Observations from HHS' FY 2019 Budget Request
The president’s FY 2019 Budget Request along with the Bipartisan Budget Act of 2018 (BBA), provides $95.4B in base discretionary budget authority to HHS, a 10% increase over FY 2017.
The president released his $1.3T discretionary budget request for FY 2019 in February 2018, which gives insight into administrative and agency priorities for the next fiscal year. An amendment to the budget request includes the additional $152B in discretionary funding from the BBA. The budget request emphasizes priorities such as national defense and force readiness, public safety, veteran care, addressing the opioid epidemic and border security.
Due to the BBA, HHS shows an increase in funding over both FY 2017 and FY 2018 levels.
The original president’s budget request greatly decreased HHS funding, however the BBA which was signed into law in December 2017, restored much of the funding, shifted some funds from mandatory to discretionary accounts, and added additional funding. Most of the originally planned decrease was due to a planned reduction in NIH funding of $8.6B and the elimination of the Low Income Home Energy Assistance Program (-$3.4B). NIH funding was restored and increased by the BBA.
The budget request aims to strengthen Medicare, repeal and replace Obamacare, comprehensively reform Medicaid, and includes a strong focus on program integrity for all health programs. The budget would also streamline NIH administrative functions, and integrate Agency for Healthcare Research and Quality (AHRQ), National Institute for Occupational Safety and Health within CDC (NIOSH) and National Institute on Disability, Independent Living, and Rehabilitation within Administration for Community Living (NIDILR) and places them under NIH. The budget also includes $5B in new resources over the next five years to combat the opioid epidemic. The BBA adds an additional $10B beyond the original FY 2019 budget request for the opioid epidemic and serious mental illness.
Notable increases in bureau budgets include a $3.4B increase at the Health Resources and Services Administration (HRSA) mostly due to an increase in the Primary Health Care account, and a $500M increase at NIH over FY 2017 enacted levels.
The HHS IT budget showed a decrease of approximately $400M (-6.8%) from FY 2017 levels.
HHS’ proposed Development, Modernization and Enhancement (DME) budget of $1.1B (20% of the total IT) is a 13% decrease from FY 2017 levels. HHS shows 603 total IT investments; the top 10 represent 32% of the total IT budget at $1.7B. $822M is slated for application costs which includes application development, support and operations, business software, distributed database services, middleware, mainframe database services, and mainframe middleware. The IT budget also includes $353M for cybersecurity.
CMS retains the largest IT budget at $2.5B, showing a $209M decrease from FY 2017, followed by NIH with a $975M IT budget, showing a $59M decrease from FY 2017.
Notable agency changes from FY 2017 include a 50% decrease at AHRQ, a 30% decrease at the Administration for Community Living (ACL), a 22% decrease at the Administration for Children and Families (ACF), and a 20% decrease for Departmental Management.
CDC’s Surveillance Data Platform investment showed the most notable change from FY 2017 to FY 2019 with an increase of $46M (+2155%). This program is a web-based, integrated data collection platform that provides and supports services for public health surveillance data collection, analysis and dissemination efforts across the agency and with CDC public health partners.
For more information on the FY 2019 President’s Budget Request, please see Deltek’s new report, “Insights and Implications: FY 2019 Federal Budget Request.”
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