pdf

2. Committee for a Responsible Federal Budget. What’s in the House Budget Committee’s FY 2025 budget resolution? April 10, 2024. Accessed July 15, 2024. https://www.crfb.org/blogs/whats-house-budget-committees-fy-2025-budget-resolution

3. U.S. Food & Drug Administration. FDA seeks $7.2 billion to enhance food safety and nutrition, advance medical product safety, and strengthen public health. March 11, 2024. Accessed July 15, 2024. https://www.fda.gov/news-events/press-announcements/fda-seeks-72-billion-enhance-food-safety-and-nutrition-advance-medical-product-safety-and-strengthen

4. Howard J. US cancer centers warn drug shortages continue, impacting different varieties of medications. CNN. June 26, 2024. Accessed July 15, 2024. https://www.cnn.com/2024/06/26/health/cancer-drug-shortages-continue/index.html

5. Van de Vate V, Mastroberardino L. House Appropriations Committee release fiscal year 2025 Labor-HHS-Education Bill. NAACHO. June 27, 2024. Accessed July 15, 2024. https://www.naccho.org/blog/articles/house-appropriations-committee-releases-fiscal-year-2025-labor-hhs-education-bill

6. U.S. Food & Drug Administration. FY 2025 FDA budget summary. Accessed July 15, 2024. https://www.fda.gov/media/176923/download?attachment