This article is more than 5 years old. Information may no longer be current.

ACP, AAFP express concerns about Trump’s ‘skinny’ budget proposal

The ACP and the American Academy of Family Physicians recently released statements about President Donald J. Trump Administration’s Fiscal Year 2018 budget outline, voicing deep concerns about its proposed reductions to medical and health services research, primary care training programs and many other essential health care programs and research, as well as its implications for patients’ health, safety and access to care.

“The United States has long been recognized as a world leader in medical research and education,” Nitin S. Damle, MD, MS, MACP, president of ACP, said in a press release. “This budget, were it to be adopted by Congress, would greatly weaken critical programs that are essential to maintaining our leadership in biomedical and health-services research, public-health programs, and medical education.”

The ACP is particularly troubled by the proposed budget cuts in funding and changes in policy. In the proposed budget, HHS funding will be significantly reduced by $15.1 billion or 17.9 %, as will NIH funding by $5.8 billion, nearly 20%.

“A cut of this magnitude [to HHS] threatens all facets of the health-care system including the operation of the Medicare and Medicaid programs,” Damle said.

“NIH is the nation’s premier medical research agency, making important discoveries that improve health and save lives,” Damle added. “A cut this large would threaten the U.S. standing as the world leader in medical and biomedical research.”

The Agency for Healthcare Research and Quality (AHRQ) will be merged into NIH under the current proposal; however, the structure of this change and whether additional funding would be granted to NIH to achieve AHRQ’s mission is unknown, according to ACP.

“Through vigorous health-services research — which differs greatly from biomedical research — this agency is responsible for improving the quality, safety, efficiency and effectiveness of care and ultimately helps physicians help their patients by making evidence-informed decisions, funding research that serves as the evidence engine for much of the private sector’s work to keep patients safe, making the healthcare market place more efficient through establishing quality measures,” Damle said. “Simply folding AHRQ into NIH could harm the vital work that AHRQ performs.”

Furthermore, $403 million will be eradicated from unspecified health and nursing training programs under the proposal.

“ACP is troubled that this cut could come from the Title VII Health Professions program which is critical because it is the only federal program dedicated to funding and improving training of primary-care physicians,” Damle noted.

Significant cuts to funding for climate change research will also cause detrimental effects to human health by continuing the warming of the planet, according to ACP.

An increase of $500 million for increasing prevention efforts for opioid substance use disorder is encouraging; however, other budget cuts have the potential to weaken this expansion, thus it needs to be fully assessed, ACP stated.

“ACP is keenly aware of the fiscal pressures facing the Trump administration and Congress at this time, but it strongly believes the U.S. must invest robustly in biomedical and health services research, workforce and delivery system initiatives that support primary care and public health, including programs that have a proven track record of effectiveness but also those that demonstrate the kind of innovation required in any high-performing health-care system,” Damle concluded. “Unfortunately, this budget proposal fails to make those investments and would make America less great by undermining our commitment to science, medical and health services research, medical education, and research on climate change.”

The American Academy of Family Physicians (AAFP) expressed similar concerns that cuts to funding for multiple health care agencies would destabilize the foundation of health care and damage the health of the nation. Reduced funding for the FDA will substantially obstruct it from protecting patients from ineffective or harmful drugs, John Meigs, Jr., MD, president of AAFP, noted. In addition, he voiced concerns that deep cuts to the CDC budget would expose Americans to emerging, deadly infectious diseases, potentially leading to a pandemic.

“Health care is, indeed, complicated,” Meigs concluded. “The system is only as strong as the agencies and programs that undergird it. The AAFP encourages Congress to reject these budget recommendations and act to ensure stability of programs that are foundational to an effective, efficient health care system.” – by Alaina Tedesco

Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of publication.