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Trump Proposes First Budget Plan; Mixed Hospital Impact

March 16, 2017

The Trump Administration sent Congress a $1.1 trillion fiscal year (FY) 2018 budget blueprint— “America First: A Budget Blueprint to Make America Great Again.” This document is an overview of the President’s budget priorities for FY 2018.

Highlights of the budget blueprint which affect hospitals and health care providers include:

  • Cuts non-defense discretionary spending to support a $54 billion increase in defense spending
  • An 18 percent or $15.1 billion cut to the U.S. Department of Health and Human Services (HHS), including a $6 billion cut to the National Institutes for Health (NIH), and a 20 percent cut that would negate funding boosts included in the 21st Century Cures Act
  • Consolidates the Agency for Healthcare Research and Quality within the NIH
  • Cuts $403 million from health professions and nurse training programs
  • Seeks reforms to public health, emergency preparedness and prevention programs—restructuring HHS preparedness grants, establishing a new $500 million block grant through the Centers for Disease Control and Prevention, and creating a Federal Emergency Response Fund to respond to public health outbreaks
  • Provides a $500 billion increase from 2016 enacted levels to expand opioid misuse prevention efforts and treatment for addiction
  • Does not address changes to mandatory spending including Medicare

Congress is still working to close out the 2017 federal fiscal year. A continuing resolution passed by Congress extended funding through the spring. Federal funding is set to expire on April 28, 2017, and action will be necessary to continue funding through the end of the fiscal year.

Yesterday, the federal debt ceiling was reached. The debt ceiling is an upper limit set on the amount of money that a government may borrow. The U.S. Department of Treasury can use “extraordinary measures” to manage the debt into the summer but Congress also will need to act to extend the debt ceiling.

Funding cuts to NIH spending and health professions and nurse training programs raise concerns. HAP has been advocating for additional approaches to address physician shortages and access to care problems, including modernizing Pennsylvania’s nursing law so that advanced practice nurses can treat patients the way they are trained to do. Any proposals to cut funds from programs that train or support these professionals could make existing challenges worse.

HAP will be reviewing the details of proposals to consolidate AHRQ within NIH and reforms to public health programs.

Given Pennsylvania’s challenges in battling the opioid crisis, the recommendation to make an additional investment in prevention and treatment is viewed positively by the association.

For more information on the budget framework and HAP’s federal advocacy efforts, please contact Laura Stevens Kent, vice president for federal advocacy.

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