IT’S BIDEN’S BUDGET DAY — The White House’s budget ask, expected to top $6 trillion overall, would pour billions of dollars into agencies like the CDC and NIH that have been at the center of the pandemic response. It’ll be a sharp reversal from the Trump era, when officials repeatedly sought spending cuts, and an expression of Biden’s embrace of big-government programs as central to solving the nation’s most entrenched health challenges, from Covid-19 to gun violence and the opioid epidemic. But the president is limiting his ambitions in one notable way. His budget request is unlikely to propose new health policy overhauls of the sort that Biden campaigned on. That means no money for implementing a public option, for expanding Medicare benefits and eligibility — or even, much to some Democrats’ dismay, for allowing the government to negotiate drug prices. The White House instead will express support for eventually accomplishing those goals, but won’t offer any specifics for how Congress should get them done or pay for them, The New York Times and Washington Post reported. It’s an additional blow to Democrats who have pressed Biden for weeks to include their health priorities in his plans for spending packages this year, for fear they’ll slip to 2022 or beyond. Obligatory annual reminder here that the president’s budget is just a wish list. Congress will almost assuredly ignore large parts of it. But among the specific initiatives to keep an eye out for: — The creation of a new health research agency. NIH Director Francis Collins this week previewed the $6.5 billion Biden will likely ask for to create a health care version of the Advanced Research Projects Agency, or ARPA-H — essentially a research accelerator that would focus on treatments for cancer and other diseases. The concept has already won bipartisan buy-in, though it’s still unclear how it would be incorporated within NIH. — New spending on public health preparedness. The White House’s “skinny budget” in April sought $8.7 billion for the CDC, representing the infectious disease agency’s biggest budget boost in years. Biden could also seek funding elsewhere to build out the U.S.’s scientific workforce and improve state and local public health operations. — Renewed emphasis on the opioid and gun violence epidemics. Biden is likely to call for renewed investment in gun violence research within HHS, as well as billions more to curb a record rise in drug overdoses. — More funding for smaller health offices, such as the Indian Health Service and Office of Refugee Resettlement. The latter agency has had to siphon money from elsewhere in HHS to manage care for its large migrant child population. DEMOCRATS’ PLAN B ON THE BUDGET — For all the fanfare around Biden’s budget, congressional Democrats are already eyeing what comes next — and devising workarounds to longstanding bans on funding for abortion and gun violence research, POLITICO’s Caitlin Emma reports. Despite White House support for abandoning the two riders (called the Hyde and Dickey amendments, respectively), there’s little expectation Congress will vote to do so. So Democrats instead are trying to fund those priorities indirectly, targeting big increases for reproductive health services and grant programs that fund clinics like Planned Parenthood. Democrats are also rushing to take advantage of a recent weakening in the restrictions around gun violence research by distributing billions of dollars to various federal agencies to bolster research, prevention initiatives and background check systems.
| 
