The Department of Health and Human Services would suffer a $15.1 billion reduction in its Fiscal Year 2018 budget, and the National Institutes of Health would see its budget cut by $5.8 billion, according to a just-released plan from the Trump Administration.
While the document provides few details on what these budget decreases would mean for IT initiatives at HHS and NIH, at a macro level the budget cuts would be devastating for both agencies, say industry groups.
Speaking on background, one association official called the White House’s America First: A Budget Blueprint to Make America Great Again, “the most radical shift in domestic spending priorities in several generations.”
According to the blueprint, the President’s FY 2018 budget request of $69 billion for HHS “excludes certain mandatory spending changes but includes additional funds for program integrity and implementing the 21st Century Cures Act.”
The Trump administration blueprint represents the opening position for budget negotiations; Congress has final discretion over funding priorities in the final federal budget.
However, Jeff Smith, vice president of public policy for the American Medical Informatics Association, contends that the budget would hinder America’s national capacity to rapidly advance discovery and deploy better cures for patients.
“The NIH cuts undermine the promises Congress made as part of the 21st Century Cures Act, and the dissolution of AHRQ severely hampers our collective ability to improve care delivery at a national level,” says Smith. “It’s hard to see how programs like Precision Medicine, the Cancer Moonshot or the BRAIN Initiative can deliver on their potential with a 20 percent cut to NIH. Basic research done at the bench in universities across the country is interconnected to treatments delivered at the bedside. So, even targeted cuts at one end of the discovery spectrum will impact the whole.”
Smith adds that AMIA is “committed to working with the White House and with Congress to ensure they keep their commitments to fully funding research at the levels outlined in the Cures Act, and to ensure policymakers understand the vital role research at the NIH, FDA, CDC and AHRQ plays in improving the health of all Americans.”
At the same time, he said “gains in efficiency and cost savings can be achieved without such drastic cuts, and we look forward to demonstrating the role informatics can play towards the goals of improved care, better outcomes and lower costs.”
Nonetheless, HHS Secretary Tom Price, MD, insists that the President’s budget blueprint will “positively and productively” serve the American people.
“HHS is dedicated to fulfilling our department’s mission to improve the health and well-being of the American people. This budget supports that mission and will help ensure we are delivering critical services to our fellow citizens in the most efficient and effective manner possible,” said Price in a written statement. “Part of that support involves a robust commitment to preventing waste, fraud and abuse across the department, particularly within the Medicare and Medicaid programs.”
For its part, the College of Healthcare Information Management Executives is currently reviewing the Trump administration’s budget blueprint.
Matthew Weinstock, director of communications and public relations at CHIME, notes that the budget document “doesn’t shed a lot of light” on the administration’s overall health IT agenda.
“We expect to see some of that fleshed out when HHS releases its detailed budget,” says Weinstock. “Overall, we are concerned about the impact that a 17 percent cut to HHS’ budget will have on improving the safety and quality of the nation’s delivery system. On the positive side, we are pleased to see increased attention in the DHS budget to cyber security.”
Also on the positive side of the ledger, the President’s 2018 budget requests $78.9 billion in discretionary funding for the Department of Veterans Affairs, a $4.4 billion, or 6 percent increase, from the 2017 enacted level.
Trump’s budget plan “invests in information technology to improve the efficiency and efficacy of VA services” while providing “sufficient funding for sustainment, development, and modernization initiatives that would improve the quality of services provided to veterans and avoid the costs of maintaining outdated, inefficient systems,” according to the document.
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