Source: American Academy of Family Physicians Washington, DC, Office
On May 23, the Trump Administration released its fiscal year (FY) 2018 budget request entitled America First – A Budget Blueprint to Make America Great Again. The AAFP responded describing the cuts as damaging to health care services, safety, and research.
The budget plan proposes to consolidate the Agency for Healthcare Research and Quality’s (AHRQ) activities in a new “National Institute for Research on Safety and Quality (NIRSQ)” within the National Institutes of Health as it seeks to cut AHRQ’s appropriation from $324 million to $272 million in FY 2018. However, it highlights “critical survey activities, support for the U.S. Preventive Services Task Force, evidence-based practice centers, patient safety, investigator-initiated grants, and researcher training grants” as well as “evidence-based practice centers, addressing the opioid epidemic, and the Health Care Cost and Utilization Project.”
The budget seeks to eliminate the Title VII, Section 747 primary care training grants and nearly all of the health professions and nursing training programs administered by the Health Resources and Services Administration (HRSA). HRSA’s rural health programs would be cut from $156 million to $74 million, but the HRSA-administered family planning program would be level-funded.
The administration explicitly assured that “Health and Human Services (HHS) will explore opportunities for states and health care professionals to further expand Direct Primary Care (DPC), which will support improved health outcomes for Medicaid populations.” In announcing the Medicaid DPC Initiative, the administration stated, “Working with states and primary care physicians, HHS will support the development of DPC practices, identify barriers to their entry into Medicaid, and outline flexibilities under existing authorities to facilitate these innovative approaches to strengthening the relationships between patients and physicians.”
It’s not just HHS under the budget ax. The budget also proposes to eliminate the Public Service Loan Forgiveness (PSLF) program arguing it unfairly favors some career choices over others and is complicated for borrowers to navigate.