President Trump’s 2018 budget request to Congress seeks massive cuts in spending on health programs, including medical research, disease prevention programs and health insurance for children of the working poor.
The National Cancer Institute would be hit with a $1 billion cut compared to its 2017 budget. The National Heart, Lung and Blood Institute would see a $575 million cut, and the National Institute of Allergy and Infectious Diseases would see a reduction of $838 million. The administration would cut the overall National Institutes of Health budget from $31.8 billion to $26 billion.
The proposed cuts to the U.S. Centers for Disease Control and Prevention drew an unusually sharp rebuke from former CDC director Tom Frieden, who went on Twitter to describe the administration’s CDC request as “unsafe at any level of enactment. Would increase illness, death, risks to Americans, and health care costs.”
In a separate tweet, Frieden listed what he sees as the dire ramifications of the Trump proposal, saying, for starters, that it “Devastates programs that protect Americans from cancer, diabetes, heart attacks, strokes and other deadly and expensive conditions.”
Admin: cut CDC $1.2B (17%). More cancer, HIV, sr falls, infx. Defund science (prevention,injury,other ctrs->0 ). Americans wd be less safe.
â Dr. Tom Frieden (@DrFrieden) May 23, 2017
The full budget document is scheduled to be released Tuesday morning, but either by mistake or design, the administration posted the section dealing with the Department of Health and Human Services late Monday afternoon. The document was soon taken offline but can be read here.
âThe only official version of the HHS budget will be released by the Office of Management and Budget at 11:00 a.m. tomorrow. At that time, Budget Director [Mick] Mulvaney will hold a press briefing and address any questions,” HHS national spokesperson Alleigh MarrÃ© wrote in an email to The Post.
The slashing of programs that normally have enjoyed bipartisan support is part of the Trump administration’s effort to trim trillions of dollars in spending over the next decade while at the same time paying for tax cuts and increases in military spending.
Trump’s Office of Management and Budget produced a âskinny budgetâ in March, in effect an outline with few details, and that document delivered a number of surprises, including a call to cut nearly one-fifth of National Institutes of Health budget and nearly one-third of the Environmental Protection Agency funding.
Lawmakers appeared to ignore that budget request entirely when putting together a spending plan for the rest of fiscal 2017, which runs through September. Much of that spending plan had been in the works before the November election. It is unclear how Congress, which has the power of the purse, will treat this new and more detailed budget request.
But the document posted late Monday shows that blow-back from that earlier budget request did not dissuade the administration from its strategy of cutting nonmilitary discretionary spending to pay for tax cuts and a boost in the Pentagon budget.
Among the highlights:
Funding for the Childrenâs Health Insurance Program (CHIP) would be slashed by at least 20 percent for the next two fiscal years. According to the budget document, the administrator favors a renewal of CHIP, a program created 20 years ago for the children of lower-working class families and which currently insures 5.6 million children.
The spending plan would, however, eliminate an element of the Affordable Care Act that increased by 23 percent the portion of the programâs costs that is paid for with federal money, leaving states to shoulder a larger share. It would also for the first time essentially limit statesâ eligibility levels to qualify, saying that the government would no longer help cover children from families with incomes of more than 250 percent of the federal poverty level. Currently, 18 states plus the District of Columbia allow families with incomes higher than 300 percent of the poverty line to sign up their children for CHIP, according to data from the Kaiser Family Foundation.
The Trump budget asks for cuts to several key programs at the Centers for Disease Control and Prevention, which responds to disease outbreaks in the United States and around the world, makes sure food and water are safe, and helps people avoid heart disease, cancer, stroke and other leading causes of death.
The president’s budget seeks an $82 million cut at the center that works on vaccine-preventable and respiratory diseases, such as influenza and measles. It proposes a cut of $186 million from programs at CDCâs center on HIV/AIDS, viral hepatitis, sexually transmitted infections and tuberculosis prevention. One of the biggest cuts, $222 million, is to the agencyâs chronic disease prevention programs, which are designed to help people prevent diabetes, heart disease and stroke, and obesity.
Some of those funds are being channeled into a new $500 million block grant program to states and territories to focus on âleading chronic disease challenges specific to each state.â Critics have said block grants allow states to plug holes in their budgets, without accountability that federal programs require.
The agencyâs center on birth defects and developmental disabilities also gets a 26 percent cut to its budget at a time when researchers have yet to understand the full consequences of Zika infections in pregnant women and their babies.
The budget calls for a 17 percent cut to CDCâs global health programs that monitor and respond to disease outbreaks around the world. It also cuts about 10 percent from CDCâs office of Â public health preparedness and response.
The budget document highlights $35 million that the CDC spends on childhood lead poisoning prevention. But the overall spending on environmental health would under Trump’s plan be cut by $60 million, down to $157 million, according the document.
Trump administration officials have also proposed the establishment of an Emergency Response Fund to respond quickly to emerging public health threats. In the wake of the Ebola and Zika epidemics, U.S. officials have repeatedly called for the need for such a fund. The budget does not provide a specific amount. It says HHS would have âdepartment-wide transfer authority to support the Fund in the case of a natural or man-made disaster or threat.â The fund would be available to receive a transfer of up to one percent of any HHS account, without any limitation on the total, for use in emergency preparedness and response.
The Food and Drug Administration would see a cut from $2.74 billion to $1.89 billion. User fees paid by manufacturers of drugs, devices and other products would be increased by close to $1 billion to pay for product reviews.
Republican Sen. Lamar Alexander of Tennessee, the chairman of the health committee, has said he does not want to reopen negotiations with the industry over fees that it pays to support FDA activities, as the Trump administration has previously suggested. His committee recently approved legislation that ignores the administration request.
This is a developing story.
Amy Goldstein and Laurie McGinley contributed to this story.
The Post’s coverage of the March for Science