TO: Coalition for Clinical and Translational Science
FR: Dale Dirks and Dane Christiansen
RE: Trump Administration FY 2018 Budget Proposal Outline
President Trump issued his administration’s Fiscal Year (FY) 2018 budget proposal outline to Congress this morning. The annual budget proposal is a non-binding set of recommendations issued to Congress by the sitting administration which starts the yearly process of the development of an annual federal budget. Congress has the final say on annual budget/appropriations for federal agencies.
The Trump Administration outline does not contain the typical level of detail found in most annual budget proposals because, in this first year of the administration, more time is needed to fill out the specifics. The administration has said it will provide more detailed recommendations in April or May.
Notwithstanding the lack of detail, enough information is provided to appreciate that the budget proposal represents a dramatic shift in priorities from the status quo and the previous administration, and marks the president’s stated priority to increase spending on defense and security programs by $54 billion annually while recommending a concurrent decrease of $54 billion in non-defense, discretionary spending.
Public health, medical research, health professions training, education, environmental, and foreign assistance programs are all cut dramatically in the president’s budget proposal outline. Congress will now begin the process of deliberations on the budget proposal. Although the funding levels and policy changes in the budget proposal seem daunting, many of the programs recommended for cuts have bipartisan support in Congress, and are likely to receive better treatment during the congressional budget/appropriations process.
We will keep you posted as this process unfolds during the next several months.
Please see below the FY 2018 recommended top line discretionary (non-entitlement) numbers for key federal agencies:
Department of Health and Human Services: $65.1 billion, a cut of $12.6 billion, or 16.2%
Department of Education: $59 billion, a cut of $9.2 billion, or $13.5%
Department of Veterans Affairs: $78.9 billion, an increase of $4.4 billion, or 5.9%
Department of Defense: $574 billion, an increase of $52.3 billion, or 10%
Of Specific interest to CCTS, the budget proposal outlines the following “highlights”:
Health and Human Services
Reduces the National Institutes of Health’s (NIH) spending relative to the 2017 annualized CR level by $5.8 billion to $25.9 billion. The Budget includes a major reorganization of NIH’s Institutes and Centers to help focus resources on the highest priority research and training activities, including: eliminating the Fogarty International Center; consolidating the Agency for Healthcare Research and Quality within NIH; and other consolidations and structural changes across NIH organizations and activities. The Budget also reduces administrative costs and rebalances Federal contributions to research funding.
Reforms key public health, emergency preparedness, and prevention programs. For example, the Budget restructures similar HHS preparedness grants to reduce overlap and administrative costs and directs resources to states with the greatest need. The Budget also creates a new Federal Emergency Response Fund to rapidly respond to public health outbreaks, such as Zika Virus Disease. The Budget also reforms the Centers for Disease Control and Prevention (CDC) through a new $500 million block grant to increase State flexibility and focus on the leading public health challenges specific to each State.
Eliminates $403 million in health professions and nursing training programs, which lack evidence that they significantly improve the Nation’s health workforce. The Budget continues to fund health workforce activities that provide scholarships and loan repayments in exchange for service in areas of the United States where there is a shortage of health professionals.
Provides a $4.6 billion increase in discretionary funding for VA health care to improve patient access and timeliness of medical care services for over nine million enrolled veterans. This funding would enable the Department to provide a broad range of primary care, specialized care, and related medical and social support services to enrolled veterans, including services that are uniquely related to veterans’ health and special needs.