Boosts in funding for senior nutrition programs, caregiver support, and elder abuse protections are among the increases in the Biden administration's fiscal year 2023 budget request released on March 28, just weeks after Congress approved final appropriations for the current fiscal year (download the current funding table (updated in December 2022)). 

The plan also calls for Medicare changes to make it easier to get mental health care and potentially lower prescription drug costs.

"We can give Medicare the power to negotiate lower prescription drug prices," President Biden said in his March 28 statement. "This will bring down the cost for seniors and reduce the deficit by hundreds of billions of dollars."

Biden's request also calls for investments in Aging Services to respond to the ongoing needs from the COVID pandemic, as part of a 14% boost in non-defense discretionary (NDD) funding.

Alison Barkoff, acting sssistant secretary for aging and administrator for the Administration for Community Living (ACL) says Biden's budget would help create equitable access to health care, education, transportation, recreation, and other systems, resources, and opportunities for older adults. "Our communities are stronger when everyone is included, everyone is valued, and everyone can contribute," she said.

ACL and HHS are committed to making community living an option for every American, regardless of age or disability, race or ethnicity, gender identity or sexual orientation, income or any other factor, and this budget aligns with that commitment.”

Below are the proposals that NCOA is tracking.

Older Americans Act (OAA) 

The budget request for the Administration for Community Living (ACL) stresses the importance of investing in the “new normal” and infrastructure, while also supporting core priorities such as protecting rights and fostering innovation. Increases in OAA programs include: 

• Supportive Services and Senior Centers: $101.4 million 
• Senior Nutrition Programs: $305.7 million
• Health Promotion and Disease Prevention: $1.5 million
• National Family Caregiver Support Program: $56 million
• Aging Network Support: $4.4 million
• Native American Services: $38.4 million
• Protection of Vulnerable Older Americans: $17.2 million
• Elder Rights/Elder Justice: $58.5 million

During the pandemic, emergency funding enabled the Aging Services Network to respond to older adults' most pressing needs. Appropriations for FY23 and beyond must be sufficient to meet the demands of the increased number and diversity of older adults and the growing need to navigate digital services. 

NCOA is advocating for investments in the core capacities of the Aging Services Network, particularly multipurpose senior centers and healthy aging and economic security programs that empower older adults to successfully emerge from the pandemic. Level funding for falls prevention, Chronic Disease Self-Management Education (CDSME), and the Senior Community Service Employment Program (SCSEP) is simply insufficient to meet today’s needs. More is also needed to support older adults' behavioral health beyond incremental investments in health promotion and combatting isolation. 

Other aging services

The budget request proposes increases for other services focused on Medicare enrollment, energy assistance, nutrition support, and civic engagement, including:

• Medicare State Health Insurance Assistance Program (SHIP): $2.1 million 
• Low-Income Home Energy Assistance Program (LIHEAP): $175 million
• Commodity Supplemental Food Program (CSFP): $6.6 million
• AmeriCorps Seniors: $14.2 million

“The President’s budget provides the U.S. Department of Agriculture (USDA) with the tools needed to support a vibrant, revitalized, and prosperous rural America," said USDA Secretary Tom Vilsack in a March 28 statement. "USDA’s core nutrition programs are the most far-reaching, powerful tools available to ensure that all Americans, regardless of race, ethnicity, or background, have access to healthy, affordable food."

The budget proposes $111 billion for the Supplemental Nutrition Assistance Program (SNAP), a budget level that supports 43.5 million Americans per month," Vilsack said.

Medicare and behavioral health

The budget includes targeted Medicare proposals to invest in mental health. One proposal NCOA supports would establish a Medicare benefit category for Licensed Professional Counselors and Marriage and Family Therapists that authorizes direct billing and payment under Medicare for these practitioners.

Another proposal we support would apply the Mental Health Parity and Addiction Equity Act to Medicare. This act requires health plans that offer mental health and substance use disorder benefits to provide coverage that is on par with the plans' medical and surgical benefits.

NCOA applauds increased budgets for improving mental health coordination and suicide prevention, but we are still determining how much of the president's mental health budget will benefit older Americans and adults with disabilities. Learn more from the National Alliance on Mental Illness. 

Social Security

Resources for Social Security Administration (SSA) staffing and outreach were cut in recent years. The Biden Administration is advocating for investments to restore that infrastructure and help reopen local offices. The FY23 budget request for SSA is $14.8 billion, an increase of 14% above 2021.

The budget plan also proposes expanding outreach to the most vulnerable individuals eligible for Supplemental Security Income (SSI) benefits. The request is for $100 million versus $75 million for FY22.

What’s next for Biden's FY23 budget request?

The House Appropriations Committee is expected to move quickly to craft the 12 individual appropriations bills for FY23. The goal: to pass the bills in the House before the Independence Day recess. Appropriations leaders from both parties are discussing the need to agree on parameters early, which will help advance the budget process.

However, given legislative priorities pending in Congress and the political realities of a mid-term election year, advocates expect FY23 appropriations will not be finalized before the start of the fiscal year on Oct. 1, making a Continuing Resolution necessary until at least November to keep the government running. 

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