The Trump Administration is calling for deep cuts to Department of Health and Human Services (HHS) funding for fiscal year (FY) 2018 along with a $1 billion hike in Food and Drug Administration (FDA) user fees in its “budget blueprint,” dubbed “America First: A Budget Blueprint to Make America Great Again.” The blueprint — which addresses only discretionary spending — seeks a 17.9% reduction in funding for HHS programs in FY 2018 (with certain spending outside these caps, including specific 21st Century Cures Act funding). HHS cuts identified in the blueprint include:

  • A $5.8 billion reduction in the National Institutes of Health (NIH) budget and a reorganization to eliminate the Fogarty International Center and consolidate the Agency for Healthcare Research and Quality within NIH, among other changes.
  • A $403 million cut to in health professions and nursing training programs.
  • Elimination of Office of Community Services discretionary programs, including the Low Income Home Energy Assistance Program and the Community Services Block Grant, saving $4.2 billion.

On the other hand, the President proposes to increase funding in several areas, including: the Health Care Fraud and Abuse Control (HCFAC) program ($70 million increase); Substance Abuse and Mental Health Services Administration opioid abuse prevention and treatment activities ($500 million increase); and a new $500 million Centers for Disease Control and Prevention state block grant to help states respond to public health challenges. Other HHS programs are discussed in general terms without specific estimates of budget impact.

The President also proposes to increase FDA medical product user fees by about $1 billion to over $2 billion in 2018, asserting that “in a constrained budget environment, industries that benefit from FDA’s approval can and should pay for their share.” The Administration would accompany the user fee increase with “a package of administrative actions designed to achieve regulatory efficiency and speed the development of safe and effective medical products.”

Note that this budget blueprint is not a traditional full federal budget and does not substantively address entitlement programs. The Trump Administration is releasing the budget “sequentially” this year; the Administration asserts that a full budget will be released later this spring including “specific mandatory and tax proposals, as well as a full fiscal path.” Various aspects of the budget blueprint have already come under fire by various lawmakers, who will ultimately craft the spending package.