Yesterday, the Trump administration released its budget for Fiscal Year (FY) 2018. It fell like a ton of bricks on the doorstep of Congress, which now has the job of deciding how much to spend on federal agencies and myriad programs to meet the needs of millions upon millions of Americans. If enacted into law, the president’s proposal would devastate federal safety net programs, eliminate health care for millions of Americans (including those living with HIV), and undercut civil rights protections in the U.S. and human rights protections abroad. Although HRC is hopeful that Congress will reject many of these draconian cuts, this budget unfortunately follows the contours of previous Republican budgets proposed by Congress.
The FY18 budget purports to save $3.6 trillion over ten years, triggering unimaginable cuts to safety net programs. On the chopping block are critical programs that focus on preventing, fighting, and finding cures for diseases, and on programs that provide health services to people living with HIV, low-income women, children, the disabled and elderly.
Health & HIV
Before delivering his detailed budget, the president endorsed the House-passed legislation to repeal the Affordable Care Act, which included $839 billion in cuts to Medicaid. The FY18 budget takes austerity to a new low by requesting another $600 billion in cuts by placing a ceiling on federal Medicaid funding to states.
Alarmingly, the administration is also proposing a $1.2 billion reduction in funding for the Centers for Disease Control and Prevention (CDC), and a $186 million - or 20 percent -- cut to the agency’s prevention efforts for HIV, hepatitis, STIs and tuberculosis. While paying lip service to the need to address the HIV epidemic, the administration actually plans to reduce activities around testing, support services for persons living with HIV, and prevention services. They also proposed curtailing Pre-Exposure Prophylaxis (PrEP) prevention projects.
The president’s attack on the nation’s health extends to research as well. He proposed gutting research at the National Institutes of Health (NIH) by $6 billion, with $838 million taken from the Institute focused on finding a cure for HIV. The proposal so thoroughly defunds science that former CDC Director Dr. Tom Frieden tweeted that the cuts advocated by the administration “would increase illness, death.”
As expected, the administration’s FY18 submission would block Planned Parenthood from receiving reimbursement for services under the Medicaid program. But this proposal goes even further by barring the organization from participating in any federal health programs. This would dramatically impact access to reproductive health services, as well as HIV testing and counseling to prevent sexual assault.
The president’s proposed parental leave program was something of a novelty, given other social programs faced drastic spending cuts. The administration proposed allowing new parents to take six weeks of paid leave for the birth or adoption of a child. However 75 percent of workers who take family leave each year do so for family caregiving or medical reasons unrelated to childbirth or adoption.
Severely undermining enforcement of employment protections, the budget contains a plan to eliminate the Office of Federal Contract Compliance Programs (OFCCP) and place responsibility for federal contract oversight with the Equal Employment Opportunity Commission (EEOC) -- ignoring the significant differences in expertise and mission. The EEOC would not be given any additional funding to address its own backlog of complaints let alone subsume the responsibilities of OFCCP. The OFCCP is responsible for enforcement of LGBTQ non-discrimination protections for employees of federal contractors.
On the international front, the budget threatens to end U.S. leadership on human rights and health and humanitarian assistance abroad, which will have an enormous impact on LGBTQ people who face threats and violence around the world. With almost 30 percent of the overall funding slashed at the Department of State and the U.S. Agency for International Development, Trump's budget would severely harm our ability to help refugees, people living with HIV & AIDS, and those fighting for human rights.
Migration and refugee assistance programs would see a jaw-dropping 83 percent cut for this year, when more refugees need our help than at any time since World War II. This would directly harm LGBTQ people who are trying to flee state-sanctioned violence in places including Chechnya, Uganda and Bangladesh.
The proposal would also eliminate the Development Assistance account, which funds democracy and human rights programs around the world and helps LGBTQ organizations to build their capacity and change hearts and minds in their communities. The budget cynically claims to fold this crucial funding tool into the Economic Support and Development Fund, but cuts that fund and decimates it even further in coming years.
Voluntary contributions by the U.S. to the United Nations, which vaccinates nearly half the world's children and provides food to 80 million hungry people across the globe, would be completely eliminated. Funding for peacekeeping has been slashed by 37 percent, which could lead to deadly destabilization in already vulnerable parts of the world, places where LGBTQ people are especially at risk.
Even Global Health — the programs that provide vaccinations, treatments and education to nursing moms, children and people fighting diseases — faces a steep cut of nearly a quarter. Family planning programs are eliminated entirely. This will put life-saving medications and treatments out of reach for some of our world's most defenseless people, especially those living with HIV.
Perhaps even more ominous, the budget lays out Trump's projections for future funding, including even steeper cuts to international affairs in 2019 — slashing more than half of our nation's diplomacy and development budget, compared the this year’s spending. Refugee programs in particular would drop from a current spending level of $3.4 billion to less than $720 million in just two years.
Rather than address the needs of the American people, the administration’s proposal turns a blind-eye. Cuts to these critical programs would have a devastating impact on LGBTQ people in the U.S. and around the world. HRC will work to defeat this proposal and fight to preserve these essential programs.