This analysis was prepared by McDermott+ Consulting, on behalf of AACOM.
On July 14, the House Appropriations Labor, Health and Human Services, and Education, and Related Agencies Subcommittee approved its fiscal year 2024 bill. The bill now moves to the full House Appropriations Committee for consideration.
A summary of key provisions relevant to the osteopathic medical education (OME) community can be found below. Information was gathered from the House bill and the minority press release.
The Labor, Health and Human Services, Education, and Related Agencies bill provides $147 billion for programs under the jurisdiction of the Subcommittee, which is $60.3 billion (29%) below the FY23 enacted level and $73 billion below the President’s Budget Request. These catastrophic spending cuts would devastate and eliminate many OME priority programs, including:
Department of Health and Human Services
The bill provides a discretionary total of $103.3 billion to the Department of Health and Human Services (HHS), which is $14 billion (12%) below the FY23 enacted level and $25.9 billion below the President’s Budget Request.
- Health Workforce – Provides $1.3 billion for carrying out titles III, VII, and VIII of the Public Health Service (PHS) Act with respect to the health workforce, sections 1128E and 1921 of the Social Security Act, and the Health Care Quality Improvement Act of 1986
- Provides $60 million for grants to public institutions of higher education to expand or support graduate education for physicians, including funding for infrastructure development, maintenance, equipment, and minor renovations.
- Secretary shall give priority to public institutions of higher education located in States with a projected primary care shortage in 2030, as determined by the Secretary.
- The grants must not be less than $1 million per year.
- The period that the grant is awarded for may not exceed 5 years.
- A grant awarded with respect to a year to an institution will be subject to a matching requirement of non-Federal funds in an amount that is not more than 10 percent of the total amount of Federal funds provided in the grant to the institution with respect to that year.
- Provides $60 million for grants to public institutions of higher education to expand or support graduate education for physicians, including funding for infrastructure development, maintenance, equipment, and minor renovations.
- Maternal and Child Health - Provides $991.5 million for carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health and title V of the Social Security Act
- Ryan White HIV/AIDS Program - Provides $2.3 billion for carrying out title XXVI of the PHS Act with respect to the Ryan White HIV/AIDS program, of which $2 billion will be available to the Secretary through September 30, 2026, for parts A and B of title XXVI of the PHS Act, and of which not less than $900.3 million will be for State AIDS Drug Assistance Programs under the authority of section 2616 or 311(c) of such Act.
- Health Systems - Provides $101 million for carrying out titles III and XII of the PHS Act with respect to health care systems, and the Stem Cell Therapeutic and Research Act of 2005, of which $122,000 shall be available until expended for facility renovations and other facilities-related expenses of the National Hansen’s Disease Program.
- Substance Abuse and Mental Health Services Administration (SAMHSA) – The bill funds SAMHSA at $7.1 billion, a cut of $234 million below the enacted level.
- Mental Health – Provides $385 million for grants to communities and community organizations who meet criteria for Certified Community Behavioral Health Clinics
- Chronic Disease Prevention and Health Promotion – Provides $797.5 million for carrying out titles II, III, XI, XV, XVII, and XIX of the PHS Act with respect to chronic disease prevention and health promotion.
- Disabilities and Health - Provides $205.5 million for carrying out titles II, III, XI, and XVII of the PHS Act with respect to birth defects, developmental disabilities, disabilities and health.
- Public Health Scientific Services – Provides $654.5 million for carrying out titles II, III, and XVII of the PHS Act with respect to health statistics, surveillance, health informatics, and workforce development.
- Rural Health – Provides $12.7 million through September 30, 2026 to support the Rural Residency Development Program
- Payments to the Health Care Trust Funds – Provides $476.7 billion for payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund
- Administration for Strategic Preparedness and Response (ASPR) – Research Development and Procurement – Provides $3.2 billion for the research, development, storage, production, and procurement of medical countermeasures to counter potential chemical, biological, radiological, and nuclear threats to civilian populations
- National Institutes of Health – The bill includes a total of $44.6 billion for NIH, a cut of $2.8 billion below enacted level, including:
- $7.1 billion for the National Cancer Institute (NCI), a cut of $216 million below the enacted level
- $2.7 billion for the National Institute of Neurological Disorders and Stroke (NINDS), a cut of $139 million below the enacted level
- $2.2 billion for the National Institute of Mental Health (NIMH), a cut of $139 million below the enacted level
- $5.1 billion for the National Institute of Allergy and Infectious Diseases (NIAID), a cut of $1.5 billion below the enacted level
- Advanced Research Projects Agency for Health (ARPA-H) – The bill includes $500 million for ARPA-H, a cut of $1 billion below the enacted level.
- Centers for Disease Control and Prevention (CDC) – The bill includes a total of $7.6 billion for CDC, a cut of 1.6 billion below the enacted level.
- The bill eliminates funding for Firearm Injury and Mortality Prevention Research, a cut of $12.5 million below the enacted level.
- The bill eliminates funding for Tobacco Prevention and Control, a cut of $247 million below the enacted level.
- The bill eliminates funding for the Ending the HIV Epidemic initiative, a cut of $220 million below the enacted level.
- The bill includes $100 million for Public Health Infrastructure and Capacity, a cut of $250 million below the enacted level.
- The bill includes $75 million for Public Health Data Modernization, a cut of $100 million below the enacted level.
- The bill includes $371 million for Global Health, a cut of $322 million below the enacted level.
- The bill eliminates funding for the Climate and Health program, a cut of $10 million below the enacted level.
- The bill eliminates funding for the Center for Forecasting and Analytics, a cut of $50 million below the enacted level.
- Health Resources and Services Administration (HRSA) – The bill includes $7.3 billion for HRSA, a cut of more than $700 million below the enacted level.
- Of the amounts made available for the National Institutes of Health (NIH), 1 percent of the amount made available for National Research Service Awards (NRSA) must be made available to the Administrator of HRSA to make NRSA awards for research in primary medical care.
- The bill eliminates funding for Title X Family Planning, a cut of $286 million below the enacted level.
- The bill includes $781 million for the Maternal and Child Health Block Grant, a cut of $35 million below the enacted level.
- The bill eliminates funding for Healthy Start, a cut of $145 million below the enacted level.
- The bill eliminates funding for the Ending HIV Epidemic initiative, a cut of $220 million below the enacted level.
- The bill eliminates funding for multiple programs to support diversity in the healthcare workforce, including:
- Health Careers Opportunity Program ($16 million)
- Centers of Excellence ($28 million)
- Nursing Workforce Diversity ($24 million)
- Provides $45 million for expenses necessary for the Office for the Advancement of Telehealth, including grants, contracts, and cooperative agreements for the advancement of telehealth activities.
- Agency for Healthcare Research and Quality (AHRQ) – The bill eliminates funding for AHRQ, a cut of $374 million below the enacted level.
- Centers for Medicare & Medicaid Services (CMS) – The bill includes a total of $3.3 billion for CMS administrative expenses, a cut of $798 million below the enacted level.
- Office of the Secretary—General Departmental Management – The bill includes $344 million for GDM, a cut of $258 million below the enacted level.
- The bill eliminates funding for the Teen Pregnancy Prevention Program, a cut of $108 million below the enacted level.
- The bill includes $26 million for the Office of Minority Health, a cut of $49 million below the enacted level.
- The bill includes $28 million for the Minority HIV/AIDS Initiative, a cut of $24 million below the enacted level.
- The bill includes $20 million for the Office on Women’s Health, a cut of $49 million below the enacted level.
Department of Education
The bill provides a discretionary total of $67.4 billion to the Department of Education, which is $12.1 billion (15%) below the FY23 enacted level and $22.6 billion below the President’s Budget Request.
Department of Labor
This bill provides a discretionary total of $9.8 billion to the Department of Labor, which is $4 billion (29%) below the FY23 enacted level and $5.7 billion below the President’s Budget Request.
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