The Administration (Washington Update, March 14, 2019)

President’s Budget Proposal
On Monday, March 11, the president released his budget proposal for FY 2020, which begins on October 1, 2019. Among other things, his budget proposes to turn Medicaid into a state block grant, and mandate that states establish work requirements for Medicaid beneficiaries. The president also proposes increased funding for the Indian Health Service and a child-care grants to states; level funding for Family-to-Family Health Information Centers; and a reduction in funding for the Maternal and Child Health (MCH) Block Grant and some other MCH programs. Proposed spending levels for agencies within the Department of Health and Human Services can be found in the HHS Budget in Brief (HRSA programs start on p. 29). The proposed budget would increase funding for pediatric-cancer research, but decrease overall funding for cancer research and the National Institutes of Health. See Trump Proposal Would Slash Total Cancer Funding While Boosting Pediatric Cancer Research (Washington Post, 3/11/19). See also Trump’s Vision for American Health Care, Explained by His Budget (VoxCare, 3/11/19) and Overnight Healthcare (The Hill, 3/11/19). The president also proposes providing at least six weeks of paid family leave to new parents.

It is important to note that the president’s budget is just a suggestion to Congress, and its most significant proposals – such as block-granting Medicaid and repealing the Affordable Care Act — would be rejected by the Democratic majority in the House of Representatives. Ultimately, spending decisions will be made through negotiations among the two chambers of Congress and the administration. ‘Get Rid of the Fat’: Why Uncle Sam’s Annual Budget Is a Lot Different from Yours (USA Today, 3/11/19).

FDA Commissioner Resigns
In an announcement that was a surprise even to many administration insiders, Scott Gottlieb, announced last week that he would resign his post as Commissioner of the Food and Drug Administration (FDA) in order to spend more time with his family (who live in Connecticut). Although some thought he was too close to the pharmaceutical industry, Dr. Gottlieb had enjoyed support from both the president and some Democrats in Congress, as he took tough stands on youth tobacco use, drug pricing, and some other sensitive issues. See ‘Something Very Rare’: FDA’s Gottlieb Aggressively Tackled Difficult Issues (Politico, 03/5/19). On March 12, President Trump named Ned Sharpless, currently the director of the National Cancer Institute, to serve as acting commissioner. See Trump Names Cancer Scientist as Interim FDA Head (Axios, 3/12/19).