President Biden released his FY 2025 budget proposal yesterday, detailing his visions for the Administration’s priorities for 2025 and beyond. The President’s proposal, along with the HHS Budget in Brief which provides some additional context, outlines additional support for the Health Center Program (under Section 330), Teaching Health Center Graduate Medical Education (TGME), National Health Service Corps (NHSC), and Medicare mental health benefits.
The proposal assumes that Congress adopted the President’s proposed FY 2024 spending levels, but because Congress didn’t finalize FY 2024 spending until late in the year, the proposed FY25 budget doesn’t reflect actual FY 24 funding numbers. For Section 330, NHSC, and THCs, these numbers are significantly higher than actual FY24 funding.
Here is a breakdown of the budget proposal that is of interest to ACH members.
Provide a pathway to double funding for the Health Center Program
Costs: $8.2 billion for FY 2025
The FY 2025 budget provides $8.2 billion for Health Centers, which includes $6.3 billion in proposed mandatory resources, an increase of $2.4 billion above FY 2023. This investment moves HRSA forward on the path to doubling Health Center funding and supports the expansion of behavioral health services at Health Centers. At this funding level, the Health Center program will provide care for approximately 3.9 million additional patients. The Health Center Program also supports the Ending HIV Epidemic and the Cancer Moonshot initiatives. The budget invests $157 million to provide prevention and treatment services to people at high risk for HIV transmission, including Pre-Exposure Prophylaxis related services, outreach, and care coordination. The budget also includes $11 million to build on recent successes through the Accelerating Cancer Screening initiative to improve access to early detection services and life-saving cancer screenings for underserved communities.
Teaching Health Center Graduate Medical Education (THCGME)
Costs: $320 million for FY 2025
The Teaching Health Center Graduate Medical Education Program helps address the critical need for primary care providers by training primary care physicians and dental residents in community-based settings, which will ultimately help increase primary care physicians practicing in high-need communities post-residency. In 2022, Teaching Health Center Graduate Medical Education residents significantly enhanced access to primary care in underserved areas by treating over 792,000 patients during more than 1.2 million patient encounters. The budget includes $320 million in mandatory funding for this program, which is $201 million above FY 2023. In FY 2025, the program will support over 1,800 resident full-time equivalent slots.
National Health Service Corps (NHSC)
Costs: $916 million for FY 2025
The National Health Service Corps offers scholarship and loan repayments to healthcare clinicians in return for their commitment to practice in rural and underserved communities across the nation. The FY 2025 budget includes $916 million, an increase of $498 million above FY 2023, for the National Health Service Corps. The budget supports scholarships and loan repayments to improve access to quality primary care, including maternal healthcare, oral healthcare, and behavioral health in underserved urban, rural, and tribal areas. Primary care providers trained through HRSA’s National Health Service Corps serves more than 19 million patients living in Health Professional Shortage Areas across the nation. Alumni data shows that 86 percent of National Health Service Corps members continue to serve in Health Professional Shortage Area 2 years after their formal service commitment has ended, providing a key mechanism for addressing health workforce challenges in these areas.
Modernize Medicare Mental Health Benefits
Cost: Not Scoreable
Currently, statutory limits on the list of practitioners and the scope of services that are eligible for Medicare payment restrict access to mental health services in Medicare. While the Consolidated Appropriations Act, 2023 added coverage of services furnished by marriage and family therapists and mental health counselors, including licensed professional counselors, gaps remain in Medicare mental health benefits. This proposal allows Medicare to identify and designate additional professionals who could enroll in Medicare and be paid when furnishing behavioral health services within their applicable state licensure or scope of practice that would otherwise be covered when furnished by a physician. The proposal also establishes a Medicare benefit category for these professionals that authorizes direct billing and payment for these practitioners; removes limits on the scope of services for which they can be paid by Medicare; allows these practitioners to bill Medicare directly for their mental health services for covered Part A qualifying Skilled Nursing Facility stays; establishes payment under Part B for services provided under an Assertive Community Treatment delivery system which provides treatment for the severe functional impairments associated with serious mental illness; allows payment to Rural Health Clinics and Federally Qualified Health Centers for these additional behavioral health professionals providing mental health services; and enables Medicare coverage of evidence-based digital applications and platforms that facilitate the delivery of mental health services. By authorizing Medicare to add professionals in statute that are able to receive direct Medicare payment for their mental health services, this proposal expands access to mental health services in Medicare, especially in rural and underserved areas with fewer mental health professionals, or communities more likely to receive care from the referenced professionals.
For more information, please contact our Policy & Government Affairs team at info@advocatesforcommunityhealth.org.