President Donald Trump’s federal budget proposal would significantly reduce spending on Medicaid, medical research, local healthcare programs, food aid, and other social welfare programs — cuts that advocates said present significant challenges for high-cost, high-needs states like New Jersey.
Trump’s plan, details of which were released Tuesday, calls for trimming more than $4.8 billion from federal programs for health and senior services next year. It also outlines significant long-term reductions, including a $610 billion cut from Medicaid over the next decade. An additional $250 billion in savings would come from eliminating the Affordable Care Act, or Obamacare.
The president’s proposal outlines reductions of $6 billion for the National Institutes of Health, $1.3 billion for the Centers for Disease Control and Prevention, and some $400 million for local mental health and substance abuse programs. It would also prevent any federal dollars from going to Planned Parenthood and sharply slash funding for housing, family support services and food aid, among other social programs.
For New Jersey — which added 800,000 residents to the insurance rolls under the ACA, most through the expansion of Medicaid, and collected billions in additional federal funding to help pay for their care — this proposal could result in a $31 billion budget gap over the next ten years, according to an Urban Institute analysis. The Garden State stands to lose more than 20 percent of its federal funding under the controversial proposal, more than any other state in the nation, the group found.
‘Devastating’ Medicaid cuts
“These Medicaid cuts will be especially devastating in New Jersey because of its higher cost of living and larger number of people in desperate need of health care. They will also hurt the state’s economy — just when it is finally starting to recover from the recession — due to the loss of thousands of jobs, especially in the health industry,” warned Ray Castro, healthcare analyst with the New Jersey Policy Perspective, a progressive think tank tracking the federal proposals. “Under this plan, basically everyone loses except for millionaires and billionaires.”
Even Gov. Chris Christie, a Republican who has been an ardent Trump supporter and confidant, agreed the proposal to cut Medicaid was worrisome. “I would be concerned about that, being a state that has a lot of people who utilize Medicaid, not only normally but due to the decision I made in 2013 to expand [Medicaid to cover more low-income residents],” Christie said Monday.
Trump’s budget proposal for federal fiscal year 2018, which starts in October, is subject to Congressional approval and therefore is likely to change. And many of the healthcare-related recommendations in it depend on the passage of the American Health Care Act, the highly controversial Republican proposal to replace Obamacare, which was passed by the U.S. House of Representatives earlier this month but faces an uphill battle in the Senate.
But the president’s $4.1 trillion budget plan — officially titled A New Foundation for American Greatness — underscores his commitment to curbing federal government spending on entitlement and other social welfare programs, while reducing taxes on the wealthiest Americans in an effort to fuel more economic growth. (The proposal assumes Congress would pass the tax plan his administration introduced in April.) The budget also includes some increases, including $639 billion for the nation’s defense, $44 billion for homeland security and $1 trillion for various infrastructure projects, details of which have yet to be made public.
Trump’s budget proposal prompted significant criticism from advocates for healthcare, housing and anti-hunger efforts, and others who warned it would seriously harm the state’s most vulnerable residents. Democrats largely savaged the plan; U.S Sen. Cory Booker called it “shortsighted, craven;” Sen. Robert Menendez warned it would “shred the social safety net;” Rep. Bill Pascrell (D-Paterson) dubbed it “cruel and extreme;” and Rep. Frank Pallone (D-Monmouth) described it as a “morally reprehensible proposal that will take our country backwards.”
Even Republicans in New Jersey’s federal delegation were lukewarm to Trump’s concept. Rep. Leonard Lance (R-Hunterdon) welcomed the president’s careful stewardship of taxpayer dollars, but noted that Congress “controls the power of the purse” with the requirement that it vote to approve the president’s proposal. Rep. Rodney Frelinghuysen (R-Morris) agreed, noting the powerful House Appropriations Committee that he chairs takes its responsibility to review spending plans “very seriously.”
And Rep. Tom MacArthur (R-Burlington), the author of a key amendment in the Republican healthcare bill, said he was reviewing the plan. MacArthur reportedly resigned his leadership position in a moderate GOP group Tuesday as controversy has continued to dog the AHCA bill.
In Trenton, Garden State lawmakers have also pushed back on the president’s plans. On Monday, Assembly Speaker Vincent Prieto (D-Hudson) led an effort to pass a resolution (AR-252) that urges the U.S. Senate not to approve the GOP’s Obamacare replacement bill. The resolution was approved largely along party lines.
Help for Planned Parenthood?
Assemblyman Troy Singleton (D-Burlington) said Tuesday he would introduce a bill, similar to one adopted in Maryland last month, that would require the state to backfill any funding for Planned Parenthood or other family planning organizations that is eliminated through the federal budget. Since 2010, Christie has declined to provide state funding for many of these services, changes that have added up to a $50 million loss for these facilities in the years since. Federal law already prohibits taxpayer-funded abortions, but Republicans hope to block all Medicaid funding for Planned Parenthood, including payments for cancer screenings, birth control or other services.
Sen. Joe Vitale (D-Middlesex), the longtime chairman of the health committee, already announced he is joining forces with Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, to form a work group to explore the state’s options if Medicaid cuts are enacted on the federal level. Analysis of the AHCA, as passed by the House of Representatives, suggests it could eliminate insurance coverage for more than 500,000 state residents, limit benefits for more than 1.3 million Medicaid patients, while driving up the cost of coverage for millions more.
Other cuts to the federal Department of Health and Senior Services outlined in the president’s budget proposal include: