Debt ceiling deal will mean even less COVID-19 funding

You’ve probably seen the news that last weekend, President Joe Biden and Congressional leaders reached a deal to raise the U.S. government’s debt ceiling. The deal passed both houses and Biden signed it yesterday.

In order to reach this bipartisan deal, Biden had to make a lot of compromises—including limiting funding for COVID-19 and other public health needs. The deal could make it harder for state and local governments to distribute COVID-19 vaccines, track disease through programs like wastewater surveillance, and prepare for future health threats.

The federal government is essentially taking back $27 billion of COVID-19 funds that it provided to various federal agencies, according to reporting by Ximena Bustillo and Tamara Keith at NPR. The move focuses on funds for programs that concluded or have “no immediate demands,” per a White House document shared by NPR.

But programs with “no immediate demands” could easily have demands in the coming months. One of NPR’s examples is funding for the federal Department of Health and Human Services (HHS) to research and distribute vaccines, which can be distributed to other agencies (the CDC, NIH, FDA, state and local health departments, etc.). Vaccine distribution might not be a big need right now, but it likely will be in the fall, when new COVID-19 boosters become available.

Another potential need could be wastewater surveillance for COVID-19 and other health threats. The CDC’s National Wastewater Surveillance System (NWSS) was funded through 2025 by the American Rescue Plan, but it’s possible some of those funds could be in the HHS money pulled back by the debt ceiling deal. This would obviously be a huge loss for the U.S.’s ability to get early warning about future COVID-19 surges, as well as warnings about other pathogens. (Shout-out to Sean Kennedy for pointing this one out.)

In addition, the debt ceiling deal may lead to a smaller budget for the NIH, as Sarah Owermohle reports in STAT News. This could have implications for the agency’s ability to fund research into many pressing diseases, including Long COVID. The NIH has already wasted a lot of its Long COVID funding so far, according to my reporting, so it would be pretty bad news if more support for this research is not available.

The White House has claimed that Biden’s deal preserves funds for some key COVID-19 issues, according to NPR, including next-generation vaccines and Long COVID research. It’s hard to verify this, though, because of how convoluted federal COVID-19 funding has been. From a recent brief by the Association of State and Territorial Health Officials:

“Given the way Congress appropriated COVID-19 funding, and the way funding was later transferred between federal accounts and agencies, it is extremely difficult to discern which federal public health programs are affected by the rescissions.”

Public health funding often follows a cycle of “panic and neglect.” When a crisis occurs, governments panic and put tons of money into the immediate response. But after that crisis fades, it falls into neglect, with less money devoted to preparedness—even though preparedness efforts could help avert the next crisis. We’re clearly in that neglect part of the cycle for COVID-19 now; the debt ceiling deal is just the latest example.

More federal data

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