AAMC (Association of American Medical Colleges) President and CEO Darrell G. Kirch, MD, issued the following statement in response to President Trump’s FY 2020 budget request, which proposes drastic decreases to nondefense discretionary spending, including the National Institutes of Health (NIH), the Health Resources and Services Administration (HRSA), and other health agencies. The budget also proposes to cut Medicare funding for graduate medical education (GME) and Medicaid and Medicare payments; to eliminate Public Service Loan Forgiveness (PSLF); and to undermine the 340B Drug Pricing Program.
“If implemented, the administration’s proposed budget would derail critical progress on cures and treatments, ravage America’s health care workforce infrastructure, and dismantle the health care safety net.
The nearly $5 billion in cuts proposed to NIH-funded research, most of which occurs at medical schools and teaching hospitals, would thwart progress and hope for patients nationwide. The federal investment in NIH to date has resulted in decreasing death rates from cancer and heart disease, treatments for those battling HIV/AIDS, and new methods for combatting the opioid epidemic, among other advances. Instead of reversing course, we must continue the bipartisan budget trajectory set forth by Congress over the last several years.
The consequences of the NIH proposal are compounded by dramatic cuts to other nondefense discretionary research and public health programs, including the Department of Veterans Affairs research program, the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention. Further, the proposal to eliminate PSLF and certain HRSA Title VII health professions and Title VIII nursing workforce development programs would limit the ability to recruit and maintain a diverse and culturally competent health care workforce and to meet the needs of rural and other underserved communities.
Likewise, the president’s proposal to block grant and consolidate funding for GME would exacerbate the projected physician shortage by forcing teaching hospitals to absorb nearly $48 billion in untenable cuts and make difficult choices between training more physicians to serve a growing, aging population or maintaining lifesaving clinical services for their communities. Teaching hospitals already are investing in physician training above and beyond the levels supported by Medicare GME payments. The proposal would weaken federal support that already does not adequately reimburse the costs associated with training enough doctors to meet the needs of our communities.
Proposals to block grant Medicaid, cut payments to hospitals that treat a disproportionate share of Medicaid beneficiaries, and eliminate facility-based reimbursements to all hospital outpatient departments would harm vulnerable patients and dismantle the health care safety net. Specifically, cuts to hospital outpatient department payments would reduce access for patients seeking care at these facilities, many of whom have more complex conditions and require higher levels of care than those cared for at physician offices and ambulatory surgical centers.
Similarly, undermining the 340B program, which requires no funding from taxpayers, would only weaken one of the most effective programs in health care. While the AAMC agrees that the high price of prescription drugs needs to be addressed, it should be addressed directly, not by cutting this critical program.
The AAMC encourages Congress to reject these proposals that would devastate the health of our nation. Instead, we urge lawmakers to work in a bipartisan manner to increase the discretionary spending caps to allow for a full investment in medical research and other vital programs and to preserve and strengthen the health care safety net.”
The Association of American Medical Colleges is a not-for-profit association dedicated to transforming health care through innovative medical education, cutting-edge patient care, and groundbreaking medical research. Its members are all 154 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 51 Department of Veterans Affairs medical centers; and more than 80 academic societies. Through these institutions and organizations, the AAMC serves the leaders of America’s medical schools and teaching hospitals and their more than 173,000 full-time faculty members, 89,000 medical students, 129,000 resident physicians, and more than 60,000 graduate students and postdoctoral researchers in the biomedical sciences.