FY23 Appropriations: What the house bills mean for infant feeding

The fiscal year 2023 appropriations process is underway. The House Committee on Appropriations released and advanced this year's appropriations bills and associated reports.

The Labor, Health and Human Services, Education, and Related Agencies bill includes $9.75 million in funding for the Centers for Disease Control and Prevention's Hospitals Promoting Breastfeeding program. This is level funding from last year, but it isn't enough.

As we enter into the fifth month of a serious and devastating infant formula shortage, we need to do everything we can to protect infant nutrition security. Increasing funding for this line item is an urgent and important step. We hope you'll join us in the call for increased funding via our easy action tool for individuals, and with our organizational sign-on letter. 

The Hospitals Promoting Breastfeeding line item is the top policy priority for the USBC, but it certainly isn't the only provision that impacts infant feeding. We are encouraged by funding included for an analysis of the macroeconomic, health, and social costs of U.S. breastfeeding rates and national breastfeeding goals. Funding relevant to the lactation field is also included in several additional appropriations bills. 

A detailed analysis of funded provisions in these bills can be found on the Federal Appropriations for Breastfeeding webpage, including funding for the Racial and Ethnic Approaches to Community Health program, WIC breastfeeding peer counselor program, and beyond. The webpage traces program funding levels at each step in the federal budget process.   

The House appropriations bills and associated reports also include several unfunded directives:
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Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations bill report:

• The Department of Health and Human Services (HHS) is directed to provide a report detailing how health insurers have implemented comprehensive lactation services, the standards insurers use to set reimbursement rates for breastfeeding supplies and services, and the current best practices used to provide coverage to help women breastfeed. HHS also is directed to examine the impact of clinically recommended breastfeeding rates on associated Medicaid expenditures, urgent care costs, and direct and indirect medical costs, including workplace productivity, and employee retention.
• The National Institutes of Health is encouraged to continue implementing recommendations from the Task Force on Research Specific to Pregnant Women and Lactating Women to the extent appropriate and feasible under the legal authorities available to the Secretary.
• The National Academies of Sciences, Engineering, and Medicine is directed to review existing Federal, State, and non-governmental programs that are designed to change the attitudes and health behaviors related to substance use by pregnant and breastfeeding women and produce a strategy to prevent and reduce consumption of today’s marijuana and THC products by pregnant and breastfeeding women.
  
  

Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill report:

• The Food and Nutrition Service is directed to collect information from all WIC agencies and prepare a report to the committee detailing any conditions WIC agencies consider, or requirements they impose, when determining whether a WIC participant who intends to fully breastfeed her infant may access breastfeeding supplies and services.
  
  

Financial Services and General Government Appropriations bill report:

• The committee continues the provision that permits breastfeeding in a Federal building or on Federal property if the woman and child are authorized to be there.
  
  

Department of Homeland Security Appropriations bill report:

• The Federal Emergency Management Agency (FEMA) is directed to work with State, local, tribal, and territorial (SLTT) governments, other federal agencies, and volunteer organizations to ensure that disaster survivors and service providers have information on support available for nursing equipment and supplies and continues to urge FEMA to ensure that breastfeeding mothers impacted by disasters have access to breastfeeding services and supplies through its Critical Needs Assistance, Other Needs Assistance, and other programs.
• The U.S. Immigration and Customs Enforcement (ICE) agency is directed to provide semiannual reports on the total number of pregnant, postpartum, and lactating women in ICE custody, including detailed justification for the circumstances warranting each detainee's continued detention. 

State, Foreign Operations bill report:

• The Committee supports the United States Agency for International Development (USAID) Multi-Sectoral Nutrition Strategy, which includes increasing breastfeeding.
• The USAID Administrator is directed to report on the nutrition outcomes achieved over the previous fiscal year, including the approximate number of women receiving prenatal vitamins and breastfeeding education and support as a result of such assistance. The report should be publicly available and track progress towards the 2025 World Health Assembly global targets on stunting, wasting, anemia, and breastfeeding.
  
  

What's next for the federal budget process? 
Once the House and Senate have each passed their appropriations bills, they must be "conferenced" to work out any differences between the two versions. House-Senate conference committees make final determinations and prepare a Conference Report. The Conference Report is then passed by the House and the Senate and sent to the President to be signed. All appropriations bills must be completed by the end of the fiscal year on September 30, or Congress will have to pass a continuing resolution to keep the government funded at the start of FY 2023 on October 1. 

The USBC will continue to mobilize support for funding that helps human milk feeding families and will be sure to keep you updated at all stages of the federal budget process. We are so grateful for your partnership, engagement, and support. Thank you! 
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~ the USBC team