President Donald Trump released his first budget proposal [PDF] on March 16, 2017, titled, America First: A Budget Blueprint to Make America Great Again. The
$1,065.4 billion dollar budget proposal is $3.3 billion lower than what was
enacted under the fiscal year (FY) 2017 continuing resolution (CR). It would
cut the budget of the U.S. Department of Education by 13.5% and the budget of
the U.S. Department of Health and Human Services by 16.2%, including a $5.8
billion cut to the National Institutes of Health (NIH).
The federal budget process requires the president
to submit a proposal each year; however, it is up to Congress to enact a budget
and approve appropriations for each department and agency. Congress needs to
complete this process for FY 2018 by September 30, 2017. Congressional budget
writers will now consider the president's request and craft their own budget
outline. Although the budget writers can follow the president’s request, the
Constitution clearly places spending decisions with Congress.
The proposed budget increases
investments in public and private school choice by $1.4 billion compared to the
2017 annualized CR level. According to the budget request, "This additional
investment in 2018 includes a $168 million increase for charter schools, $250
million for a new private school choice program, and a $1 billion increase for
Title I, dedicated to encouraging districts to adopt a system of student-based
budgeting and open enrollment that enables federal, state, and local funding to
follow the student to the public school of his or her choice."
President Trump's budget request
maintains approximately $13 billion in funding for the Individuals with
Disabilities Education Act (IDEA) programs to support students with special
ASHA members who conduct research should
pay close attention to the reduced request for NIH funding. The proposed budget
reduced NIH's funding to $25.9 billion. The proposed 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 proposed budget also reduces administrative
costs and rebalances federal contributions to research funding.
Health Care Professionals and
Funding levels for the U.S. Department
of Health and Human Services are addressed in a vaguely written section of the proposed
budget stating that the Administration wishes to eliminate $403 million in
health care professions and nursing training programs. The document attributes
this cut to a lack of evidence that these professions and programs
significantly improve the nation's health care workforce. The section does not
give any specifics about which professions or programs the Administration plans
to cut other than the mention of nurses. The Administration would continue to
fund health care 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 care professionals.
U.S. Department of Veterans Affairs (VA)
The president’s proposed budget calls
for an increase of $4.4 billion (6%) in discretionary funding for the VA. Most
of the money is earmarked for improving patient access and timeliness of
medical care services for veterans. Further, this budget proposal extends and appropriates
funds for the Veterans Choice Program, which allows veterans to seek care either
at the VA or through a private provider.
ASHA Government Relations and Public
Policy staff members are closely reviewing the budget proposal and are following
its progress in Congress. ASHA members will be updated on key areas in the
coming weeks. For questions or comments, please contact Neil Snyder, ASHA's
director of federal advocacy, at [email protected] or 202-624-7750.