President’s FY18 Budget

As you have probably seen, President Donald Trump’s Fiscal Year 2018 (FY18) Budget proposal was released earlier this week.  Included in the budget is a $27 million dollar (or 17.2 percent) cut to the Division of STD Prevention (DSTDP) at CDC.  Large cuts are also proposed for HIV programs, school health, TB, and other safety net programs throughout CDC. Click here to read NCSD’s analysis of the President’s Budget Proposal.

From information included in the budget proposal, NCSD has determined that in the event that the full proposed cuts were enacted for NCHHSTP:

• Support for DSTDP Disease Intervention Specialist (DIS) positions would be reduced by up to 300 positions nationwide and training for clinicians would end.
• Funding would only be provided to jurisdictions “most in need” – meaning that DSTDP would no longer fund every state, territory, or directly funded city.
• Funding would be reduced for HIV testing, support, and prevention services (including school-based health programs), and PrEP demonstration programs.

As a reminder, this is a proposed FY18 budget request to Congress. Many have already said that this proposed budget is dead on arrival, but there will be a major fight over priorities.  We are currently re-invigorating our advocacy strategy for FY18, but there is no way to sugar coat it– FY18 is going to be an incredibly challenging year for federal funding.  To read NCSD’s press release on the proposed budget cuts, see here.  Additionally, NCSD joined with other national partners on a press release to oppose the proposed cuts.  That statement can be read here.

It should be noted that the President’s Budget contained FY17 funding numbers that assumed the levels contained in the Continuing Resolution would be the funding for the full fiscal year.

As a result, the FY17 numbers contained in the President’s Budget are not accurate as final FY17 funding levels and they do not reflect the cuts (or increases) to programs Congress enacted in the FY17 Omnibus final funding.  For example, the President’s Budget proposes a 17% cut to CDC STD Prevention.  However, it did not account for the $5 million cut in the final FY17 funding bill passed by Congress.  As a result, the funding level proposed for CDC STD Prevention in the President’s FY18 Budget Proposal ($130 M) is a 14.6% cut compared to current funding.

Federal Funding Chart

NCSD has developed a funding chart that outlines the recent funding history of STD, HIV, and other safety net federal funding.  Please click here for this chart.

ACA Replacement Legislation

According to the Congressional Budget Office (CBO), the House passed ACA replacement bill, the American Healthcare Act (AHCA), would reduce federal spending by nearly $119 billion over a decade.  But, in 2018, 14 million more people would be uninsured if the bill became law.  The number of Americans lacking health insurance in the United States could hit 51 million by 2026 under the GOP law, compared to an estimated 28 million under the ACA.

Additionally, premiums would rise by an average of about 20 percent in 2018.  Starting in 2020, average premiums would partially depend on changes that states may seek to ACA insurance requirements.  Average premiums could drop as a younger and healthier population would be purchasing insurance but people with pre-existing medical conditions would likely face extremely high premiums.

Republican senators have been waiting to see the CBO score of the House bill as it will serve as a foundation for the Senate measure though senators plan to write their own version.