President Biden this week released his proposed $5.8 trillion budget plan, which includes funds to reduce violence and accelerate criminal justice reforms, investments in evidence-based higher education programs, and a boost for climate change and clean energy needs. It offers only the promise of more work ahead to lower drug prices for Americans, and a concerning delay in the reform of failing organ procurement organizations.
Criminal Justice
Biden’s presidential budget has requested millions in new investments in evidence-based practices to maximize opportunity and minimize injustice in the criminal justice system.
It allocates $60 million — a 140% increase — for the Centers for Disease Control and Prevention and National Institutes of Health to research gun violence, a leading cause of preventable death and injury in the United States. About 40,000 Americans die every year from gun violence, yet the government has underfunded its study since 1996’s Dickey Amendment was misinterpreted as an outright ban on most gun research. A recent report supported by the Joyce Foundation and Arnold Ventures found that to close this knowledge gap, the government needs to spend $120 million annually over five years to collect and research the comprehensive, transparent data that could help stem this public health crisis.
The budget also allocates $500 million to support community violence intervention in the Departments of Justice and Health and Human Services, at a time when communities across the country are grappling with a spike in violence. Efforts are underway from Texas to California to identify data-driven reforms that have the potential to reduce violence, and many involve programs that see law enforcement and communities working together to address violence.
Additionally, the budget includes $300 million for new programs to accelerate criminal justice reforms and $100 million for community-based alternatives to youth incarceration.
Health Care
President Biden reaffirmed his commitment to lower prescription drug prices — an objective supported by a majority of Americans from across the political spectrum — and urged Congress to deliver meaningful reforms.
Congress has proposals on the table that would lower drug prices by allowing Medicare to negotiate the prices of prescription drugs, penalize manufacturers for raising prices faster than inflation, and reform Medicare Part D to ensure life-saving medications don’t bankrupt Americans. While Congress has yet to agree on specific legislation, a recent U.S. Senate Finance committee hearing underscored the demand and the appetite for action.
The budget did not expressly address reforms in high-priority policy areas — including addressing high prices charged by hospitals; better coordinating of care for people with complex medical needs; ensuring that Medicare remains sustainable long-term; and reducing waste and excessive costs in health care — but these remain ripe for action to ensure a more affordable and equitable health care system.
Organ Donation
The budget proposal suggests further delaying the replacement of failing organ procurement organizations with higher performers until as late as 2030, a concerning development that could lead to thousands of unnecessary deaths.
A rule issued by the Centers for Medicare and Medicaid Services gave OPOs until 2026 to adhere to new performance standards or lose their contracts, and bipartisan Congressional leaders have rightly called for the rule to be accelerated. Each year of delay costs 7,000 lives and $1 billion to Medicare. As past NAACP president Ben Jealous wrote: “Further delay of the new regulations, which would consign thousands of patients — mostly patients of color — to unnecessary death. If we understand the problem and know the solution, to withhold its implementation is cruel and senseless.”
Higher Education
The Biden budget calls for a $110 million investment in evidence-based college retention and completion efforts. College completion programs such as Bottom Line, CUNY ASAP, and others have shown in rigorous evaluations to be effective in raising college graduation rates. Nearly one in seven adults between the ages of 25 and 64 have taken some college courses but not completed a degree, and Black adults are disproportionately likely to have some college education but no degree, according to The Institute for College Access and Success. “The reality is, based on average graduation rates, if four-year institutions were high schools, according to federal law, then they would be considered dropout factories,” said Kelly McManus, director of higher education at Arnold Ventures. These new dollars could have a significant impact in scaling interventions proven to work and building the evidence base of additional interventions to promote student success.
Climate and Clean Energy
Several climate-related departments would receive a significant funding boost. The Department of Energy is slated to receive $48.2 billion, a 15.1% increase over the 2021 enacted level. Roughly mirroring spending priorities in the Bipartisan Infrastructure Law, the DOE proposal puts $22.6 billion toward clean energy-related research, development, demonstration, infrastructure, jobs, and manufacturing.
This proposal, together with the Bipartisan Infrastructure Law and the recent appropriations bill, will greatly improve the odds of successful implementation of former President Trump’s Energy Act of 2020 as well as aid the U.S. in hitting climate goals to reduce greenhouse gas emissions by 50% in 2030 and reach net-zero emissions by 2050.
Said Conrad Schneider, advocacy director at climate nonprofit Clean Air Task Force: “We applaud the Administration’s commitment to American leadership in energy innovation and job creation. It is now up to Congress to build on this starting point and enact robust annual funding levels that will enhance our energy security, decarbonize our economy, and stabilize energy prices for American consumers.”
