Proposed budget includes cuts to CDC, Medicare and Medicaid, U.S. Department of Health and Human Services, NIH and funding for physician training
March 6, 2020 (ACP) – The Trump Administration's proposed fiscal year 2021 budget calls for drastic cuts to government health programs that could impair access to coverage for Medicaid beneficiaries and worsen the existing shortage of physicians, among other shortcomings, the American College of Physicians warns.
The budget likely won't pass the Democratic-controlled House of Representatives, but it does serve to spotlight the Trump Administration's priorities when it comes to health care. “The budget will not be enacted in its entirety, but it includes massive cuts to programs that ACP values and cares deeply about,” said Jared Frost, ACP senior associate for legislative affairs. Of note and in contrast to previous budget proposals, the new proposal doesn't discuss repealing the Affordable Care Act, according to The New York Times. Instead, the budget cites an $844 billion savings that could come from any number of possible cuts.
The administration proposes cutting nearly $700 million from the Centers for Disease Control and Prevention (CDC) for 2021. “The CDC is going to need more resources, not less, as they prepare for a possible coronavirus (COVID-19) pandemic,” Frost said.
Medicare and Medicaid are also under fire in the new budget. Specifically, Medicare would be cut by $756 billion over 10 years with reductions in payments for uncompensated care or care for which no payment is received, expansion of Medicare Advantage plans at the expense of traditional Medicare and promotion of high-deductible health plans for seniors, he said.
Medicaid would be cut by $920 billion over 10 years through limiting eligibility, imposing work requirements and offering states waivers to curtail Medicaid spending. “ACP has long opposed these measures,” Frost said.
The administration's proposal cuts funding for the U.S. Department of Health and Human Services by almost $10 billion, he said. This includes $2.6 billion in cuts to the National Institutes of Health (NIH), with the National Cancer Institute losing $559 million from its yearly budget. The proposal also seeks to fold the Agency for Healthcare Research and Quality into the NIH, while providing nearly $100 million less for the agency. These changes will be devastating for medical researchers and research and will stymie innovation, Frost said.
Physician Workforce in Jeopardy
The proposal would also eliminate a large part of Title VII health profession funding including all $49 million of Section 747 training in primary care medicine. This is the only federal program that funds training for primary care physicians. “We need these programs as we have a health care practitioner shortage,” Frost said. “We can't eliminate whole programs that help train professionals including physicians.”
Moreover, the proposal includes more than $50 billion in cuts to the Graduate Medical Education (GME) program. “We have been trying to increase caps in current GME funding because there is a shortage of physicians especially in primary care,” Frost said.
“Congress should set aside this flawed plan. Instead, Congress should enact a budget that would support the health and well-being of all Americans,” stated Dr. Robert McLean, ACP president.