Domestic HIV Funding in the White House FY2021 Budget Request

The White House released its FY 2021 budget request to Congress on February 10, 2020, which includes funding for key programs aimed at addressing the domestic HIV epidemic.  Specifically, the request asks for funding for HIV activities at the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS and Health Center Programs, the National Institutes of Health (NIH), and the Indian Health Service (IHS).  Details on additional funding in other departments/agencies is not yet known but will be provided here, when available.

The request supports historic HIV-related activities within the agencies as well as the second year of the Trump Administration’s “Ending the HIV Epidemic (EHE)” initiative.  Key budget highlights are as follows (see tables below for additional detail).

CDC – HIV prevention

Funding for domestic HIV prevention at the CDC, which accounts for most federal funding for domestic HIV prevention, totals $1,160 million in the request, an increase of $231 million (25%) over both the FY 2020 enacted level and the President’s FY 2020 request.

All of the increase is attributed to the EHE. If finalized, CDC EHE funding in the FY21 Request would represent an increase of $231 million (165%) over both the FY 2020 enacted level for the EHE at CDC and the President’s FY 2020 EHE request.

HRSA – Ryan White and Health Center HIV Funding

  • The Ryan White HIV/AIDS Program, the nation’s safety net for HIV care and treatment, receives $2,484 million in the FY 2021 request, a $95 million (4%) increase over both the FY 2020 enacted level and the President’s FY 2020 request. All of the increase for Ryan White is attributed to EHE activities, which receive $165 million in the request, an increase of $95 million (136%) over both the FY 2020 enacted level and the President’s FY 2020 request for EHE activities through the program.
  • The FY 2021 budget request also includes HIV funding for the Health Center Program at HRSA, all of which is for the EHE initiative, totaling $137 million, an $87 million (174%) increase over both the FY 2020 enacted level and the President’s FY 2020 request for EHE activities.

NIH – Domestic HIV Research

  • The National Institutes of Health (NIH) carries out almost all federally funded HIV research activities. In the FY 2021 budget request, domestic HIV research funding at NIH totaled $2,2534 million, which if finalized, would be a decrease of $218 million (-9%) over the FY 2020 enacted level and a 7% increase over the President’s FY 2020 request.
  • All new domestic HIV NIH funding in the request is attributed to the EHE. The agency received $16 million in EHE funding in the request. If finalized, NIH EHE funding in the FY 2021 request would be an increase of $10 million (167%) over both the FY 2020 enacted level and the President’s FY 2020 request for EHE activities.

IHS

  • The FY 2021 budget request includes $27 million for EHE activities at the IHS. While the FY 2020 budget request included $25 million in EHE funding for IHS, no funding was appropriated by Congress.

The tables below compare federal funding levels for domestic HIV, where specified, in the FY 2021 request to the FY 2020 enacted levels and the FY 2020 request. Funding for the “Ending the HIV” Initiative is included in the overall table (Table 1) and in a dedicated table (Table 2).

Table 1: FY21 Key Accounts in the Domestic HIV Budget Request (in Millions)
Department / Agency FY20 FY20 FY21 Difference
Request Enacted Request FY21 Request –
FY20 Request
FY21 Request –
FY20 Enacted
CDC – HIV Prevention $928.712 $928.712 $1,159.712 25% 25%
      Of which EHE $140.000 $140.000 $371.000 165% 165%
HRSA
   Ryan White $2,388.781 $2,388.781 $2,483.781 4% 4%
       Of which EHE $70.000 $70.000 $165.000 136% 136%
   Community Health Centers
   (all of which EHE)
$50.000 $50.000 $137.000 174% 174%
NIH – Domestic HIV Research $2,110.066 $2,471.754 $2,253.844  7% -9%
      Of which EHE $6.000 $6.000 $16.000 167% 167%
IHS (all of which EHE) $25.000 $0 $27.000 8%
Table 2: FY21 Ending the HIV Epidemic Budget Request (in Millions)
Department / Agency FY20 FY20 FY21 Difference
Request Enacted Request FY20 Request –
FY21 Request
FY20 Enacted –FY21 Request
CDC $140.000 $140.000 $371.000 165% 165%
HRSA
   Ryan White $70.000 $70.000 $165.000 136% 136%
   Community Health Centers $50.000 $50.000 $137.000 174% 174%
NIH $6.000 $6.000 $16.000 167% 167%
IHS $25.000 $0 $27.000 8%
Total $291 $266 $716 146% 169%

Key Documents:

This work was supported in part by the Elton John AIDS Foundation. We value our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

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