On Thursday, March 16, President Donald J. Trump issued his fiscal year (FY) 2018 Federal Budget Blueprint. Entitled the America First Budget, the Trump Administration is reprioritizing federal spending to advance the safety and security of the American people. The Budget Blueprint also significantly increases the budget for immigration enforcement at the Department of Justice and the Department of Homeland Security and includes additional resources for a wall on the southern border with Mexico, immigration judges, expanded detention capacity, U.S. Attorneys, U.S. Immigration and Customs Enforcement, and Border Patrol. The budget is also intended to increase defense spending without adding to the federal deficit.
The America First Budget is the first step in the FY 2018 budget and appropriations process. The release serves as a blueprint, but does not provide specifics on many of the agency funding levels beyond what is included for the cabinet level departments. A full federal budget proposal is expected by May 2017.
The blueprint includes a $54 billion increase in defense spending in FY 2018 that is offset by targeted reductions in non-defense discretionary spending. The targeted reductions are spread across all government agencies, including the Department of Health and Human Services (HHS). The Blueprint requests $69.0 billion for HHS, a $15.1 billion or 17.9 percent decrease from the 2017 annualized Continuing Resolution (CR) level. This funding level excludes certain mandatory spending changes, but includes additional funds for program integrity and implementing the 21st Century CURES Act.
For HHS, the National Institutes of Health (NIH) budget blueprint includes $25.9 billion, a reduction of $5.8 billion relative to the 2017 annualized CR level. The Budget outline includes a major reorganization of NIH’s Institutes and Centers to help focus resources on the highest priority research and training activities. and includes a proposal to consolidate the
Agency for Healthcare Research and Quality within NIH. HIMSS is an active member of the Friends of AHRQ and has worked for several years to ensure Congress and each Administration are knowledgeable of the unique and critical role AHRQ-funded health IT research and tools have in improving care quality, safety, and efficiency for patients and providers.
For Medicare and Medicaid, the blueprint outlines plans to strengthen the integrity and sustainability of the program by investing in activities to prevent fraud, waste, and abuse and promote high quality and efficient health care.
The Trump Administration blueprint calls for a $4.6 billion increase at the Department of Veterans Affairs for veterans’health spending, including support for “a broad range of primary care, specialized care, and related medical and social support services.”
No details were included in the blueprint about healthcare or the Defense Health Agency in the Department in the Department of Defense budget, but it does discuss initiating an ambitious reform agenda to build a military that is as effective and efficient as possible, and underscores President Trump’s commitment to reduce the costs of military programs wherever feasible.