The Debt Limit Deal: Implications for Maternal & Child Health
June 05, 2023

Over the weekend, President Biden signed into law a bipartisan deal to raise the nation’s debt ceiling, averting a financial crisis. The Fiscal Responsibility Act of 2023 (H.R.3746) makes numerous changes to federal spending for the next two fiscal years. Components of the Fiscal Responsibility Act of 2023 that could impact maternal and child health populations include:

1. Cap on discretionary federal spending: The legislation places limits on the amount of federal funding that can go to discretionary federal funding, which includes funding for Title V and other public health programs, for FY24 and FY25. Congress will need to set funding levels for federal agencies such as HRSA, CDC, and NIH within the bounds of the overall spending cap.

What it means to MCH: It will be very difficult for Title V and other public health programs to see major funding increases over the next two fiscal years. Congress will need to make difficult decisions on how to allocate funding increases and possible decreases to keep within the set limits for FY24 and FY25.

2. Recalls unobligated federal COVID-19 funds: The bipartisan deal includes a provision to claw back roughly $30 billion in funding passed as part of COVID-19 emergency legislation that has not yet been obligated. It is unclear how much and from where funding will be rescinded.

What it means to MCH: While it remains unclear exactly which funding and how much will be impacted, MCH and other public health programs at CDC, HRSA, and other agencies that have unobligated COVID-19 funds will be impacted. AMCHP will continue to communicate with our federal partners to understand which programs will experience funding rescissions.

3. Changes to nutrition and family assistance programs: The legislation makes changes to eligibility requirements for the Supplemental Nutrition Assistance Program (SNAP): able-bodied adults ages 18-54 will now be subject to a work requirement, raising the current age requirement by 5 years; however, the SNAP work requirement now exempts individuals experiencing homelessness, veterans, and individuals aging out of the foster care system. Additionally, the debt limit agreement makes several changes to the Temporary Assistance to Needy Families program (TANF), which provides financial assistance to low-income families with children.

What it means to MCH: Many women, children, and families who rely upon the SNAP and TANF programs for assistance could experience greater nutritional and financial insecurity because of these changes. Others, such as those experiencing homelessness or exiting the foster care system, could more easily access nutritional assistance.

The AMCHP Government Affairs team will continue to advocate for funding increases to the Title V Block Grant and other federal MCH programs throughout the FY24 appropriations process and beyond. To learn more and stay up-to-date about AMCHP’s appropriations efforts:

As always, please don’t hesitate to get in touch with AMCHP’s Government Affairs Team: Amy Haddad (, Sherie Lou Santos (, and Lauren Blachowiak (