| . Today's Managing Health Care Costs Number is $1.5 Trillion |
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The Trump budget is out today, and the Congressional Budget Office report on the House-passed American Health Care Act is due tomorrow. It's a big week for policy nerds, and a terrible weak for the less fortunate among us.
There's a lot to unpack in the Trump budget plan -which assumes growth rates that have not been achieved by developed countries, drives huge tax cuts to the richest Americans, violates a host of campaign promises, and double counts extra tax revenue from growth. But the cuts in our safety net, which is already less robust than most developed countries, would cause staggering worsening of the overall health of Americans.
Among the cuts proposed by the Trump Administration:
- $6 billion cut in the National Institutes of Health. The NIH funds the most important groundbreaking basic and applied science research. We can't cure cancer without the NIH. Here's a review of research showing that NIH funding actually leads to more value than the underlying spending.
- Cut Medicaid by 47%, or about $1.5 trillion over a decade. This is $660 billion cut on top of the devastating cuts already in the AHCA which alone would have led to more than 14 million Americans losing access to health insurance. Medicaid already covers almost half of all births in the US (70% in Louisiana) But 2/3 of Medicaid spending historically has been for the elderly and disabled. Medicaid is the largest purchaser of nursing home beds. The Trump budget promises to leave untouched the elderly and the disabled. But the algebra doesn't work - you can't cut half the budget while telling those who represent 2/3 of the costs that they will escape harm. Here's a summary from statnews.com on where Medicaid spends its dollars, and from vox.com on the potential impact of these cuts.
- 29% cut in food stamps (Supplementary Nutritional Assistance Program). Food stamps now allow about $2 per meal. There will be many more children going hungry!
- 19% cut in Children's Health Insurance Program (CHIP). We have uninsured rate among children at an all-time low - and this is clearly at risk.
- 13% cut in Temporary Assistance for Needy Families (TANF)
- 12% cut in unemployment insurance
- 8% decrease in earned income tax credit
The Trump budget funds huge tax cuts by ripping away the social safety net that is critical to population health. This is especially ironic, as the world is recognizing that changes in the workplace might make a universal basic income a necessity. Yesterday's post shows that our health access and quality is far worse than other countries. Irresponsible cuts like this are likely to cause huge and unnecessary human tragedy, and to make our subsequent scores even worse.
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