Trump administration's budget criticized by medical and health advocacy groups wary of cuts

Medical and health advocacy groups have come out largely in opposition to the Trump administration's proposed cuts in the 2018 budget, with one executive calling it a "disaster" to federal programs and institutions that provide resources to improve health.

The American College of Rheumatology has decried proposed cuts to the National Institutes of Health, the U.S. Food and Drug Administration and the Children's Health Insurance Program, calling them "critical" in the fight against rheumatic diseases.

The President's proposed fiscal year 2018 budget would cut NIH funding by $6 billion, reduce taxpayer funding for the FDA by $854 million, and cut CHIP program funding by $4.8 billion.

Separately, Mitchell Warren, executive director of AVAC -- formerly the AIDS Vaccine Advocacy Coalition, an AIDS advocacy nonprofit -- released a statement saying the budget would harm people living with HIV and those at risk of contracting the virus.

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"The budget ... would, in fact, devastate health, development and research programs that are hallmarks of America's profound commitment to advancing knowledge and saving lives at home and abroad," said Mitchell.

He said the HIV pandemic is driven by poverty, gender inequality and violence, and that the proposed budget would foster conditions in which HIV and other health threats will thrive. In particular, Mitchell pointed to 15 percent cuts affecting the  U.S. President's Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the latter of which receives significant contributions from the United States.

Mitchell also spoke out against the proposed 50 percent cuts to USAID's global health programs, cuts to the Centers for Disease Control and Prevention and the elimination of the NIH's Fogarty International Center, which builds scientific expertise in developing countries.

The ACR, meanwhile, bemoaned the proposed cuts' effects on both rheumatic disease prevention and the broader American healthcare system. ACR President Sharad Lakhanpal, MBBS, MD, said in a statement that the cuts "would threaten jobs and our nation's status as a leader in medical innovation while slowing down life-saving research that leads to better prevention strategies and new treatments for arthritis, rheumatic diseases and their comorbidities."

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The ACR also expressed concern about the proposed reduction in taxpayer funding for FDA regulatory activities, as well as cuts to Medicare and CHIP. The agency did, however, express support for a Medicare provision included in the budget proposal regarding the recommendation to repeal the Independent Payment Advisory Board.

"An appointed panel with sweeping authority to impose arbitrary payment cuts is not the appropriate way to curb healthcare spending," said Lakhanpal. "The risk of harm is too great when responsibility for Medicare decisions is mired in additional levels of bureaucracy, particularly one that is immune from Congressional oversight and not accountable to all stakeholders."

The effects of the budget proposal on the future supply of rheumatologists would be mixed, ACR said. In order to fulfill its goals of improving and expanding access to care, the ACR endorsed additional funding for graduate medical education, which is included in the budget proposal.

Twitter: @JELagasse