On Thursday, March 9, President Biden released his Fiscal Year 2024 (FY24) budget request. The budget proposes $144.3 billion in discretionary and $1.7 trillion in mandatory budget authority for the Department of Health and Human Services for FY 2024.

The budget demonstrates the Administration’s commitment to areas such as health equity and maternal health, among other priority areas. According to HHS, “The budget also works to secure a healthier, more vibrant future for all Americans by investing in expanded coverage and access to care; addressing the needs of those most at risk, including Indian country, children, families, and seniors; growing our health workforce; and advancing science to improve health.”

Aligning for Health was pleased to see the inclusion of several key provisions related to SDOH, health equity, and maternal health in this budget request, including a $100 million request for the CDC for the Social Determinants of Health program. Through this particular request, CDC would continue to expand SDOH efforts by funding another round of Social Determinant Accelerator Plans to states, tribes, territories, and/or localities to develop new or implement and evaluate existing SDOH plans, including but not limited to, previously funded accelerator plans recipients, and building the evidence base through applied research, data collection, and surveillance.

For a full summary of the SDOH-related provisions included in the request, click here or see below:

On December 20, 2022, House and Senate Appropriators released the text of the FY2023 Omnibus Appropriations bill, which includes $1.7 trillion in appropriations for fiscal year 2023 and several key health care extenders and new authorizations. The Consolidated Appropriations Act, 2023 was signed into law by President Biden on on December 29, 2022.

Aligning for Health was thrilled to see the inclusion of many key social determinants of health policies, funding, and initiatives included in this package. Along with the appropriations bill, the accompanying Joint Explanatory Statement, which cross-references the House Committee on Appropriations Report for the Departments of Labor, Health and Human Services, and Education, and Related Agencies for Fiscal Year 2023 Appropriations, includes additional details related to the appropriated amounts.

Most notably:

• CDC’s Social Determinants of Health Accelerator Grants continue to be funded at $8M for FY23.
• Section 2201, Addressing Factors Related to Improving Health Outcomes, stems from the Senate HELP Committee’s PREVENT Pandemics Act and includes similar concepts as the Aligning for Health-endorsed Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act and the Social Determinants Accelerator Act. Aligning for Health has provided feedback on previous versions of this provision and looks forward to working with the Administration on its implementation.
  • Section 2201 authorizes the HHS Secretary to award $35M a year in grants, contracts, or cooperative agreements to states or other eligible entities to support the implementation of strategies to address factors related to health outcomes; to establish, maintain or improve technology platforms or networks to support coordination and information sharing; implementation of best practices; and supporting consideration of factors related to health outcomes in preparing for and responding to public health emergencies.

Other notable provisions include:

• CMS – Social Determinants of Health. —The Committee encourages CMS to continue to clarify and disseminate strategies that States can implement under current Medicaid and CHIP authority, or through waivers, to address social determinants of health (SDOH) in the provision of health care, including strategies specifically targeting the pediatric population. This should include guidance on how States can encourage and incentivize managed care organizations to address SDOH through contracts.
• CMS – Utilization of Z Codes for Social Determinants of Health. — The Committee is concerned about whether the current Z codes definitions are expansive and specific enough to track the SDOH impacting underserved communities. To help reduce these barriers, the Committee encourages HHS to update the current Z code definitions and establish a national standard to review SDOH to ensure physicians nationwide use the same tools to analyze SDOH. The Committee requests a briefing within 180 days of the date of enactment of this Act on the current utilization of Z codes, how HHS suggests the Z codes definitions could be updated to better track SDOH impacting underserved communities and recommendations on how to increase the utilization of Z codes.
• CMS – Social Determinants of Health Analytics. —. The Committee requests a report within 180 days of the date of enactment of this Act on efforts by CMS to ensure the transparency by MA and MCO plans in the use of data of beneficiaries in addressing SDOH, how CMS ensures that MA and MCO plans notify beneficiaries of the use of protected or consumer data, and how ongoing CMS work with MA and MCOs around SDOH and the use of consumer data and protected medical information aligns with and improves health equity as per the goals of Executive Order 13985 and the HHS’s Equity Action Plan.

Below we have pulled notable provisions related to social determinants of health, health equity, and maternal health that were included as part of this package. You can also find this summary here.