An Unhealthy Budget


President Donald Trump released his budget plan for fiscal year 2018 yesterday morning, presenting Congress with a blueprint for how he believes they should fund the federal government. Unfortunately the President’s proposed budget will weaken the nation’s health care system and jeopardize the scientific research that’s necessary to keep Americans healthy. The ANA opposes the President’s budget, and urges Congress to reject it in favor of a plan that doesn’t compromise health care in favor of political and partisan posturing.

Photo: Shawn Thew, European Pressphoto Agency
Photo: Shawn Thew, European Pressphoto Agency

The President’s budget, which represents his priorities but does not carry the power of the appropriations process controlled by Congress, makes a number of ill-considered cuts when it comes to the American health care system, including:

  • A $403 million reduction in funding for health professions and nursing workforce programs;
  • A $5.8 billion cut from the National Institutes of Health (NIH) budget, constituting a 22% reduction in funding for scientific research to find medical cures, and;
  • A decision to fold the Agency for Healthcare Research and Quality (ARHQ) into the NIH. Currently, AHRQ is the only federal agency mandated to conduct health services research.

“As the demand for high-quality health care intensifies, Congress must firmly invest in the nation’s largest health-care workforce, registered nurses. Decreasing funding by $403 million will significantly cripple efforts to effectively recruit, train and educate nurses for practice in rural and medically underserved communities,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN.

The ANA is instead urging Congress to provide $244 million to fund nursing workforce development programs, $160 million for the National Institute of Nursing Research, $380 million for the National Health Service Corps, and to restore AHRQ’s funding to at least $364 million in FY 2018.

Despite the organization’s concerns over these misguided cuts, the ANA does support the President’s call for a $500 million increase to expand opioid misuse prevention and treatment efforts.

GOP Health Plan CBO Score


Earlier today, the nonpartisan Congressional Budget Office (CBO) released its assessment (commonly referred to as a ‘score’) of how the House Republican health care plan, the American Health Care Act (AHCA), will impact the healthcare market and it’s cost estimates. The CBO found that the plan, which repeals the Obama era ACA law and is replaced with AHCA, would result in over 24 million individuals being uninsured by the year 2026.

The House Republican plan would make cuts to Medicaid, cutting the deficit by $337 billion over the next decade. The CBO also found that premiums in the individual market will rise by 15%-20% over the current law; the rise in premiums is attributed to the repeal of the ACA’s individual mandate.

The CBO estimates present a political challenge for House Republicans, with the immediate effects of an ACA repeal and an AHCA replacement resulting in 14 million more uninsured individuals by next year. A sizable shift in the uninsured population could translate in to a backlash in the lead up to the 2018 midterm election. The plan would likely also face significant opposition from Republican and Democratic Governors alike.

We’ll continue to closely monitor developments around healthcare reform, and urge you to continue to following Capitol Beat and our RN Action twitter account for the updates.

House GOP Health Reform Update


On Monday, the House Republican caucus unveiled their long awaited health reform plan that would repeal and replace the Affordable Care Act. The bill, titled the American Health Care Act (AHCA), subsequently passed the two primary House committees of jurisdiction. The House Energy & Commerce Committee and the House Ways & Means Committee held marathon hearings on Wednesday and Thursday, with the former lasting more than 27 hours while they considered amendments offered by Democrats (none of which were accepted). The vote approving the bill out of committee fell along party lines, with House Republicans voting unanimously in favor of the bill and every Democratic member opposing it.

Next week, we expect the bill to have a similar markup hearing in the House Budget committee, paving the way for the legislation to be introduced for a floor vote by the full House before the end of the month. On Monday, the nonpartisan Congressional Budget Office (CBO) is expected to release its score assessing the impact of the AHCA on the healthcare system, and it is expected to show a loss of health coverage reaching as many as 15 million individuals.

The Conservative House Freedom Caucus, which famously pushed Speaker Boehner out of office, has continued to push for a provision that would halt state Medicaid expansion by the end of this year. That provision would make it even more difficult for the AHCA to pass the Senate, where Republican Senators from Medicaid expansion states have said that provision would be a non-starter. With the bill expected to face a close vote in the Senate, the slim two-vote Republican majority means that only two Senators can defect.

Following the expected House vote before the end of the month, the Senate will likely try to bring it up for a vote in the first half of April, before Congress breaks for Easter recess.