On Feb. 12 President Donald Trump released his budget for fiscal year 2019, which largely serves to outline his agenda for the coming year. If enacted the budget would amount to $4.4 trillion in federal spending.

While important in defining a policy agenda, particularly while the President’s party controls both branches of the U.S. legislature, Presidential budgets are not accepted or rejected as written. Instead, the Trump budget will be used as a blueprint by Republican leaders of the Senate and House of Representatives for crafting policy while Democrats, the current minority party, will assess the budget for areas of shared interest or areas where they will stand in opposition.

Notably, the budget projects that there will be massive savings from the repeal of the Affordable Care Act – commonly referred to as Obamacare – despite the fact that Republican repeal efforts came up short throughout 2017. True to the “repeal and replace” promise made by Republicans during the 2016 election, the budget endorses a reform bill, known as Graham-Cassidy, that failed to garner sufficient support in 2017.

The budget also signals significant reform for Medicaid, with spending cuts amounting to more than $1 trillion over the next decade. Further Medicaid reform proposals include ending state expansions and mandating fewer covered services for patients under the program.

Regarding health-focused agencies, the Department of Health and Human Services (HHS) would receive substantial funding cuts, with its budget line item decreasing by 21% to $68.4 billion for the year. Under the HHS umbrella, the National Institutes of Health (NIH) would receive a $1.4 billion spending increase to $35.5 billion, and the Food and Drug Administration (FDA) would see its budget rise to $5.8 billion. The Centers for Disease Control and Prevention (CDC), however, would see a cut of around 8%, reducing its budget to $11 billion for the year.

Outside of the health care realm, the Trump budget also outlines a path forward for other key goals of the administration, including large-scale entitlement reform, scaling back the size of the public sector, increasing military spending, and funding a wall on the southern U.S. border.

To discuss health care appropriations, please contact AASM advocacy staff by phone at (630) 737-9700 or by email at policy@aasm.org.