On March 16, 2017, President Trump released a document titled America First: A Budget Blueprint to Make America Great Again (the “budget”). The
document, also called the skinny budget, outlines the President’s funding
priorities for FY18. It is referred to as the “skinny budget” because it only
addresses the discretionary portion of the federal budget, it makes no mention
of funding proposals to the mandatory (entitlement) allocation of the budget,
revenue proposals or economic assumptions. The President’s more detailed budget
is due to be released in May 2017.
There are only three federal agencies designated in the
budget to receive increased funding in FY18: Departments of Defense (DoD),
Homeland Security (DHS) and Veterans Affairs (VA). The following is a brief
overview of funding proposals for federal agencies and programs of interest to
academic dentistry and dental and craniofacial research.
of Health and Human Services (HHS)
The overall HHS budget is cut by 17.9% ($15.1 billion) to
$69 billion. According to the budget document, the focus is on direct health
services through community health centers, Ryan White HIV/AIDS providers, the
Indian Health Service (IHS) and “medical products review and innovation.” The
budget also seeks to eliminate programs that have limited impact on public
health or are duplicative.
The National Institutes of Health (NIH) faces a proposed cut
of $5.8 billion below the FY16 level, from $31.5 billion to $25.9 billion (the
math does not work because of rounding, but the amounts are correct). ADEA is
joining other dental organizations in requesting that Congress appropriate a
total of $452 million, compared with the $413 million appropriated in FY16, for
the National Institute of Dental and Craniofacial Research (NIDCR) in FY18.
The Health Resources and Services Administration (HRSA)
manages the Health Profession Workforce programs and the health professions and
nursing training programs, which face proposed cuts of $403 million, or nearly
50% of the FY16 program funding of about $786.9 million. The document goes on
to say, “The budget continues to fund health workforce activities that provide
scholarships and loan repayments in exchange for service” in areas where there
are shortages of health professionals. Even without details, we can expect that
these proposed reductions will certainly affect the Oral Health Training
The Agency for Health Research and Quality (AHRQ) is folded
into NIH, and the budget eliminates the Fogarty International Center. The document
describes “consolidations and structural changes across NIH organizations and
activities.” Also, it states that the budget will rebalance federal
contributions to research funding. ADEA staff is seeking further clarification
of the consolidations and structural changes and what rebalancing federal
contributions to research funding means particularly for NIDCR, but this may
not be clarified until the more
detailed budget is released in May.
The budget proposes “reforms” to the CDC through a new $500
million block grant to states for public health. The document does not explain
what is rolled into this block grant, but ADEA expects that the grants to
states from the Division of Oral Health may be consolidated into this proposed
block grant. There are two other notable funding proposals: the budget includes
a $500 million increase over FY16 to address the opioid epidemic. This is in
addition to the $1 billion appropriated in FY16 in the 21st Century Cures Act. Also,
the budget proposes to restructure public health, emergency preparedness and
prevention programs. The stated intent is to reduce overlap and administrative
costs and to direct resources to the states with the greatest need.
of Education (ED)
The overall ED budget is cut by $9 billion to $59 billion
for FY18. The budget proposes to appropriate $1.4 billion for school choice. Higher
education proposals mentioned are below.
The President’s proposed budget for higher education would
eliminate the $733.1 million appropriated in FY16 for the Supplemental
Educational Opportunity Grant Program (SEOG). This is a formula grant program
administered by 3,700 higher education institutions.
For Pell Grants, the budget proposes level funding of the
discretionary amount and a cancellation of $3.9 billion from unobligated
carryover funding. Funding in FY16 comprised $22.5 billion in discretionary funding
and $5.8 billion in mandatory funding (note that since this document does not
address mandatory spending, no mention is made of the Pell Grant mandatory
funding). The $3.9 billion in “unobligated carryover” funds refers to the Pell
Grant surplus. House and Senate Appropriations Committees are considering using
that surplus to fund year-round Pell Grants in FY17.
As for Historically Black Colleges and Universities (HBCU),
the budget calls for “maintaining $492 million in funding.” It is unclear what
this number refers to; in FY16, HBCUs received $334 million for administration
and $20.2 billion in loan subsidies.
of Justice (DOJ)
Under the Department of Justice (DOJ) section, the budget
states that “the Administration is concerned about so-called sanctuary
jurisdictions and will be taking steps to mitigate the risk their actions pose
to public safety.” In the past, discussions of sanctuary jurisdictions have
included college and university campuses. Currently, there is no threat of
funding cut off or exclusion of certain programs mentioned; however, if the
Trump Administration follows through on restricting federal funds for sanctuary
jurisdictions, there may be an issue with federal grants funneled through these
ADEA awaits the President’s more detailed budget to be
released in May 2017.