ADEA Washington Update

President Trump’s Budget Blueprint

(Funding, Research, HHS, Medicare and Medicaid Services, Department of Justice, Department of Education, Financial Aid, Graduate Students, Higher Education, HRSA, NIH, NIDCR, Research) Permanent link   All Posts

BudgetCutOn 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.

  • Department 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 programs.

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.

  • Department 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.

  • Department 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 jurisdictions.

ADEA awaits the President’s more detailed budget to be released in May 2017.

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