There's a three-legged stool supporting children's healthcare in this country, which is especially critical for children with complex medical needs -- like pediatric cancer. Those three legs are Medicaid, the Children's Health Insurance Program, and the Affordable Care Act. Thanks to those three pillars of protection, only 4.8% of children went uninsured in 2016 -- a new all-time coverage record. This should be considered a significant public health victory. Except... all three legs of that stool are currently at risk of collapsing.
President Trump's FY2018 budget request, as sent to Congress on Tuesday ("A New Foundation for American Greatness"), calls for massive cuts to medical research and health insurance for low-income children. There's an incredible amount on the chopping block that could potentially impact children with cancer.
Here's a sampling of what's at stake:
- A $1 billion cut to the National Cancer Institute budget, compared to this year's funding. The NIH would suffer cuts of almost $6 billion total.
On a related note: Brand new polling data from One Voice Against Cancer, a coalition we're proud to be a part of, shows overwhelming public support for federal funding of medical research (90%!).
- Funding for the Children's Health Insurance Program would be cut by at least 20 percent for FY2018 and FY2019, snowballing into $5.8 billion in cuts over the next ten years. CHIP currently ensures 5.6 million low-income children, whose families fall into a gap: they can't afford private coverage but earn too much to qualify for Medicaid. The Trump budget calls for states to shoulder a heavier burden of CHIP by eliminating an element of the Affordable Care Act that increased federal funding of the program.
- A $1.2 billion cut to the Centers for Disease Control and Prevention (CDC), including an $82 million cut to the center that works on vaccine-preventable diseases like influenza and measles, which is an area of particular concern for cancer-stricken children with weakened immune systems.
- $22 million in cuts to the Office of the National Coordinator for Health IT (ONC), which could impact precision medicine initiatives and implementation of the 21st Century Cures Act.
- $800 billion in cuts to Medicaid over the next decade, by assuming the American Health Care Act will pass with its provisions calling for a transition to block grants to states... like the one in Arizona that forced the state to stop accepting new children into their version of CHIP. We estimate that approximately 1/3 of the nation's children with cancer are covered by Medicaid.
Read more: Trump's Budget Cuts Deeply Into Medicaid & Anti-Poverty Efforts by the New York Times, and Top Five Threats to Children and Families Posed by a Medicaid Block Grant by the Georgetown University Health Policy Institute
The threats to Medicaid and CHIP are particularly troubling. Together, Medicaid and CHIP cover nearly half of children age 6-and-under, including thousands of children with cancer. We know that a childhood cancer diagnosis can be financially devastating, resulting in 10-15% of families who were not poor at the time of diagnosis becoming poor during their child's treatment. These families need more help -- not less.
It's important to emphasize that Congress - not the Executive Branch - controls the federal budget. Reaction from many policymakers was swift on Tuesday, as #TrumpBudget soared to the top of the trending topics:
We're collecting and sharing healthcare testimonials from childhood cancer families, and we would love to hear from you -- especially if you have experience with coverage under CHIP, Medicaid or the ACA exchanges. Your stories make us much stronger advocates in Washington as we fight for quality, affordable healthcare for our nation's children.