This week has been another exciting one in Washington! Here is a brief update on two major developments:
President’s Budget
This week, President Trump released his detailed budget proposal for FY 2018. The proposal is mixed for programs of interest to the community. The CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD), which houses the Division of Blood Disorders and bleeding disorders activities, would receive a significant cut of $35 million (or about 26% of the current $135 million budget). The budget doesn’t show precisely how bleeding disorders programs would be affected, but we anticipate cuts to our programs due to the size of the reduction for the Center. The President is also proposing a decrease of $7.2 billion (21%) to the NIH from the final FY 2017 of $34.1 billion. On the brighter side, the budget would not reduce funding for the HRSA MCH/SPRANS program that funds HTCs, as the President had proposed for FY 2017.
There are many concerning aspects of the proposal, but it is important to remember that while this reflects President Trump’s priorities, Congress ultimately decides funding levels for federal programs through the appropriations process. Many House and Senate appropriators of both parties have expressed skepticism or outright opposition to the budget. NHF will continue to advocate for funding for the federal programs affecting the community.
Congressional Budget Office Score of the American Health Care Act
Yesterday, the Congressional Budget Office (CBO) released its long-awaited score of the House-passed American Health Care Act (AHCA). If enacted, CBO estimates that the AHCA would result in 23 million more Americans being uninsured over 10 years than under current law (an earlier version of the AHCA would have led to 24 million people uninsured). The AHCA may result in slightly lower premiums for some, because plans would cover fewer healthcare services.
The CBO’s analysis also confirms many of NHF’s concerns about the AHCA. The report describes how the controversial MacArthur amendment that allows states to waive certain provisions of the Affordable Care Act (ACA) would significantly affect people with pre-existing conditions. The CBO estimates that one-sixth of the population live in states that would apply for waivers of both the Essential Health Benefits and community rating as allowed by the amendment. These individuals would experience substantial increases in out-of-pocket spending, may have to forego services, or face premiums that are so high that they would have to drop coverage. The CBO also described how lifetime and annual limits could be reinstituted, and how those would also lead to significant increases in out-of-pocket spending.
The CBO score will provide more fodder for advocates as the Senate works to draft its ACA repeal and replace legislation. Many Senators have expressed concern about the effects of the AHCA on those with pre-existing conditions, and the CBO is clear about the dire consequences of the AHCA for this population. We will incorporate the CBO’s analysis into our advocacy moving forward and will continue to update the community as the ACA debate progresses.
