Trump Proposing Billions in Spending Cuts to Congress

https://www.usnews.com/news/politics/articles/2018-05-07/trump-sending-spending-cuts-of-up-to-15b-to-congress

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The Trump administration is unveiling a multibillion-dollar roster of proposed spending cuts but is leaving this year’s $1.3 trillion catchall spending bill alone.

The cuts wouldn’t have much impact, however, since they come from leftover funding from previous years that wouldn’t be spent anyway.

The White House said it is sending the so-called rescissions package to lawmakers Tuesday. Administration officials, who required anonymity because they weren’t authorized to speak publicly on the matter, said the package proposes killing $15 billion in unused funds. A senior official said about $7 billion would come from the Children’s Health Insurance Program, or CHIP, which provides health care to kids from low-income families, though that official stressed the cuts won’t have a practical impact on the popular program.

The administration is trying to use its authority to prod Congress to “rescind” spending approved years ago, but even if the package is approved it would only have a tiny impact on the government’s budget deficit, which is on track to total more than $800 billion this year. Some of the cuts wouldn’t affect the deficit at all since budget scorekeepers don’t give credit for rescinded money that they don’t think would have ever been spent.

For instance, more than $4 billion in cuts to a loan program designed to boost fuel-efficient, advanced-technology vehicles wouldn’t result in fewer loans since the loans are no longer being made. And $107 million worth of watershed restoration money from the 2013 Superstorm Sandy aid bill is going unused because local governments aren’t stepping up with matching funds. Another $252 million is left over from the 2015 fight against Ebola, which has been declared over.

Still, the cuts, if enacted by Congress, would take spending authority off the table so it couldn’t be tapped by lawmakers for other uses in the future. The catchall spending bill, for instance, contained $7 billion in cuts to CHIP that were used elsewhere to boost other programs.

“This is money that was never going to be spent,” a senior administration official said on a press call ahead of Tuesday’s submission. “The only thing it would be used for is offsets down the line.”

Democrats have supported such cuts in the past, eager to grab easy budget savings to finance new spending. But some Democrats howled over the White House proposal anyway.

“Let’s be honest about what this is: President Trump and Republicans in Congress are looking to tear apart the bipartisan Children’s Health Insurance Program (CHIP), hurting middle-class families and low-income children,” said Senate Minority Leader Chuck Schumer, D-N.Y.

Pressure from party conservatives to increase cuts in a tentative $11 billion proposal contributed to a delay from Monday’s original release date.

The White House and tea party lawmakers upset by the budget-busting “omnibus” bill have rallied around the plan, aiming to show that Republicans are taking on out-of-control spending. The administration says it will propose cuts to the omnibus measure later in the year.

The spending cuts are also a priority for House Majority Leader Kevin McCarthy, R-Calif., who likens them to “giving the bloated federal budget a much-needed spring cleaning.” But while the package may pass the House it faces a more difficult path — and potential procedural roadblocks — in the Senate.

McCarthy wants to succeed soon-to-retire House Speaker Paul Ryan, R-Wis., and some of his allies view the project as a way to improve his standing with fractious GOP conservatives who blocked his path to the speakership in 2015.

The proposal has already had a tortured path even before its unveiling. More pragmatic Republicans, including the senior ranks of the powerful House and Senate Appropriations committees, rebelled against the measure. They argued that it would be breaking a bipartisan budget pact just weeks after it was negotiated. In response, White House budget director Mick Mulvaney cleansed the measure of cuts to the huge omnibus bill.

Last month, Mulvaney told lawmakers the plan could have totaled $25 billion or so. Now he says he’s planning to submit several different packages of spending cuts — and it’s likely they’ll get more conservative with each new proposal.

Either way, the idea faces a challenging path in Congress — particularly the Senate, where a 51-49 GOP majority leaves little room for error even though budget rules permit rescissions measures to advance free of the threat of Democratic filibusters. But the cuts to the popular children’s health insurance program probably could still be filibustered because they are so-called mandatory programs rather than annual appropriations.

 

Trump’s $4.1 trillion budget: 9 healthcare takeaways

http://www.beckershospitalreview.com/finance/trump-s-4-1-trillion-budget-9-healthcare-takeaways.html

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President Donald Trump’s first full budget proposal will include $3.6 trillion in spending cuts to balance the budget in the next decade.

Although the full $4.1 trillion budget plan, titled “A New Foundation for American Greatness,” will be released Tuesday, Office of Management and Budget Director Mick Mulvaney briefed White House reporters Monday on the budget.

Here are nine of the key proposals related to healthcare in President Trump’s budget proposal for fiscal year 2018, which begins Oct. 1.

1. Medicaid cuts. President Trump’s budget includes $610 billion in Medicaid cuts over 10 years. The reduction is in addition to the $839 billion pulled from Medicaid under the proposed American Health Care Act, the ACA repeal and replacement bill that phases out Medicaid expansion, according to The Hill.

2. Repeal and replace the ACA. The budget assumes passage of the AHCA. The Trump administration expects to save $250 billion over 10 years by repealing and replacing the ACA. These savings are in addition to the $610 billion in proposed Medicaid cuts in the budget, according to The New York Times.

3. Medicare unscathed. The budget makes no changes to the Medicare program or to core Social Security benefits, two programs President Trump vowed during his campaign to leave alone, according to The Hill.

4. Reduction in CHIP funding. Under the budget, $5.8 billion would be cut from the Children’s Health Insurance Program over 10 years, according to a budget document posted by The Washington Post.

5. NIH funding cut. Under the budget proposal, the National Institutes of Health budget would be reduced from $31.8 billion to $26 billion, according to The Washington Post.

6. Cuts to CDC funding. Several CDC programs would be hit with cuts under the budget proposal. One of the biggest cuts is to the agency’s chronic disease prevention programs, which would have funding reduced by $222 million, according to The Washington Post.

7. Veterans Choice Program extended. The budget calls for extension of the Veterans Choice Program, which allows veterans to go outside of the Veterans Affairs system for care. Under the budget, $29 billion more would be spent on this program over 10 years, according to The New York Times.

8. Medical malpractice limits. The budget includes medical malpractice reforms, such as capping awards for noneconomic damages, that are intended to reduce the practice of defensive medicine. The Trump administration expects these changes to save Medicare $31 billion over a decade, according to The New York Times.

9. Funds substance abuse treatment. The budget would allocate $500 million to expand access to treatments, including medication-assisted treatment, for those suffering from opioid addiction. The budget also includes $1.9 billion in block grants for states to use for substance abuse treatment and $25 million for the Substance Abuse and Mental Health Services Administration for expanding access to critical interventions. SAMHSA would also receive an additional $24 million to equip first responders with overdose reversing drugs.

Trump budget proposal cuts billions and would ‘devastate’ healthcare programs

http://www.fiercehealthcare.com/healthcare/trump-budget-proposal-cuts-billions-and-would-devastate-healthcare-programs?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiT0RGaE9USTFOR1F4T0dGbSIsInQiOiJsMHdQVHhVK1pcL0c4S0JpV21SZXJxaVFNU3M5TWFHWWRJSU1XWnp1Szl0VkJlT29xdkFzNWJqdE9YMURvUTJYVjl4NVB3RHlBcVpZMEJVUEVVMVZNakFnUUVPNWV4SzU5amdCeGNWTURDdllzYzhrQWwxdFJHdHlxMDZidnlYN3MifQ%3D%3D

Despite criticism over his initial proposal in March that included huge cuts to the Department of Health and Human Services, National Institutes of Health and Centers for Disease Control and Prevention, President Trump’s fleshed-out 2018 budget will slash billions from those health programs in order to spend more on the military and cover planned tax cuts.

The full budget plan is due to be released this morning at 11 a.m., but the White House administration inadvertently posted the section (PDF) that dealt with cuts to the HHS late Monday before it quickly took it offline.

In addition to a proposal to eliminate $800 billion from Medicaid, the Trump administration wants to make deep cuts to other health programs, including:

  • $5.8 billion from the overall NIH budget, including $1 billion from the National Cancer Institute, $838 million from the National Institute of Allergy and Infectious Diseases and $575 million from the National Heart, Lung and Blood Institute
  • $1.2 billion from the CDC
  • $403 million from health workforce programs, including diversity training, mental and behavioral programs, and select nursing and physician training programs
  • $22 million from the Office of the National Coordinator for Health IT.

Trump budget would force tough choices in disease research

http://abcnews.go.com/Technology/wireStory/trump-budget-force-tough-choices-disease-research-46183046

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What goes on the chopping block: Research into cancer or Alzheimer’s? A Zika vaccine or a treatment for superbugs?

Health groups say President Donald Trump’s proposal to slash funds for the nation’s engine of biomedical research would be devastating for patients with all kinds of diseases — and for jobs.

“It is possible that the next cure for some cancer is sitting there waiting to be discovered, and it won’t get to the table,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

In his budget blueprint Thursday, Trump called for a cut of $5.8 billion from the National Institutes of Health. That’s a staggering 18 percent drop for the $32 billion agency that funds much of the nation’s research into what causes different diseases and what it will take to treat them.

It comes despite Trump recently telling Congress about the need to find “cures to the illnesses that have always plagued us.”

“All of us woke up this morning in a state of shock about this number,” said Dr. Blase Polite, a cancer specialist at the University of Chicago who chairs the American Society for Clinical Oncology’s government relations committee.

Trump’s proposal would roll back NIH’s 2018 budget to about what it was in 2003. The president called for a “major reorganization” of NIH to stress the “highest priority research,” but only specifically targeted for elimination the $69 million Fogarty International Center that focuses on global health and has played a big role in HIV research abroad.

Drops in deaths from cancer and heart disease, breakthroughs in genetics, and new ways to treat and prevent HIV and other infectious diseases all are credited to decades of NIH-funded basic research.

 

Trump budget proposes 19 percent cut in NIH funding, leaving life science institutions reeling

Trump budget proposes 19 percent cut in NIH funding, leaving life science institutions reeling

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As part of Trump’s budget proposal, he wants to chop $5.8B from the National Institutes of Health, or 19 percent, as part of a spending overhaul the Department of Health and Human Services.  The budget calls for a major reorganization of NIH’s institutes and centers, describing the move as a way to “help focus resources on the highest priority research and training activities.”

The proposal would also consolidate the Agency for Healthcare Research and Quality within NIH, and it would also mean “other consolidations and structural changes across NIH organizations and activities”.

Life science institutions are horrified.

It seems like only yesterday that Congress was prepared to boost NIH spending by $2 billion  — the biggest increase in 12 years.

Here is a round-up of reactions from national and regional institutions.

The American Cancer Society Cancer Action Network released a statement estimating that the NIH budget cuts were likely to cut $1 billion from the National Cancer Institute, noting it would be the biggest budget cut to the institution in its history.

Chris Hansen, president of the network said the cuts would be a significant setback for millions of American cancer patients, survivors and their families and would “dramatically constrain the prospect for breakthrough American medical innovation”.

For the last 50 years every major medical breakthrough can be traced back to investments in the NIH. Because of these investments, there are more than 15.5 million American cancer survivors alive today and researchers stand on the cusp of numerous innovative new diagnostic tools and treatments. From new immunotherapies that harness the body’s own immune system to destroy cancer cells to less toxic and more precise chemotherapies and advanced diagnostic and preventive tools.

“These developments save lives and spur economic progress. NIH-funded medical research is conducted in thousands of labs and universities across the country. These grants in turn spawn increased private investment and development. Drastically reducing NIH’s budget would jeopardize our nation’s potential to save more lives while simultaneously risking America’s position as the global leader in medical research.

 

An infographic of healthcare cuts in Trump’s draft budget

An infographic of healthcare cuts in Trump’s draft budget

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Healthcare groups bash Trump’s budget proposal: Cuts threaten public health

http://www.fiercehealthcare.com/healthcare/trump-s-budget-proposal-faces-opposition-from-healthcare-industry-groups-members-both?mkt_tok=eyJpIjoiWXpoa05EZzFZamxrTkdVMiIsInQiOiJYVXpYMVo4VThobmJJdXRqUUlSempJc0dBeUdTVkRcL3ZDTW9qZHU5eStXdnAxOHdwbkUwTlQrdjA3bldVYXRiQ1Z2a2FQYTdKSFVxWG9qd2hlTTRmNCt5MHFZdTZKTlB5aWY4Zm5DSzBvcHVLRjBQWDNlalwvSW9LRk4xT2Jyd2JHIn0%3D&mrkid=959610&utm_medium=nl&utm_source=internal

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Nurses, docs and medical research groups said the budget cuts proposed by President Donald Trump threaten the future of healthcare.

Among the cuts: Nearly 18% of HHS’ budget, with the largest cuts coming to National Institutes of Health. The agency would see a $5.9 million decrease in its budget and a significant reorganization effort that would fold the Agency for Healthcare Quality and Research into its ranks and close the Fogarty International Center

Nurses came out in force against the budget cuts. The American Nurses Association urged Congress to reject Trump’s proposal, which they said in a statement will  “weaken the nation’s healthcare system and jeopardize the scientific research needed to keep America healthy.”

The ANA is especially upset about plans to reduce funding for health professions and nursing workforce programs by $403 million. The proposal “drastically hampers efforts to address critical faculty shortages and recruit new nurses into the profession,” the association said.

Furthermore, the National Nurses United called the cuts a “broad attack on public protections that also targets some of the nation’s most vulnerable people while shifting resources to the least needed areas.”

The American Public Health Association agreed, stating that the proposal undermines the health and well-being of Americans.

“Cuts to these agencies would threaten programs that protect the public from the next infectious disease outbreak, polluted air and water, health threats due to climate change and our growing chronic disease epidemic,” APHA Executive Director Georges C. Benjamin, M.D., said in the statement.

And Andrew Gurman, M.D., president of the American Medical Association, said the cuts cause great concerns about future medical research and public health in general and in the wake of Zika, Ebola.

The Association of American Medical Colleges noted in a statement that medical research can’t be “turned on and off like a faucet.” Indeed, “the proposed cuts would set back progress toward critical advancements that could take decades to regain, prevent new ideas from being explored, and have a chilling effect on those who would potentially enter the biomedical research workforce.”

And the American Cancer Society said the reduction in funding would set cancer research back at least two decades.

“For the last 50 years every major medical breakthrough can be traced back to investments in the NIH,” Chris Hansen, president of the ACS Cancer Action Network, said in the statement. “Because of these investments, there are more than 15.5 million American cancer survivors alive today and researchers stand on the cusp of numerous innovative new diagnostic tools and treatments.”

Deficit-Slashing Plan Advances Through House Panel

http://www.nytimes.com/aponline/2016/03/16/us/politics/ap-us-congress-budget.html?_r=0

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