Breaking down the Budget: Implications on Public Health

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For those of us in the childhood cancer community desperate for new treatments, one of the most important resources is the National Cancer Institute (NCI). The vast majority of childhood cancer research is funded by the NCI, which provides grants to researchers and supports cooperative groups that test new treatments in clinical trials. While Congress doesn't determine the exact amount of funding NCI will spend on pediatric research, a rising tide of funding will ensure that more is dedicated to childhood cancer research. That's why it's critical that we impress upon our representatives the urgency of NCI funding.

Congress finally came to an agreement on a FY2018 budget in late March, following several stopgap measures. President Trump sent his FY2019 budget request to the Hill just days later and - because of the timing - didn't include any of the funding agreements reached in the 2018 budget. Instead, the Administration's budget includes cuts to most of the health programs that children with cancer and their families rely upon.

Despite the bipartisan deal by Congress to boost domestic spending to $597 billion, the Trump budget includes only $540 billion in such funding, which puts a squeeze on NIH and NCI. In terms of Medicaid, the budget proposes various policy changes that will negatively impact the health and well-being of children and families who rely on this program.

Below is a sampling of what's at stake for our community:

  • National Institutes of Health (NIH): The Budget Request seeks $34.8 billion for NIH in FY2019. This is $800 million above the FY2017 level of $34 billion -- but $2.2 billion less than FY2018.
  • National Cancer Institute: The budget proposes $5.63 billion for NCI, compared to $5.4 billion in 2017.
  • Medicaid Funding: Approximately one-third of childhood cancer patients and their families rely on Medicaid for their treatment. The budget proposal cuts Medicaid funding by almost $1.4 trillion over the next ten years. The proposal would eliminate the Medicaid expansion and implement block grants and per-capita caps for Medicaid funding. The block grant proposal itself would result in a $680 billion cut to health coverage programs between FY2019-2028.
  • CHIP Funding: Although recent Congressional agreements extended CHIP funding until FY2027, the President's budget includes policy changes to CHIP that lower the commitment and requirements of both the state and federal government to support these children and families. 
  • CDC Funding: The CDC supports cancer registries and state cancer control programs that include childhood cancer. The Administration requested $10.9 billion for 2019 for the Centers for Disease Control and Prevention, a cut of more than $1 billion.

The proposed threats to Medicaid and implications for future CHIP policy 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. The FY2019 proposed budget is a blueprint for Congress to consider. 

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 or Medicaid. Your stories make us much stronger advocates in Washington as we fight for quality, affordable healthcare for our nation's children and to expand the research needed to assure them care.

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